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Stockholders' equity - Schedule of Reclassifications Out of AOCI (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2025
Mar. 31, 2024
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Product sales $ 8,149 $ 7,447
Other income (expense), net 1,518 (235)
Income (loss) before income taxes 1,973 (68)
Provision for income taxes (243) (45)
Net income (loss) 1,730 (113)
Reclassification out of AOCI | Cash flow hedges    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Income (loss) before income taxes 139 20
Provision for income taxes (30) (4)
Net income (loss) 109 16
Cross-currency swap contract gains (losses) | Reclassification out of AOCI | Cash flow hedges    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Other income (expense), net 83 (31)
Cross-currency swap contract gains (losses) | Cash flow hedges | Reclassification out of AOCI | Cash flow hedges    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Other income (expense), net 83 (31)
Product    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Product sales 7,873 7,118
Product | Foreign currency forward contract gains | Reclassification out of AOCI | Cash flow hedges    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Product sales 56 51
Product | Foreign currency forward contract gains | Cash flow hedges | Reclassification out of AOCI | Cash flow hedges    
Reclassification out of Accumulated Other Comprehensive Income [Line Items]    
Product sales $ 56 $ 51