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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2021
Sep. 30, 2020
Operating Activities:    
Net income (loss) $ 5,825 $ (1,455)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:    
Depreciation expense 239 209
Amortization expense 1,276 844
Stock-based compensation expense 476 482
Acquired in-process research and development expenses 177 5,792
Deferred income taxes 243 (12)
Net loss from equity securities 667 1,046
Other 601 210
Changes in operating assets and liabilities:    
Accounts receivable, net 272 (334)
Inventories (24) (48)
Prepaid expenses and other (17) 22
Accounts payable (242) (134)
Income taxes payable (463) (428)
Accrued and other liabilities (851) 58
Net cash provided by operating activities 8,179 6,252
Investing Activities:    
Purchases of marketable debt securities (2,891) (19,809)
Proceeds from sales of marketable debt securities 506 12,367
Proceeds from maturities of marketable debt securities 1,808 8,528
Acquisitions, including in-process research and development, net of cash acquired (1,401) (5,804)
Purchases of equity securities (332) (388)
Capital expenditures (423) (469)
Other (120) (63)
Net cash used in investing activities (2,853) (5,638)
Financing Activities:    
Proceeds from debt financing, net of issuance costs 0 7,189
Proceeds from issuances of common stock 157 248
Repurchases of common stock (497) (1,583)
Repayments of debt and other obligations (3,750) (2,500)
Payments of dividends (2,711) (2,591)
Other (134) (124)
Net cash provided by (used in) financing activities (6,935) 639
Effect of exchange rate changes on cash and cash equivalents (26) 2
Net change in cash and cash equivalents (1,635) 1,255
Cash and cash equivalents at beginning of period 5,997 11,631
Cash and cash equivalents at end of period $ 4,362 $ 12,886