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Stockholders' equity - Reclassifications out of AOCI (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Revenues $ 26,323 $ 25,979 $ 25,424
Other (expense) income, net (814) 259 256
Interest expense, net (1,406) (1,197) (1,262)
Income before income taxes 7,346 6,701 8,133
Provision for income taxes (794) (808) (869)
Net income 6,552 5,893 7,264
Product sales      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Revenues 24,801 24,297 24,240
Reclassification out of AOCI [Member] | Cash flow hedges [Member]      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Income before income taxes (2) (253) 501
Provision for income taxes 0 55 (110)
Net income (2) (198) 391
Reclassification out of AOCI [Member] | Available-for-sale securities [Member]      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Other (expense) income, net 0 0 33
Provision for income taxes 0 0 (7)
Net income 0 0 26
Reclassification out of AOCI [Member] | Foreign currency contract [Member] | Product sales | Cash flow hedges [Member]      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Revenues 231 (8) 178
Reclassification out of AOCI [Member] | Cross-currency swap contract [Member] | Cash flow hedges [Member]      
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]      
Other (expense) income, net $ (233) $ (245) $ 323