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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Operating Activities:    
Net income (loss): $ 6,327 $ (1,303)
Adjustments to reconcile Net income (loss) to Net cash provided by operating activities:    
Depreciation expense 280 286
Amortization expense 1,793 1,788
Stock-based compensation expense 664 613
Deferred income taxes 282 (1,465)
Net (gain) loss from equity securities (198) 148
Acquired in-process research and development expenses 485 4,674
In-process research and development impairments 190 4,180
Other, net 213 294
Changes in operating assets and liabilities:    
Accounts receivable, net (546) 67
Inventories (913) (200)
Prepaid expenses and other (275) (113)
Accounts payable (37) 348
Income tax assets and liabilities, net (1,974) (1,268)
Accrued and other liabilities 401 (197)
Net cash provided by operating activities 6,692 7,853
Investing Activities:    
Purchases of marketable debt securities (2,557) (244)
Proceeds from sales of marketable debt securities 514 2,265
Proceeds from maturities of marketable debt securities 32 327
Acquisitions, including in-process research and development, net of cash acquired (461) (4,765)
Purchases of equity securities (119) (453)
Purchases of property, plant and equipment (358) (376)
Other investing activities, net (9) 23
Net cash used in investing activities (2,958) (3,224)
Financing Activities:    
Proceeds from issuances of common stock 376 249
Repurchases of common stock under repurchase programs (1,692) (800)
Repayments of debt and other obligations (1,780) (1,963)
Payments of dividends (3,009) (2,945)
Other financing activities, net (377) (234)
Net cash used in financing activities (6,482) (5,693)
Effect of exchange rate changes on cash and cash equivalents 87 15
Net change in cash and cash equivalents (2,661) (1,049)
Cash and cash equivalents at beginning of period 9,991 6,085
Cash and cash equivalents at end of period $ 7,330 $ 5,037