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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Cash flows from operating activities:      
Net income $ 4,060.5 $ 5,888.5 $ 4,474.0
Adjustments to reconcile net income to net cash flows from operating activities:      
Depreciation and amortization 457.2 464.7 650.5
Impairment of intangible assets 209.7 215.9 366.1
Acquired in-process research and development 75.0 0.0 112.5
Share-based compensation 198.3 182.3 157.5
Contingent consideration (86.3) (63.7) (12.3)
(Gain)/loss on divestiture of Hillerod, Denmark manufactuing operations (92.5) 55.3 0.0
Deferred income taxes 149.0 67.1 108.3
Unrealized (gain) loss on strategic investments (681.8) (147.3) (124.8)
Loss on equity method investment (3.3) 77.4 0.0
Other 131.2 139.1 55.7
Changes in operating assets and liabilities, net:      
Accounts receivable 2.8 68.8 (205.2)
Due from anti-CD20 therapeutic programs 176.7 (63.3) 5.7
Inventory (316.3) (19.2) (52.1)
Accrued expenses and other current liabilities 154.2 240.2 465.5
Income tax assets and liabilities (67.5) 16.1 321.7
Other changes in operating assets and liabilities, net (137.1) (43.3) (135.4)
Net cash flows provided by operating activities 4,229.8 7,078.6 6,187.7
Cash flows from investing activities:      
Proceeds from sales and maturities of marketable securities 7,299.4 6,007.0 9,173.7
Purchases of marketable securities (6,397.7) (5,252.6) (7,694.8)
Contingent consideration paid related to Fumapharm AG acquisition 0.0 (300.0) (1,500.0)
Acquisition of Nightstar Therapeutics plc, net of cash acquired 0.0 (744.4) 0.0
Proceeds from divesiture of Hillerod, Denmark manufacturing operations 0.0 923.7 0.0
Purchases of property, plant and equipment (424.8) (514.5) (770.6)
Acquired in-process research and development (75.0) 0.0 (112.5)
Acquisitions of intangible assets (52.0) (155.0) (3.0)
Investment in Samsung Bioepis 0.0 0.0 (676.6)
Proceeds from sales of strategic investments 74.9 479.3 0.0
Other (26.9) 27.0 0.4
Net cash flows provided by (used in) investing activities (608.6) 470.5 (2,046.3)
Cash flows from financing activities:      
Purchase of treasury stock (6,679.1) (5,868.3) (4,352.6)
Payments related to issuance of stock for share-based compensation arrangements, net (4.6) 0.0 0.0
Proceeds from borrowings 2,967.4 0.0 0.0
Repayments of borrowings (1,500.0) 0.0 (3.2)
Net contribution (distribution) to noncontrolling interest   4.3  
Net contribution (distribution) to noncontrolling interest (71.0)   (36.4)
Contingent consideration payments 0.0 0.0 (58.2)
Other 14.6 3.6 (21.6)
Net cash flows (used in) financing activities (5,272.7) (5,860.4) (4,472.0)
Net increase (decrease) in cash and cash equivalents (1,651.5) 1,688.7 (330.6)
Effect of exchange rate changes on cash and cash equivalents 69.0 0.4 (18.6)
Cash and cash equivalents, beginning of the year 2,913.7 1,224.6 1,573.8
Cash and cash equivalents, end of the year 1,331.2 2,913.7 1,224.6
Ionis Pharmaceuticals      
Cash flows from investing activities:      
Purchase of subsidiaries and affiliates 0.0 0.0 (462.9)
Sangamo Therapeutics, Inc. Agreement      
Cash flows from investing activities:      
Purchase of subsidiaries and affiliates (141.8) 0.0 0.0
Denali Therapeutics      
Cash flows from investing activities:      
Purchase of subsidiaries and affiliates (423.7) 0.0 0.0
Sage Therapeutics      
Cash flows from investing activities:      
Purchase of subsidiaries and affiliates $ (441.0) $ 0.0 $ 0.0