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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2025
Mar. 31, 2024
Operating Activities:    
Net income (loss) $ 1,315 $ (4,170)
Adjustments to reconcile Net income (loss) to net cash provided by operating activities:    
Depreciation expense 97 94
Amortization expense 599 596
Stock-based compensation expense 209 187
Deferred income taxes (199) (723)
Net loss from equity securities 426 14
Acquired in-process research and development expenses 253 4,131
In-process research and development impairments 0 2,430
Other, net 91 119
Changes in operating assets and liabilities:    
Accounts receivable, net 79 (66)
Inventories (223) (45)
Prepaid expenses and other 12 (37)
Accounts payable (105) 72
Income tax assets and liabilities, net (552) (208)
Accrued and other liabilities (244) (175)
Net cash provided by operating activities 1,757 2,219
Investing Activities:    
Purchases of marketable debt securities 0 (244)
Proceeds from sales of marketable debt securities 0 2,265
Proceeds from maturities of marketable debt securities 0 327
Acquisitions, including in-process research and development, net of cash acquired (273) (4,043)
Purchases of equity securities (16) (410)
Purchases of property, plant and equipment (104) (105)
Other investing activities, net (23) 5
Net cash used in investing activities (415) (2,207)
Financing Activities:    
Proceeds from issuances of common stock 252 146
Repurchases of common stock under repurchase programs (730) (400)
Repayments of debt and other obligations (1,762) 0
Payments of dividends (1,010) (990)
Other financing activities, net (176) (116)
Net cash used in financing activities (3,426) (1,361)
Effect of exchange rate changes on cash and cash equivalents 19 (18)
Net change in cash and cash equivalents (2,065) (1,367)
Cash and cash equivalents at beginning of period 9,991 6,085
Cash and cash equivalents at end of period $ 7,926 $ 4,718