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Acquisitions and divestitures - ChemoCentryx Inc. Narrative (Details) - USD ($)
$ / shares in Units, $ in Millions
3 Months Ended
Oct. 20, 2022
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Business Acquisition [Line Items]        
Goodwill   $ 15,529 $ 14,890 $ 14,689
ChemoCentryx, Inc.        
Business Acquisition [Line Items]        
Acquisition price per share (in dollars per share) $ 52.00      
Total consideration $ 3,900      
Acquisition related costs   $ 106    
Cash purchase price 3,700      
Business acquisition, cash consideration paid to equity holders for pre-acquisition services 181      
Inventories $ 41      
Business combination, turnover period of inventory acquired 13 months      
Deferred tax liabilities $ 516      
Goodwill 667      
ChemoCentryx, Inc. | Developed Technology Rights        
Business Acquisition [Line Items]        
Finite-lived intangible assets – developed-product-technology rights $ 3,497      
Weighted average period of amortization 11 years