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Goodwill and other intangible assets - Narrative (Details) - USD ($) $ in Millions | 3 Months Ended | 9 Months Ended |  |
--- | --- | --- | --- | ---
Sep. 30, 2025 | Mar. 31, 2025 | Sep. 30, 2024 | Sep. 30, 2025 | Sep. 30, 2024 | Jun. 30, 2025 | Dec. 31, 2024
Finite-Lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Finite-lived intangible assets, net | $ 22,429 |  |  | $ 22,429 |  |  | $ 26,639
Impairment charge | 400 |  |  | 1,200 |  |  |
Intangible assets, net | 23,139 |  |  | 23,139 |  |  | 27,699
Amortization charges associated with finite-lived intangible assets | 1,100 |  | $ 1,200 | 3,400 | $ 3,600 |  |
Total estimated amortization of finite-lived intangible assets for the remainder of the year | 900 |  |  | 900 |  |  |
Total estimated amortization of finite-lived intangible assets for 2026 | 3,600 |  |  | 3,600 |  |  |
Total estimated amortization of finite-lived intangible assets for 2027 | 3,500 |  |  | 3,500 |  |  |
Total estimated amortization of finite-lived intangible assets for 2028 | 2,800 |  |  | 2,800 |  |  |
Total estimated amortization of finite-lived intangible assets for 2029 | 2,300 |  |  | 2,300 |  |  |
Total estimated amortization of finite-lived intangible assets for 2030 | 2,200 |  |  | 2,200 |  |  |
Developed-product-technology rights |  |  |  |  |  |  |
Finite-Lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Finite-lived intangible assets, net | 21,919 |  |  | 21,919 |  |  | $ 26,017
Otezla | Developed-product-technology rights |  |  |  |  |  |  |
Finite-Lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Finite-lived intangible assets, fair value disclosure | 3,000 | $ 4,000 |  | 3,000 |  |  |
Finite-lived intangible assets, net | 3,400 | 4,800 |  | $ 3,400 |  |  |
Impairment charge | $ 400 | $ 800 |  |  |  |  |
UPLIZNA | In-process research and development |  |  |  |  |  |  |
Finite-Lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Intangible assets, net |  |  |  |  |  | $ 350 |
UPLIZNA | In-process research and development |  |  |  |  |  |  |
Finite-Lived Intangible Assets [Line Items] |  |  |  |  |  |  |
Finite-lived intangible asset, useful life |  |  |  |  |  | 11 years |

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