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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($)
$ in Millions
 6 Months Ended
Jun. 30, 2025
Jun. 30, 2024
Operating Activities:    
Net income (loss) $ 3,275 $ (2,556)
Adjustments to reconcile Net income (loss) to Net cash provided by operating activities:    
Depreciation expense 190 192
Amortization expense 1,197 1,192
Stock-based compensation expense 434 397
Deferred income taxes (377) (889)
Net loss from equity securities 284 405
Acquired in-process research and development expenses 315 4,169
In-process research and development impairments 190 2,430
Other, net 124 208
Changes in operating assets and liabilities:    
Accounts receivable, net (213) (95)
Inventories (398) (115)
Prepaid expenses and other 93 (56)
Accounts payable (267) (11)
Income tax assets and liabilities, net (1,852) (1,379)
Accrued and other liabilities (410) (349)
Net cash provided by operating activities 2,584 3,544
Investing Activities:    
Purchases of marketable debt securities (2,287) (244)
Proceeds from sales of marketable debt securities 295 2,265
Proceeds from maturities of marketable debt securities 15 327
Acquisitions, including in-process research and development, net of cash acquired (294) (4,195)
Purchases of equity securities (37) (444)
Purchases of property, plant and equipment (211) (235)
Other investing activities, net (13) 12
Net cash used in investing activities (2,531) (2,514)
Financing Activities:    
Proceeds from issuances of common stock 279 151
Repurchases of common stock under repurchase programs (1,257) (500)
Repayments of debt and other obligations (1,771) (1,851)
Payments of dividends (2,004) (1,962)
Other financing activities, net (240) (152)
Net cash used in financing activities (4,993) (4,314)
Effect of exchange rate changes on cash and cash equivalents 92 (29)
Net change in cash and cash equivalents (4,848) (3,313)
Cash and cash equivalents at beginning of period 9,991 6,085
Cash and cash equivalents at end of period $ 5,144 $ 2,772