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Goodwill and intangible assets (Details 2) - USD ($)
$ in Millions
Dec. 31, 2020
Dec. 31, 2019
Disclosure of detailed information about intangible assets [line items]    
Net book value $ 66,808 $ 55,311
Operating segments [member] | Innovative Medicines    
Disclosure of detailed information about intangible assets [line items]    
Net book value 56,839 46,336
Operating segments [member] | Sandoz    
Disclosure of detailed information about intangible assets [line items]    
Net book value 9,817 8,892
Operating segments [member] | Corporate    
Disclosure of detailed information about intangible assets [line items]    
Net book value 152 83
Goodwill    
Disclosure of detailed information about intangible assets [line items]    
Net book value 29,999 26,524
Goodwill | Operating segments [member] | Innovative Medicines    
Disclosure of detailed information about intangible assets [line items]    
Net book value 21,718 18,750
Goodwill | Operating segments [member] | Sandoz    
Disclosure of detailed information about intangible assets [line items]    
Net book value 8,274 7,767
Goodwill | Operating segments [member] | Corporate    
Disclosure of detailed information about intangible assets [line items]    
Net book value 7 7
Intangible Assets other than Goodwill    
Disclosure of detailed information about intangible assets [line items]    
Net book value 36,809 28,787
Intangible Assets other than Goodwill | Operating segments [member] | Innovative Medicines    
Disclosure of detailed information about intangible assets [line items]    
Net book value 35,121 27,586
Intangible Assets other than Goodwill | Operating segments [member] | Sandoz    
Disclosure of detailed information about intangible assets [line items]    
Net book value 1,543 1,125
Intangible Assets other than Goodwill | Operating segments [member] | Corporate    
Disclosure of detailed information about intangible assets [line items]    
Net book value 145 76
Acquired research and development [member]    
Disclosure of detailed information about intangible assets [line items]    
Net book value 4,700 5,424
Acquired research and development [member] | Operating segments [member] | Innovative Medicines    
Disclosure of detailed information about intangible assets [line items]    
Net book value 4,548 5,339
Acquired research and development [member] | Operating segments [member] | Sandoz    
Disclosure of detailed information about intangible assets [line items]    
Net book value 152 85
Acquired research and development [member] | Operating segments [member] | Corporate    
Disclosure of detailed information about intangible assets [line items]    
Net book value 0  
Technologies    
Disclosure of detailed information about intangible assets [line items]    
Net book value 230 163
Technologies | Operating segments [member] | Innovative Medicines    
Disclosure of detailed information about intangible assets [line items]    
Net book value 3 7
Technologies | Operating segments [member] | Sandoz    
Disclosure of detailed information about intangible assets [line items]    
Net book value 227 156
Technologies | Operating segments [member] | Corporate    
Disclosure of detailed information about intangible assets [line items]    
Net book value 0  
Currently marketed products    
Disclosure of detailed information about intangible assets [line items]    
Net book value 30,767 22,579
Currently marketed products | Operating segments [member] | Innovative Medicines    
Disclosure of detailed information about intangible assets [line items]    
Net book value 29,645 21,720
Currently marketed products | Operating segments [member] | Sandoz    
Disclosure of detailed information about intangible assets [line items]    
Net book value 1,122 859
Currently marketed products | Operating segments [member] | Corporate    
Disclosure of detailed information about intangible assets [line items]    
Net book value 0  
Other intangible assets    
Disclosure of detailed information about intangible assets [line items]    
Net book value 1,112 621
Other intangible assets | Operating segments [member] | Innovative Medicines    
Disclosure of detailed information about intangible assets [line items]    
Net book value 925 520
Other intangible assets | Operating segments [member] | Sandoz    
Disclosure of detailed information about intangible assets [line items]    
Net book value 42 25
Other intangible assets | Operating segments [member] | Corporate    
Disclosure of detailed information about intangible assets [line items]    
Net book value $ 145 $ 76