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Stockholders' equity (Reclassifications out of AOCI) (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2023
Mar. 31, 2022
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Total revenues $ 6,105 $ 6,238
Other income (expense), net 2,064 (530)
Income before income taxes 3,442 1,675
Provision for income taxes (601) (199)
Net income 2,841 1,476
Product sales    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Total revenues 5,846 5,731
Reclassification out of Accumulated Other Comprehensive Income | Cash flow hedges    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Income before income taxes 30 (51)
Provision for income taxes (6) 11
Net income 24 (40)
Reclassification out of Accumulated Other Comprehensive Income | Foreign currency contract gains | Cash flow hedges | Product sales    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Total revenues 52 27
Reclassification out of Accumulated Other Comprehensive Income | Cross-currency swap contract losses | Cash flow hedges    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Other income (expense), net (22) (78)
Reclassification out of Accumulated Other Comprehensive Income | Cash flow hedges | Foreign currency contract gains | Cash flow hedges | Product sales    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Total revenues 52 27
Reclassification out of Accumulated Other Comprehensive Income | Cash flow hedges | Cross-currency swap contract losses | Cash flow hedges    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Other income (expense), net $ (22) $ (78)