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Derivative instruments - Summary of Income and Expense Line Items (Details) - USD ($) $ in Millions | 3 Months Ended
--- | ---
Mar. 31, 2024 | Mar. 31, 2023
Derivative Instruments, Gain (Loss) [Line Items] |  |
Product sales | $ 7,447 | $ 6,105
Other (expense) income, net | (235) | 2,064
Interest expense, net | (824) | (543)
Interest rate swap agreements |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |
Gains (losses) on fair value hedging relationships, Hedged items | 49 | (88)
Gains (losses) on fair value hedging relationships, Derivatives designated as hedging instruments | (28) | 114
Reclassification out of Accumulated Other Comprehensive Income | Cash flow hedges | Cross-currency swap contracts |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |
Other (expense) income, net | (31) | (22)
Product sales |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |
Product sales | 7,118 | 5,846
Product sales | Reclassification out of Accumulated Other Comprehensive Income | Cash flow hedges | Foreign currency forward contracts |  |
Derivative Instruments, Gain (Loss) [Line Items] |  |
Product sales | $ 51 | $ 52

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