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Equity-based compensation - Summary of information of options outstanding (Details)
shares in Thousands
 12 Months Ended
Dec. 31, 2019
$ / shares
Dec. 31, 2018
shares
$ / shares
Dec. 31, 2017
shares
$ / shares
Novartis equity plan select, outside North America [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Number of share options outstanding in share-based payment arrangement (in shares) | shares   426 500
Weighted average remaining contractual life of outstanding share options   3 years 3 months 18 days  
Options outstanding, weighted average exercise price (in dollars per share)   $ 61.4 $ 61.1
Novartis equity plan select, outside North America [member] | Exercise Price Range, 45-55 [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Number of share options outstanding in share-based payment arrangement (in shares) | shares   32  
Weighted average remaining contractual life of outstanding share options   21 days  
Options outstanding, weighted average exercise price (in dollars per share)   $ 52.4  
Novartis equity plan select, outside North America [member] | Exercise Price Range, 45-55 [member] | Minimum [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Exercise price, share options granted (in dollars per share) $ 45    
Novartis equity plan select, outside North America [member] | Exercise Price Range, 45-55 [member] | Maximum [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Exercise price, share options granted (in dollars per share) 55    
Novartis equity plan select, outside North America [member] | Exercise Price Range, 56-66 [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Number of share options outstanding in share-based payment arrangement (in shares) | shares   394  
Weighted average remaining contractual life of outstanding share options   3 years 6 months  
Options outstanding, weighted average exercise price (in dollars per share)   $ 62.1  
Novartis equity plan select, outside North America [member] | Exercise Price Range, 56-66 [member] | Minimum [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Exercise price, share options granted (in dollars per share) 56    
Novartis equity plan select, outside North America [member] | Exercise Price Range, 56-66 [member] | Maximum [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Exercise price, share options granted (in dollars per share) 66    
Novartis equity plan select, North America [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Number of share options outstanding in share-based payment arrangement (in shares) | shares   1,288 1,800
Weighted average remaining contractual life of outstanding share options   3 years 6 months  
Options outstanding, weighted average exercise price (in dollars per share)   $ 62.6 $ 62.5
Novartis equity plan select, North America [member] | Exercise Price Range, 45-55 [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Number of share options outstanding in share-based payment arrangement (in shares) | shares   30  
Weighted average remaining contractual life of outstanding share options   18 days  
Options outstanding, weighted average exercise price (in dollars per share)   $ 50.7  
Novartis equity plan select, North America [member] | Exercise Price Range, 45-55 [member] | Minimum [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Exercise price, share options granted (in dollars per share) 45    
Novartis equity plan select, North America [member] | Exercise Price Range, 45-55 [member] | Maximum [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Exercise price, share options granted (in dollars per share) 55    
Novartis equity plan select, North America [member] | Exercise Price Range, 56-66 [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Number of share options outstanding in share-based payment arrangement (in shares) | shares   1,258  
Weighted average remaining contractual life of outstanding share options   3 years 7 months 6 days  
Options outstanding, weighted average exercise price (in dollars per share)   $ 62.9  
Novartis equity plan select, North America [member] | Exercise Price Range, 56-66 [member] | Minimum [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Exercise price, share options granted (in dollars per share) 56    
Novartis equity plan select, North America [member] | Exercise Price Range, 56-66 [member] | Maximum [member]      
Disclosure of range of exercise prices of outstanding share options [line items]      
Exercise price, share options granted (in dollars per share) $ 66