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Financing arrangements - Narrative (Details)
3 Months Ended 6 Months Ended
Jun. 30, 2023
USD ($)
Mar. 31, 2023
USD ($)
Jun. 30, 2023
USD ($)
renewal_option
Jun. 30, 2023
CHF (SFr)
Dec. 31, 2022
USD ($)
Debt Instrument [Line Items]          
Extinguishment of debt $ 420,000,000        
Gain (loss) on extinguishment of debt 113,000,000        
Face amount 24,000,000,000   $ 24,000,000,000    
Commitment fee percentage     0.09%    
Horizon Therapeutics          
Debt Instrument [Line Items]          
Aggregate principal amount         $ 24,500,000,000
term loan credit agreement, total amount 4,000,000,000   $ 4,000,000,000   4,000,000,000
term loan outstanding 0   $ 0   0
Horizon Therapeutics | Other Nonoperating Income (Expense)          
Debt Instrument [Line Items]          
Financing cost 98,000,000        
Debt Securities Payable | Minimum          
Debt Instrument [Line Items]          
Redemption period without payment     2 months    
Debt Securities Payable | Maximum          
Debt Instrument [Line Items]          
Redemption period without payment     6 months    
Line of Credit          
Debt Instrument [Line Items]          
Maximum borrowing capacity 4,000,000,000   $ 4,000,000,000    
Amount by which borrowing capacity under a syndicated unsecured revolving credit agreement may be increased upon our request at discretion of banks     $ 1,250,000,000    
Initial commitment term     5 years    
Number of renewal options | renewal_option     2    
Commitment term extension period     1 year    
Amounts outstanding under credit facility $ 0   $ 0   0
Line of Credit | Secured overnight financing rate | Variable Rate Component One          
Debt Instrument [Line Items]          
Basis spread on variable rate     1.01%    
Line of Credit | Secured overnight financing rate | Variable Rate Component Two          
Debt Instrument [Line Items]          
Basis spread on variable rate     1.10%    
Line of Credit | Federal Funds Purchased          
Debt Instrument [Line Items]          
Basis spread on variable rate 0.50%        
prior line of credit          
Debt Instrument [Line Items]          
Maximum borrowing capacity         $ 2,500,000,000
Amount by which borrowing capacity under a syndicated unsecured revolving credit agreement may be increased upon our request at discretion of banks   $ 750,000,000      
4.563% notes due 2048 (4.563% 2048 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 4.563%   4.563% 4.563%  
Effective interest rate 6.30%   6.30% 6.30%  
4.663% notes due 2051 (4.663% 2051 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 4.663%   4.663% 4.663%  
Effective interest rate 5.60%   5.60% 5.60%  
2.77% notes due 2053 (2.77% 2053 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 2.77%   2.77% 2.77%  
Effective interest rate 5.20%   5.20% 5.20%  
5.25% notes due 2025 (5.25% 2025 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 5.25%   5.25% 5.25%  
Percentage of the principal amount of the notes     101.00%    
Percentage of the principal amount of the notes, change in control triggering event     101.00%    
Face amount $ 2,000,000,000   $ 2,000,000,000    
5.507% notes due 2026 (5.507% 2026 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 5.507%   5.507% 5.507%  
Percentage of the principal amount of the notes     101.00%    
Percentage of the principal amount of the notes, change in control triggering event     101.00%    
Face amount $ 1,500,000,000   $ 1,500,000,000    
5.507% notes due 2026 (5.507% 2026 Notes) | Debt Securities Payable          
Debt Instrument [Line Items]          
Redemption period without payment     2 years    
5.15% notes due 2028 (5.15% 2028 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 5.15%   5.15% 5.15%  
Percentage of the principal amount of the notes     101.00%    
Percentage of the principal amount of the notes, change in control triggering event     101.00%    
Face amount $ 3,750,000,000   $ 3,750,000,000    
5.25% notes due 2030 (5.25% 2030 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 5.25%   5.25% 5.25%  
Percentage of the principal amount of the notes     101.00%    
Percentage of the principal amount of the notes, change in control triggering event     101.00%    
Face amount $ 2,750,000,000   $ 2,750,000,000    
5.25% notes due 2033 (5.25% 2033 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 5.25%   5.25% 5.25%  
Percentage of the principal amount of the notes     101.00%    
Percentage of the principal amount of the notes, change in control triggering event     101.00%    
Face amount $ 4,250,000,000   $ 4,250,000,000    
5.60% notes due 2043 (5.60% 2043 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 5.60%   5.60% 5.60%  
Percentage of the principal amount of the notes     101.00%    
Percentage of the principal amount of the notes, change in control triggering event     101.00%    
Face amount $ 2,750,000,000   $ 2,750,000,000    
5.65% notes due 2053 (5.65% 2053 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 5.65%   5.65% 5.65%  
Percentage of the principal amount of the notes     101.00%    
Percentage of the principal amount of the notes, change in control triggering event     101.00%    
Face amount $ 4,250,000,000   $ 4,250,000,000    
5.75% notes due 2063 (5.75% 2063 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 5.75%   5.75% 5.75%  
Percentage of the principal amount of the notes, change in control triggering event     101.00%    
Face amount $ 2,750,000,000   $ 2,750,000,000    
2.00% notes due 2032 (2.00% 2032 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 2.00%   2.00% 2.00%  
3.15% notes due 2040 (3.15% 2040 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 3.15%   3.15% 3.15%  
2.80% notes due 2041 (2.80% 2041 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 2.80%   2.80% 2.80%  
3.375% notes due 2050 (3.375% 2050 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 3.375%   3.375% 3.375%  
3.00% notes due 2052 (3.00% 2052 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 3.00%   3.00% 3.00%  
4.20% notes due 2052 (4.20% 2052 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 4.20%   4.20% 4.20%  
4.40% notes due 2062 (4.40% 2062 Notes) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 4.40%   4.40% 4.40%  
0.41% CHF700 million bonds due 2023 (0.41% 2023 Swiss franc Bonds) | Cross-currency swap contracts | Cash flow hedge          
Debt Instrument [Line Items]          
Notional amounts $ 704,000,000   $ 704,000,000    
0.41% CHF700 million bonds due 2023 (0.41% 2023 Swiss franc Bonds) | Notes          
Debt Instrument [Line Items]          
Interest rate, stated percentage 0.41%   0.41% 0.41%  
Face amount | SFr       SFr 700,000,000