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Fair value measurement - Fair Value of Financial Assets and Liabilities on Recurring Basis (Details) - USD ($) $ in Millions | Dec. 31, 2024 | Dec. 31, 2023 | Dec. 31, 2022 | Dec. 31, 2021
--- | --- | --- | --- | ---
Assets: |  |  |  |
Available-for-sale securities: | $ 11,486 | $ 10,404 |  |
Equity securities | 4,188 | 4,514 |  |
Derivatives: |  |  |  |
Total assets | 16,094 | 15,063 |  |
Derivatives: |  |  |  |
Contingent consideration obligations | 106 | 96 | $ 270 | $ 342
Total liabilities | 1,128 | 1,188 |  |
Foreign currency contract gains |  |  |  |
Derivatives: |  |  |  |
Derivative assets | 420 | 145 |  |
Derivatives: |  |  |  |
Derivative liabilities | 8 | 116 |  |
Cross-currency swap contract (losses) gains |  |  |  |
Derivatives: |  |  |  |
Derivative assets | 0 | 0 |  |
Derivatives: |  |  |  |
Derivative liabilities | 483 | 405 |  |
Interest rate swap contracts |  |  |  |
Derivatives: |  |  |  |
Interest rate swap contracts | 0 | 0 |  |
Derivatives: |  |  |  |
Interest rate swap contracts | 531 | 571 |  |
Quoted prices in active markets for identical assets (Level 1) |  |  |  |
Assets: |  |  |  |
Equity securities | 4,188 | 4,514 |  |
Derivatives: |  |  |  |
Total assets | 14,542 | 14,780 |  |
Derivatives: |  |  |  |
Contingent consideration obligations | 0 | 0 |  |
Total liabilities | 0 | 0 |  |
Quoted prices in active markets for identical assets (Level 1) | Foreign currency contract gains |  |  |  |
Derivatives: |  |  |  |
Derivative assets | 0 | 0 |  |
Derivatives: |  |  |  |
Derivative liabilities | 0 | 0 |  |
Quoted prices in active markets for identical assets (Level 1) | Cross-currency swap contract (losses) gains |  |  |  |
Derivatives: |  |  |  |
Derivative assets | 0 | 0 |  |
Derivatives: |  |  |  |
Derivative liabilities | 0 | 0 |  |
Quoted prices in active markets for identical assets (Level 1) | Interest rate swap contracts |  |  |  |
Derivatives: |  |  |  |
Interest rate swap contracts | 0 | 0 |  |
Derivatives: |  |  |  |
Interest rate swap contracts | 0 | 0 |  |
Significant other observable inputs (Level 2) |  |  |  |
Assets: |  |  |  |
Equity securities | 0 | 0 |  |
Derivatives: |  |  |  |
Total assets | 1,552 | 283 |  |
Derivatives: |  |  |  |
Contingent consideration obligations | 0 | 0 |  |
Total liabilities | 1,022 | 1,092 |  |
Significant other observable inputs (Level 2) | Foreign currency contract gains |  |  |  |
Derivatives: |  |  |  |
Derivative assets | 420 | 145 |  |
Derivatives: |  |  |  |
Derivative liabilities | 8 | 116 |  |
Significant other observable inputs (Level 2) | Cross-currency swap contract (losses) gains |  |  |  |
Derivatives: |  |  |  |
Derivative assets | 0 | 0 |  |
Derivatives: |  |  |  |
Derivative liabilities | 483 | 405 |  |
Significant other observable inputs (Level 2) | Interest rate swap contracts |  |  |  |
Derivatives: |  |  |  |
Interest rate swap contracts | 0 | 0 |  |
Derivatives: |  |  |  |
Interest rate swap contracts | 531 | 571 |  |
Significant unobservable inputs (Level 3) |  |  |  |
Assets: |  |  |  |
Equity securities | 0 | 0 |  |
Derivatives: |  |  |  |
Total assets | 0 | 0 |  |
Derivatives: |  |  |  |
Contingent consideration obligations | 106 | 96 |  |
Total liabilities | 106 | 96 |  |
Significant unobservable inputs (Level 3) | Foreign currency contract gains |  |  |  |
Derivatives: |  |  |  |
Derivative assets | 0 | 0 |  |
Derivatives: |  |  |  |
Derivative liabilities | 0 | 0 |  |
Significant unobservable inputs (Level 3) | Cross-currency swap contract (losses) gains |  |  |  |
Derivatives: |  |  |  |
Derivative assets | 0 | 0 |  |
Derivatives: |  |  |  |
Derivative liabilities | 0 | 0 |  |
Significant unobservable inputs (Level 3) | Interest rate swap contracts |  |  |  |
Derivatives: |  |  |  |
Interest rate swap contracts | 0 | 0 |  |
Derivatives: |  |  |  |
Interest rate swap contracts | 0 | 0 |  |
U.S. Treasury bills |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 997 | 0 |  |
U.S. Treasury bills | Quoted prices in active markets for identical assets (Level 1) |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 0 | 0 |  |
U.S. Treasury bills | Significant other observable inputs (Level 2) |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 997 | 0 |  |
U.S. Treasury bills | Significant unobservable inputs (Level 3) |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 0 | 0 |  |
Money market mutual funds |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 10,354 | 10,266 |  |
Money market mutual funds | Quoted prices in active markets for identical assets (Level 1) |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 10,354 | 10,266 |  |
Money market mutual funds | Significant other observable inputs (Level 2) |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 0 | 0 |  |
Money market mutual funds | Significant unobservable inputs (Level 3) |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 0 | 0 |  |
Other short-term interest-bearing securities |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 135 | 138 |  |
Other short-term interest-bearing securities | Quoted prices in active markets for identical assets (Level 1) |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 0 | 0 |  |
Other short-term interest-bearing securities | Significant other observable inputs (Level 2) |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | 135 | 138 |  |
Other short-term interest-bearing securities | Significant unobservable inputs (Level 3) |  |  |  |
Assets: |  |  |  |
Available-for-sale securities: | $ 0 | $ 0 |  |

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