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Taxes - Analysis of tax rate (Details) - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018
Reconciliation of accounting profit multiplied by applicable tax rates [abstract] |  |  |
Applicable tax rate | $ 98 | $ 39 | $ 82
Effect of disallowed expenditures | (20) | (23) | (26)
Effect of equity-based compensation | (5) | (1) | (2)
Effect of income taxed at reduced rates | 4 | 2 | 2
Effect of tax credits and allowances | 9 | 7 | 13
Effect of adjustments to contingent consideration and other liabilities | 17 | 11 | 11
Effect of option payments | (6) | (12) | (17)
Tax effect from change in tax rate | 10 | (342) | (14)
Effect of changes in uncertain tax positions | (8) | 10 | (33)
Effect of other items | (10) | (2) | (4)
Tax effect of prior year items | (15) | 13 | (61)
Total income tax income/(expense) | $ 104 | $ (324) | $ 73
Reconciliation of average effective tax rate and applicable tax rate [abstract] |  |  |
Applicable tax rate | 15.40% | 11.70% | 27.30%
Effect of disallowed expenditures | (3.10%) | (6.90%) | (8.70%)
Effect of equity-based compensation | (0.80%) | (0.30%) | (0.70%)
Effect of income taxed at reduced rates | 0.60% | 0.60% | 0.70%
Effect of tax credits and allowances | 1.40% | 2.10% | 4.30%
Effect of adjustments to contingent consideration and other liabilities | 2.70% | 3.30% | 3.70%
Effect of option payments | (0.90%) | (3.60%) | (5.70%)
Effect of tax rate changes | 1.60% | (103.00%) | (4.70%)
Effect of changes in uncertain tax positions | (1.30%) | 3.00% | (11.00%)
Effect of other items | (1.60%) | (0.60%) | (1.20%)
Effect of prior year items | 2.40% | (3.90%) | 20.30%
Effective tax rate | 16.40% | (97.60%) | 24.30%
Adjustments for current tax of prior periods | $ 15 | $ 13 | $ (61)
Switzerland [member] |  |  |
Reconciliation of accounting profit multiplied by applicable tax rates [abstract] |  |  |
Effect of tax rate change on current and deferred tax assets and liabilities from US tax reform |  | 304 |
United States [member] |  |  |
Reconciliation of accounting profit multiplied by applicable tax rates [abstract] |  |  |
Effect of tax rate change on current and deferred tax assets and liabilities from US tax reform |  | $ 31 |

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