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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities:
Net income	$ 1,408.8	$ 1,171.2
Adjustments to reconcile net income to net cash flows from operating activities:
Depreciation, amortization and impairments	121.1	168.9
Acquired in-process research and development	0.0	10.0
Share-based compensation	45.7	43.4
Contingent consideration	(11.5)	5.6
Loss on assets and liabilities held for sale	115.5	0.0
Deferred income taxes	228.0	53.1
Unrealized (gain) loss on strategic investments	(375.0)	0.0
Other	50.7	31.7
Changes in operating assets and liabilities, net:
Accounts receivable	(136.6)	(134.0)
Inventory	(129.0)	(2.6)
Accrued expenses and other current liabilities	138.4	121.8
Income tax assets and liabilities	170.3	257.6
Other changes in operating assets and liabilities, net	(171.1)	(20.0)
Net cash flows provided by operating activities	1,459.5	1,457.1
Cash flows from investing activities:
Proceeds from sales and maturities of marketable securities	1,489.2	4,068.9
Purchases of marketable securities	(825.0)	(1,919.2)
Contingent consideration paid related to Fumapharm AG acquisition	(300.0)	(600.0)
Purchases of property, plant and equipment	(127.1)	(194.7)
Acquired in-process research and development	0.0	(10.0)
Other	(1.7)	(1.6)
Net cash flows provided by investing activities	238.8	1,346.6
Cash flows from financing activities:
Purchases of treasury stock	(655.8)	(250.0)
Payments related to issuance of stock for share-based compensation arrangements, net	(32.2)	(21.2)
Other	8.7	2.6
Net cash flows used in financing activities	(679.3)	(268.6)
Net increase (decrease) in cash and cash equivalents	1,019.0	2,535.1
Effect of exchange rate changes on cash and cash equivalents	0.4	0.9
Cash and cash equivalents, beginning of the period	1,224.6	1,573.8
Cash and cash equivalents, end of the period	$ 2,243.2	$ 4,108.0

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