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Other Consolidated Financial Statement Detail (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Cash Paid During the Year        
Interest $ 243.2 $ 281.7 $ 281.2  
Income taxes 1,007.1 1,066.4 1,642.2  
Other Nonoperating Income (Expense) [Abstract]        
Interest income 112.5 78.5 63.4  
Interest expense 200.6 250.8 260.0  
Gain (loss) on investments, net 119.5 (36.3) 6.0  
Foreign exchange gains (losses), net (9.9) 6.3 (9.8)  
Other income (expense) (10.5) (14.7) (18.3)  
Total other income (expense), net 11.0 (217.0) (218.7)  
Accrued Liabilities, Current [Abstract]        
Revenue related reserves for discounts and allowances 1,051.3 761.6 $ 605.5 $ 662.7
Current portion of contingent consideration obligations 444.8 844.6    
Employee compensation and benefits 320.9 297.7    
Royalties and licensing fees 224.7 206.7    
Collaboration expenses 261.6 183.7    
Accrued construction in progress 125.2 159.7    
Other 609.3 636.9    
Accrued expenses and other 2,861.2 2,901.3    
Other Current Liabilities        
Accrued Liabilities, Current [Abstract]        
Revenue related reserves for discounts and allowances $ 874.7 $ 572.0