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Acquisitions and divestitures - Schedule of Business Acquisitions, by Acquisition (Details) - USD ($)
$ in Millions
Dec. 31, 2024
Dec. 31, 2023
Oct. 06, 2023
Dec. 31, 2022
Business Acquisition [Line Items]        
Goodwill $ 18,637 $ 18,629   $ 15,529
Horizon Therapeutics        
Business Acquisition [Line Items]        
Cash and cash equivalents     $ 681  
Inventories     5,014  
Property, plant and equipment, net     318  
IPR&D     1,060  
Goodwill     3,136  
Deferred tax asset     795  
Deferred tax liability     (2,488)  
Other assets and liabilities, net     (273)  
Total assets acquired, net of liabilities assumed     27,833  
Horizon Therapeutics | Developed-product-technology rights        
Business Acquisition [Line Items]        
Finite-lived intangible assets—developed-product-technology rights     $ 19,590