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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2024 | Dec. 31, 2023 | Dec. 31, 2022
Operating Activities: |  |  |
Net income: | $ 480 | $ 5,613 | $ 4,566
Adjustments to reconcile net income to net cash provided by operating activities: |  |  |
Depreciation expense | 381 | 354 | 323
Amortization expense | 2,386 | 2,339 | 1,780
Stock-based compensation expense | 835 | 766 | 637
Deferred income taxes | (1,844) | (962) | (1,552)
Net loss from equity securities | 274 | 167 | 657
Acquired in-process research and development expenses | 4,663 | 1,155 | 944
In-process research and development impairments | 4,180 | 50 | 2,700
Other | 353 | 826 | 780
Changes in operating assets and liabilities: |  |  |
Accounts receivable, net | 139 | 157 | (406)
Inventories | (426) | (842) | (310)
Prepaid expenses and other | (259) | 39 | (134)
Accounts payable | 290 | (347) | 226
Income tax assets and liabilities, net | (732) | (1,768) | (364)
Accrued and other liabilities | 108 | 458 | (775)
Net cash provided by operating activities | 10,828 | 8,006 | 9,072
Investing Activities: |  |  |
Purchases of marketable debt securities | (244) | (1,930) | (1,770)
Proceeds from sales of marketable debt securities | 2,265 | 510 | 412
Proceeds from maturities of marketable debt securities | 327 | 1,334 | 1,590
Acquisitions, including in-process research and development, net of cash acquired | (4,840) | (1,152) | (1,797)
Purchases of equity securities | (492) | (442) | (172)
Capital expenditures | (523) | (585) | (728)
Other | 58 | (1) | (1)
Net cash used in investing activities | (3,449) | (2,265) | (2,466)
Financing Activities: |  |  |
Proceeds from debt financing, net of issuance costs | 3,464 | 1,980 | 0
Proceeds from issuances of common stock | 422 | 232 | 309
Repurchases of common stock under repurchase programs | (1,150) | (1,000) | (1,396)
Repayments of debt and other obligations | (1,970) | (2,250) | (1,500)
Payments of dividends | (3,918) | (3,809) | (3,709)
Other | (281) | (279) | (173)
Net cash used in financing activities | (3,433) | (5,125) | (6,469)
Effect of exchange rate changes on cash and cash equivalents | (40) | 57 | (63)
Net change in cash and cash equivalents | 3,906 | 673 | 74
Cash and cash equivalents at beginning of period | 6,085 | 5,412 | 5,338
Cash and cash equivalents at end of period | 9,991 | 6,085 | 5,412
Supplemental disclosure of cash flow information: |  |  |
Interest paid, net of amounts capitalized | 951 | 891 | 907
Income taxes paid | $ 2,779 | $ 3,990 | $ 3,136

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