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Goodwill and other intangible assets (Identifiable Intangible Assets) (Details) - USD ($)
$ in Millions
 3 Months Ended 6 Months Ended
Jun. 30, 2023
Jun. 30, 2022
Jun. 30, 2023
Jun. 30, 2022
Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]          
Gross carrying amounts $ 35,608   $ 35,608   $ 35,596
Accumulated amortization (21,916)   (21,916)   (20,525)
Other intangible assets, net 13,692   13,692   15,071
Gross carrying amount 36,549   36,549   36,605
Accumulated amortization (21,916)   (21,916)   (20,525)
Intangible assets, net 14,633   14,633   16,080
Amortization charges associated with finite-lived intangible assets 693 $ 629 1,400 $ 1,300  
In-process research and development          
Indefinite-lived Intangible Assets [Line Items]          
Indefinite-lived intangible assets: 941   941   1,009
Developed-product-technology rights          
Finite-Lived Intangible Assets [Line Items]          
Gross carrying amounts 29,040   29,040   29,028
Accumulated amortization (16,310)   (16,310)   (15,045)
Other intangible assets, net 12,730   12,730   13,983
Licensing rights          
Finite-Lived Intangible Assets [Line Items]          
Gross carrying amounts 3,864   3,864   3,864
Accumulated amortization (3,197)   (3,197)   (3,123)
Other intangible assets, net 667   667   741
Marketing-related rights          
Finite-Lived Intangible Assets [Line Items]          
Gross carrying amounts 1,312   1,312   1,326
Accumulated amortization (1,195)   (1,195)   (1,167)
Other intangible assets, net 117   117   159
Research and development technology rights          
Finite-Lived Intangible Assets [Line Items]          
Gross carrying amounts 1,392   1,392   1,378
Accumulated amortization (1,214)   (1,214)   (1,190)
Other intangible assets, net $ 178   $ 178   $ 188