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Fair value measurement (Details) - USD ($)
$ in Millions
Mar. 31, 2023
Dec. 31, 2022
Mar. 31, 2022
Dec. 31, 2021
Assets:        
Interest-bearing securities $ 31,065 $ 4,335    
Other investments 131 130    
Equity securities 4,833 815    
Derivatives:        
Total assets 36,281 5,621    
Derivatives:        
Contingent consideration obligations 273 270 $ 330 $ 342
Total liabilities 1,525 1,668    
Derivative Liability 1,252 1,398    
Foreign currency forward contracts        
Derivatives:        
Foreign currency and cross-currency swap contracts 252 287    
Derivatives:        
Foreign currency and cross-currency swap contracts 73 76    
Cross-currency swap contracts        
Derivatives:        
Foreign currency and cross-currency swap contracts 0 54    
Derivatives:        
Foreign currency and cross-currency swap contracts 517 541    
Interest rate swap contracts        
Derivatives:        
Interest rate swap contracts 662 776    
Forward Interest Rate Contracts        
Derivatives:        
Derivative Liability 0 5    
Quoted prices in active markets  for identical assets (Level 1)        
Assets:        
Other investments 0 0    
Equity securities 4,545 480    
Derivatives:        
Total assets 35,609 4,815    
Derivatives:        
Contingent consideration obligations 0 0    
Total liabilities 0 0    
Quoted prices in active markets  for identical assets (Level 1) | Foreign currency forward contracts        
Derivatives:        
Foreign currency and cross-currency swap contracts 0 0    
Derivatives:        
Foreign currency and cross-currency swap contracts 0 0    
Quoted prices in active markets  for identical assets (Level 1) | Cross-currency swap contracts        
Derivatives:        
Foreign currency and cross-currency swap contracts 0 0    
Derivatives:        
Foreign currency and cross-currency swap contracts 0 0    
Quoted prices in active markets  for identical assets (Level 1) | Interest rate swap contracts        
Derivatives:        
Interest rate swap contracts 0 0    
Quoted prices in active markets  for identical assets (Level 1) | Forward Interest Rate Contracts        
Derivatives:        
Derivative Liability 0 0    
Significant other observable inputs (Level 2)        
Assets:        
Other investments 131 130    
Equity securities 0 0    
Derivatives:        
Total assets 384 471    
Derivatives:        
Contingent consideration obligations 0 0    
Total liabilities 1,252 1,398    
Significant other observable inputs (Level 2) | Foreign currency forward contracts        
Derivatives:        
Foreign currency and cross-currency swap contracts 252 287    
Derivatives:        
Foreign currency and cross-currency swap contracts 73 76    
Significant other observable inputs (Level 2) | Cross-currency swap contracts        
Derivatives:        
Foreign currency and cross-currency swap contracts 0 54    
Derivatives:        
Foreign currency and cross-currency swap contracts 517 541    
Significant other observable inputs (Level 2) | Interest rate swap contracts        
Derivatives:        
Interest rate swap contracts 662 776    
Significant other observable inputs (Level 2) | Forward Interest Rate Contracts        
Derivatives:        
Derivative Liability 0 5    
Significant unobservable inputs (Level 3)        
Assets:        
Other investments 0 0    
Equity securities 288 335    
Derivatives:        
Total assets 288 335    
Derivatives:        
Contingent consideration obligations 273 270    
Total liabilities 273 270    
Significant unobservable inputs (Level 3) | Foreign currency forward contracts        
Derivatives:        
Foreign currency and cross-currency swap contracts 0 0    
Derivatives:        
Foreign currency and cross-currency swap contracts 0 0    
Significant unobservable inputs (Level 3) | Cross-currency swap contracts        
Derivatives:        
Foreign currency and cross-currency swap contracts 0 0    
Derivatives:        
Foreign currency and cross-currency swap contracts 0 0    
Significant unobservable inputs (Level 3) | Interest rate swap contracts        
Derivatives:        
Interest rate swap contracts 0 0    
Significant unobservable inputs (Level 3) | Forward Interest Rate Contracts        
Derivatives:        
Derivative Liability 0 0    
U.S. Treasury bills        
Assets:        
Interest-bearing securities 0 1,676    
U.S. Treasury bills | Quoted prices in active markets  for identical assets (Level 1)        
Assets:        
Interest-bearing securities 0 1,676    
U.S. Treasury bills | Significant other observable inputs (Level 2)        
Assets:        
Interest-bearing securities 0 0    
U.S. Treasury bills | Significant unobservable inputs (Level 3)        
Assets:        
Interest-bearing securities 0 0    
Money market mutual funds        
Assets:        
Interest-bearing securities 31,064 2,659    
Money market mutual funds | Quoted prices in active markets  for identical assets (Level 1)        
Assets:        
Interest-bearing securities 31,064 2,659    
Money market mutual funds | Significant other observable inputs (Level 2)        
Assets:        
Interest-bearing securities 0 0    
Money market mutual funds | Significant unobservable inputs (Level 3)        
Assets:        
Interest-bearing securities 0 0    
Other short-term interest-bearing securities        
Assets:        
Interest-bearing securities 1 0    
Other short-term interest-bearing securities | Quoted prices in active markets  for identical assets (Level 1)        
Assets:        
Interest-bearing securities 0 0    
Other short-term interest-bearing securities | Significant other observable inputs (Level 2)        
Assets:        
Interest-bearing securities 1 0    
Other short-term interest-bearing securities | Significant unobservable inputs (Level 3)        
Assets:        
Interest-bearing securities $ 0 $ 0