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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Operating Activities:      
Net income $ 89 $ 5,364 $ 5,460
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation expense 288 255 226
Amortization expense 1,192 1,149 1,203
Stock-based compensation expense 643 636 845
Deferred income taxes (214) (2,098) 289
Net (gains) losses from equity securities 1,662 (1,241) (115)
Acquired in-process research and development expenses 5,856 4,251 0
In-process research and development impairment 0 800 820
Write-downs for slow moving and excess raw material and work in process inventory 40 547 440
Other 250 279 171
Changes in operating assets and liabilities:      
Accounts receivable, net (1,171) (218) 480
Inventories (195) (95) (310)
Prepaid expenses and other (214) (307) 903
Accounts payable 80 (61) (39)
Income taxes payable (778) 272 (1,459)
Accrued liabilities 640 (389) (514)
Net cash provided by operating activities 8,168 9,144 8,400
Investing Activities:      
Purchases of marketable debt securities (20,315) (30,455) (10,233)
Proceeds from sales of marketable debt securities 23,239 7,523 1,522
Proceeds from maturities of marketable debt securities 9,479 22,398 24,336
Acquisitions, including in-process research and development, net of cash acquired (25,742) (4,251) 0
Purchases of equity securities (455) (1,773) (156)
Capital expenditures (650) (825) (924)
Other (171) (434) (190)
Net cash (used in) provided by investing activities (14,615) (7,817) 14,355
Financing Activities:      
Proceeds from debt financing, net of issuance costs 8,184 0 0
Proceeds from issuances of common stock 256 209 289
Repurchases of common stock (1,583) (1,749) (2,900)
Repayments of debt and other obligations (2,500) (2,750) (6,250)
Payment of dividends (3,449) (3,222) (2,971)
Other (138) (122) (486)
Net cash provided by (used in) financing activities 770 (7,634) (12,318)
Effect of exchange rate changes on cash and cash equivalents 43 (2) (85)
Net change in cash and cash equivalents (5,634) (6,309) 10,352
Cash and cash equivalents at beginning of period 11,631 17,940 7,588
Cash and cash equivalents at end of period 5,997 11,631 17,940
Supplemental disclosure of cash flow information:      
Interest paid, net of amounts capitalized 951 982 1,070
Income taxes paid $ 2,639 $ 1,793 $ 3,198