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Acquisitions and divestitures - Acquisition of ChemoCentryx, Inc. Narrative (Details) - USD ($) $ / shares in Units, $ in Millions |  | 12 Months Ended |  |
--- | --- | --- | --- | ---
Oct. 20, 2022 | Dec. 31, 2023 | Dec. 31, 2024 | Dec. 31, 2022
Business Acquisition [Line Items] |  |  |  |
Goodwill |  | $ 18,629 | $ 18,637 | $ 15,529
ChemoCentryx, Inc. |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Acquisition price per share (in usd per share) | $ 52.00 |  |  |
Business asset acquisition, consideration transferred | $ 3,900 |  |  |
Goodwill, net decrease |  | $ 18 |  |
Cash purchase price | 3,700 |  |  |
Business acquisition, cash consideration paid to equity holders for pre-acquisition services | 181 |  |  |
Inventories | $ 41 |  |  |
Business combination, turnover period of inventory acquired (in months) | 13 months |  |  |
Deferred tax liability | $ (502) |  |  |
Goodwill | 649 |  |  |
ChemoCentryx, Inc. | Developed-product-technology rights |  |  |  |
Business Acquisition [Line Items] |  |  |  |
Finite-lived intangible assets | $ 3,499 |  |  |
Weighted average period of amortization (in years) | 11 years |  |  |

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