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Financial instruments (Details) - USD ($) $ in Millions | 3 Months Ended | 6 Months Ended |
--- | --- | --- | ---
Jun. 30, 2025 | Jun. 30, 2024 | Jun. 30, 2025 | Jun. 30, 2024 | Dec. 31, 2024
Financial instruments fair value gains |  |  |  |  |
Net (losses)/gains on equity investments measured at fair value through other comprehensive income | $ (67) | $ 54 | $ (125) | $ 89 |
Non-cash and other movements |  |  | 304 | (550) |
Net cash inflow from operating activities |  |  | 7,099 | 5,571 |
Reconciliation of changes in contingent liabilities in business combination |  |  |  |  |
Contingent liabilities recognised in business combination at beginning of period |  |  | 1,751 | 2,137 |
Additions |  |  |  | 198 |
Settlements |  |  | (629) | (474) |
Revaluations |  |  | (30) | 251 |
Discount unwind |  |  | 32 | 57 |
Contingent liabilities recognised in business combination at end of period | 1,124 | $ 2,169 | 1,124 | 2,169 |
Diabetes alliance |  |  |  |  |
Reconciliation of changes in contingent liabilities in business combination |  |  |  |  |
Contingent liabilities recognised in business combination at beginning of period |  |  | 1,309 |  |
Settlements |  |  | (518) |  |
Revaluations |  |  | (30) |  |
Discount unwind |  |  | 21 |  |
Contingent liabilities recognised in business combination at end of period | 782 |  | 782 |  |
Increase/decrease in contingent consideration balance with change in current estimates | 78 |  | $ 78 |  |
Percentage of reasonably possible increase or decrease in sales estimates |  |  | 10.00% |  |
Other |  |  |  |  |
Reconciliation of changes in contingent liabilities in business combination |  |  |  |  |
Contingent liabilities recognised in business combination at beginning of period |  |  | $ 442 |  |
Settlements |  |  | (111) |  |
Discount unwind |  |  | 11 |  |
Contingent liabilities recognised in business combination at end of period | 342 |  | 342 |  |
Interest-Bearing Loans and Borrowings | Not measured at fair value in statement of financial position but for which fair value is disclosed |  |  |  |  |
Financial instruments fair value gains |  |  |  |  |
Carrying value, financial liabilities | 32,839 |  | 32,839 |  |
Financial liabilities, at fair value | 32,203 |  | 32,203 |  |
Financial assets at amortised cost |  |  |  |  |
Financial instruments fair value gains |  |  |  |  |
Cash collateral pledged to counterparties | 32 |  | 32 |  |
Other Investments | Financial assets measured at fair value |  |  |  |  |
Financial instruments fair value gains |  |  |  |  |
Financial assets | 1,880 |  | 1,880 |  |
Money market funds | Financial assets measured at fair value |  |  |  |  |
Financial instruments fair value gains |  |  |  |  |
Financial assets | 5,597 |  | 5,597 |  |
Derivatives | Financial assets measured at fair value |  |  |  |  |
Financial instruments fair value gains |  |  |  |  |
Financial assets | 504 |  | 504 |  |
Level 3 |  |  |  |  |
Financial instruments fair value gains |  |  |  |  |
Net (losses)/gains on equity investments measured at fair value through other comprehensive income |  |  | (35) | $ 1 |
Level 3 | Equity investments |  |  |  |  |
Financial instruments fair value gains |  |  |  |  |
Financial assets | 523 |  | 523 |  | $ 353
Level 3 | Equity investments | Financial assets measured at fair value |  |  |  |  |
Financial instruments fair value gains |  |  |  |  |
Financial assets | $ 523 |  | $ 523 |  |

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