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Acquisitions and divestitures - Horizon Therapeutics PLC (Details)
 1 Months Ended
Dec. 31, 2022
USD ($)
Dec. 22, 2022
USD ($)
traunche
Dec. 31, 2022
USD ($)
Dec. 12, 2022
USD ($)
product
program
$ / shares
bridge credit agreement        
Business Acquisition [Line Items]        
Bridge credit agreement amount $ 0   $ 0  
Horizon Therapeutics [Member]        
Business Acquisition [Line Items]        
Acquisition price per share (in dollars per share) | $ / shares       $ 116.50
Cash purchase price     27,800,000,000  
Approved products | product       12
Development programs | program       20
Bridge credit agreement, maximum length 364 days      
Bridge credit agreement, initial amount $ 28,500,000,000   28,500,000,000 $ 28,500,000,000
Term loan credit agreement, total amount   $ 4,000,000,000    
Term loan credit agreement, number of traunches | traunche   2    
Bridge credit reduced amount   $ 24,500,000,000    
Financing costs   $ 97,000,000    
Compensating balance, amount       $ 2,960,000,000
Horizon Therapeutics [Member] | bridge credit agreement        
Business Acquisition [Line Items]        
Bridge credit agreement amount $ 0   $ 0