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Goodwill and other intangible assets - Schedule of Identifiable Intangible Assets (Details) - USD ($)
$ in Millions
Sep. 30, 2024
Dec. 31, 2023
Finite-lived intangible assets:    
Gross carrying amounts $ 55,103 $ 55,229
Accumulated amortization (27,273) (23,806)
Other intangible assets, net 27,830 31,423
Indefinite-lived intangible assets:    
Identifiable intangible assets 56,193 56,447
Accumulated amortization (27,273) (23,806)
Intangible assets, net 28,920 32,641
In-process research and development    
Indefinite-lived intangible assets:    
Indefinite-lived intangible assets 1,090 1,218
Developed-product-technology rights    
Finite-lived intangible assets:    
Gross carrying amounts 48,636 48,631
Accumulated amortization (21,472) (18,049)
Other intangible assets, net 27,164 30,582
Licensing rights    
Finite-lived intangible assets:    
Gross carrying amounts 3,864 3,865
Accumulated amortization (3,360) (3,265)
Other intangible assets, net 504 600
Marketing-related rights    
Finite-lived intangible assets:    
Gross carrying amounts 1,203 1,339
Accumulated amortization (1,188) (1,264)
Other intangible assets, net 15 75
Research and development technology rights    
Finite-lived intangible assets:    
Gross carrying amounts 1,400 1,394
Accumulated amortization (1,253) (1,228)
Other intangible assets, net $ 147 $ 166