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Goodwill and other intangible assets - Schedule of Other Intangible Assets (Details) - USD ($)
$ in Millions
Sep. 30, 2025
Dec. 31, 2024
Finite-Lived Intangible Assets [Line Items]    
Gross carrying amounts, finite-lived intangible assets $ 54,301 $ 55,062
Accumulated amortization, finite-lived intangible assets (31,872) (28,423)
Other intangible assets, net, finite-lived intangible assets 22,429 26,639
Identifiable intangible assets 55,011 56,122
Accumulated amortization (31,872) (28,423)
Identifiable intangible assets, net 23,139 27,699
In-process research and development    
Finite-Lived Intangible Assets [Line Items]    
Indefinite-lived intangible assets 710 1,060
Developed-product-technology rights    
Finite-Lived Intangible Assets [Line Items]    
Gross carrying amounts, finite-lived intangible assets 47,803 48,611
Accumulated amortization, finite-lived intangible assets (25,884) (22,594)
Other intangible assets, net, finite-lived intangible assets 21,919 26,017
Licensing rights    
Finite-Lived Intangible Assets [Line Items]    
Gross carrying amounts, finite-lived intangible assets 3,875 3,875
Accumulated amortization, finite-lived intangible assets (3,490) (3,392)
Other intangible assets, net, finite-lived intangible assets 385 483
Research and development technology rights    
Finite-Lived Intangible Assets [Line Items]    
Gross carrying amounts, finite-lived intangible assets 1,421 1,374
Accumulated amortization, finite-lived intangible assets (1,296) (1,235)
Other intangible assets, net, finite-lived intangible assets 125 139
Marketing-related rights    
Finite-Lived Intangible Assets [Line Items]    
Gross carrying amounts, finite-lived intangible assets 1,202 1,202
Accumulated amortization, finite-lived intangible assets (1,202) (1,202)
Other intangible assets, net, finite-lived intangible assets $ 0 $ 0