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Summary of significant accounting policies - Narrative (Details) $ in Millions	12 Months Ended
	Dec. 31, 2022 USD ($) segment	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Number of business segment | segment	1
Sales return provisions as a percentage of gross product sales (less than)	1.00%
Advertising cost	$ 841	$ 843	$ 962
Total revenues	26,323	25,979	25,424
Nplate | US
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Total revenues	$ 848	$ 566	$ 485
Minimum
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenue payment term	30 days
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Revenue payment term	120 days

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Number of operating segments. An operating segment is a component of an enterprise: (a) that engages in business activities from which it may earn revenues and incur expenses (including revenues and expenses relating to transactions with other components of the same enterprise), (b) whose operating results are regularly reviewed by the enterprise's chief operating decision maker to make decisions about resources to be allocated to the segment and assess its performance, and (c) for which discrete financial information is available. An operating segment may engage in business activities for which it has yet to earn revenues, for example, start-up operations may be operating segments before earning revenues.

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