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Goodwill and other intangible assets - Identifiable Intangible Assets (Details) - USD ($)
$ in Millions
Dec. 31, 2022
Dec. 31, 2021
Finite-lived intangible assets:    
Gross carrying amounts $ 35,596 $ 32,099
Accumulated amortization (20,525) (17,987)
Other intangible assets, net 15,071 14,112
Indefinite-lived intangible assets:    
Identifiable intangible assets 36,605 33,169
Accumulated amortization (20,525) (17,987)
Identifiable intangible assets, net 16,080 15,182
IPR&D    
Indefinite-lived intangible assets:    
Indefinite-lived intangible assets 1,009 1,070
Developed Technology Rights    
Finite-lived intangible assets:    
Gross carrying amounts 29,028 25,561
Accumulated amortization (15,045) (12,769)
Other intangible assets, net 13,983 12,792
Licensing rights    
Finite-lived intangible assets:    
Gross carrying amounts 3,864 3,807
Accumulated amortization (3,123) (2,973)
Other intangible assets, net 741 834
Marketing-related rights [Member]    
Finite-lived intangible assets:    
Gross carrying amounts 1,326 1,354
Accumulated amortization (1,167) (1,112)
Other intangible assets, net 159 242
R&D technology rights [Member]    
Finite-lived intangible assets:    
Gross carrying amounts 1,378 1,377
Accumulated amortization (1,190) (1,133)
Other intangible assets, net $ 188 $ 244