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Financing arrangements - Narrative (Details)
1 Months Ended 3 Months Ended 6 Months Ended 9 Months Ended
Oct. 31, 2023
Sep. 30, 2023
USD ($)
Jun. 30, 2023
USD ($)
Sep. 30, 2023
USD ($)
renewal_option
Oct. 06, 2023
USD ($)
Sep. 30, 2023
CHF (SFr)
Dec. 31, 2022
USD ($)
Debt Instrument [Line Items]              
Extinguishment of debt   $ 550,000,000          
Gain (loss) on extinguishment of debt   182,000,000          
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   4,000,000,000   $ 4,000,000,000     4,000,000,000
term loan outstanding   0   $ 0     0
Horizon Therapeutics | Subsequent Event              
Debt Instrument [Line Items]              
term loan credit agreement, total borrowed         $ 4,000,000,000    
term loan credit agreement, due in 18 months         2,000,000,000    
term loan credit agreement, due in 36 months         $ 2,000,000,000    
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        
term loan credit agreement | Secured overnight financing rate | Variable Rate Component Three | Subsequent Event              
Debt Instrument [Line Items]              
Basis spread on variable rate 1.225%            
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, 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, 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, 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, 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, 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, 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, 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  
2.25% notes due 2023 (2.25% 2023 Notes) | Notes              
Debt Instrument [Line Items]              
Interest rate, stated percentage   2.25%   2.25%   2.25%  
Face amount   $ 750,000,000   $ 750,000,000