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Derivative instruments - Summary of Income and Expense Line Items (Details) - USD ($)
$ in Millions
 3 Months Ended 6 Months Ended
Jun. 30, 2024
Jun. 30, 2023
Jun. 30, 2024
Jun. 30, 2023
Derivative Instruments, Gain (Loss) [Line Items]        
Product sales $ 8,388 $ 6,986 $ 15,835 $ 13,091
Other (expense) income, net (307) (318) (542) 1,746
Interest expense, net (808) (752) (1,632) (1,295)
Interest rate swap agreements        
Derivative Instruments, Gain (Loss) [Line Items]        
Gains (losses) on fair value hedging relationships, hedged items (18) 93 31 5
Gains (losses) on fair value hedging relationships, Derivatives designated as hedging instruments 36 (72) 8 42
Reclassification out of Accumulated Other Comprehensive Income | Cash flow hedges | Cross-currency swap contracts        
Derivative Instruments, Gain (Loss) [Line Items]        
Other (expense) income, net (3) 51 (34) 29
Product sales        
Derivative Instruments, Gain (Loss) [Line Items]        
Product sales 8,041 6,683 15,159 12,529
Product sales | Reclassification out of Accumulated Other Comprehensive Income | Cash flow hedges | Foreign currency forward contracts        
Derivative Instruments, Gain (Loss) [Line Items]        
Product sales $ 55 $ 36 $ 106 $ 88