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Goodwill and intangible assets (Details 4) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Disclosure of detailed information about intangible assets [line items]      
Reversal of impairment charge   $ 37 $ 0
Operating segments [member]      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge $ (914) (1,175) (841)
Operating segments [member] | Innovative Medicines      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge (768) (669) (592)
Operating segments [member] | Sandoz      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge (141) (506) (249)
Operating segments [member] | Sandoz | Disposal groups classified as held for sale [member]      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge     (220)
Operating segments [member] | Corporate      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge (5)    
Accumulated depreciation, amortisation and impairment | Intangible Assets other than Goodwill      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge (914) (1,175)  
Reversal of impairment charge   37  
Accumulated depreciation, amortisation and impairment | Acquired research and development [member]      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge (515) (984)  
Reversal of impairment charge   37  
Accumulated depreciation, amortisation and impairment | Technologies      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge (40) (105)  
Accumulated depreciation, amortisation and impairment | Currently marketed products      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge (338) (54)  
Accumulated depreciation, amortisation and impairment | Other intangible assets      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge (21) (32)  
Accumulated depreciation, amortisation and impairment | Disposal groups classified as held for sale [member] | Currently marketed products      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge     (37)
Accumulated depreciation, amortisation and impairment | Innovative Medicines | Acquired research and development [member]      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge (485) (416)  
Accumulated depreciation, amortisation and impairment | Innovative Medicines | Votrient [member] | Acquired research and development [member]      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge $ (181)    
Accumulated depreciation, amortisation and impairment | Innovative Medicines | Votrient [member] | Currently marketed products      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge     $ (400)
Accumulated depreciation, amortisation and impairment | Innovative Medicines | Other [member] | Acquired research and development [member]      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge   (108)  
Accumulated depreciation, amortisation and impairment | Operating segments [member] | Acquired research and development [member]      
Disclosure of detailed information about intangible assets [line items]      
Impairment charge   $ (442)