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Equity-based compensation - Summary of non-vested share movements (Details) $ / shares in Units, shares in Thousands, $ in Thousands |  | 9 Months Ended | 12 Months Ended
--- | --- | --- | ---
Apr. 08, 2019 USD ($) shares | Dec. 31, 2019 USD ($) shares $ / shares | Dec. 31, 2018 USD ($) shares $ / shares
Disclosure of terms and conditions of share-based payment arrangement [line items] |  |  |
Non-vested shares at January 1 (in shares) |  | 4,222 | 2,800
Granted (in shares) | 4,200 | 700 |
Vested (in shares) |  | (108) | (814)
Forfeited (in shares) |  | (114) | (208)
Non-invested shares at December 31 (in shares) | 4,222 | 4,742 | 3,443
Outstanding, beginning balance, weighted average fair value at grant date (in dollars per share) | $ / shares |  |  | $ 74.4
Vested, weighted average fair value at grant date (in dollars per share) | $ / shares |  |  | 93.0
Forfeited, weighted average fair value at grant date (in dollars per share) | $ / shares |  |  | 80.4
Outstanding, ending balance, weighted average fair value at grant date (in dollars per share) | $ / shares |  | $ 51.2 | $ 72.9
Fair value, beginning balance, non-vested | $ |  | $ 212,367 | $ 208,300
Fair value, vested | $ |  | (5,432) | (75,702)
Fair value, forfeited | $ |  | (5,734) | (16,723)
Fair value, ending balance, non-vested | $ | $ 212,367 | $ 243,020 | $ 251,046
Restricted awards [Member] |  |  |
Disclosure of terms and conditions of share-based payment arrangement [line items] |  |  |
Granted (in shares) |  | 625 |
Granted, weighted average fair value at grant date (in dollars per share) | $ / shares |  | $ 56.1 |
Fair value, granted | $ |  | $ 35,037 |
Performance awards [Member] |  |  |
Disclosure of terms and conditions of share-based payment arrangement [line items] |  |  |
Granted (in shares) |  | 117 |
Granted, weighted average fair value at grant date (in dollars per share) | $ / shares |  | $ 58.0 |
Fair value, granted | $ |  | $ 6,782 |
Annual incentive [member] |  |  |
Disclosure of terms and conditions of share-based payment arrangement [line items] |  |  |
Granted (in shares) |  |  | 168
Granted, weighted average fair value at grant date (in dollars per share) | $ / shares |  |  | $ 83.7
Fair value, granted | $ |  |  | $ 14,062
Share savings plans [member] |  |  |
Disclosure of terms and conditions of share-based payment arrangement [line items] |  |  |
Granted (in shares) |  |  | 109
Granted, weighted average fair value at grant date (in dollars per share) | $ / shares |  |  | $ 85.5
Fair value, granted | $ |  |  | $ 9,320
Novartis equity plan select, North America [member] |  |  |
Disclosure of terms and conditions of share-based payment arrangement [line items] |  |  |
Granted (in shares) |  |  | 689
Granted, weighted average fair value at grant date (in dollars per share) | $ / shares |  |  | $ 77.9
Fair value, granted | $ |  |  | $ 53,673
Novartis equity plan select, outside North America [member] |  |  |
Disclosure of terms and conditions of share-based payment arrangement [line items] |  |  |
Granted (in shares) |  |  | 141
Granted, weighted average fair value at grant date (in dollars per share) | $ / shares |  |  | $ 79.8
Fair value, granted | $ |  |  | $ 11,252
Long-term performance plan [member] |  |  |
Disclosure of terms and conditions of share-based payment arrangement [line items] |  |  |
Granted (in shares) |  |  | 316
Granted, weighted average fair value at grant date (in dollars per share) | $ / shares |  |  | $ 88.4
Fair value, granted | $ |  |  | $ 27,934
Long-term relative performance plan [member] |  |  |
Disclosure of terms and conditions of share-based payment arrangement [line items] |  |  |
Granted (in shares) |  |  | 37
Granted, weighted average fair value at grant date (in dollars per share) | $ / shares |  |  | $ 51.2
Fair value, granted | $ |  |  | $ 1,894
Other share awards [member] |  |  |
Disclosure of terms and conditions of share-based payment arrangement [line items] |  |  |
Granted (in shares) |  |  | 205
Granted, weighted average fair value at grant date (in dollars per share) | $ / shares |  |  | $ 83.1
Fair value, granted | $ |  |  | $ 17,036

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