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Commitment and contingencies - Narrative (Details) - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015
Other Commitments [Line Items] |  |  |
Operating leases expense | $ 84 | $ 81 | $ 78
Active Pharmaceutical Ingredient [Member] |  |  |
Purchase Commitments, Fiscal Year Maturity |  |  |
2018 | 902 |  |
2019 | 179 |  |
2020 | 50 |  |
2021 | 48 |  |
2022 | 45 |  |
Actual payments for purchases related to active pharmaceutical ingredients | $ 1,700 | $ 2,000 | $ 2,200

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- Definition Minimum amount of purchase arrangement maturing in the fifth fiscal year following the latest fiscal year. Includes, but not limited to, recorded and unrecorded purchase obligations, long-term purchase commitments, and short-term purchase commitments. + References No definition available. + Details
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- Definition The amount purchased during the period under an unrecorded unconditional purchase obligation (for example, under the take-or-pay or throughput contract). + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 440 -SubTopic 10 -Section 50 -Paragraph 4 -Subparagraph (d) -URI http://asc.fasb.org/extlink&oid=73718637&loc=d3e25336-109308 + Details
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