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Deferred tax assets and liabilities (Details 3) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets $ 6,805 $ 2,986  
Tax loss carryforwards expired 14 9 $ 8
One year [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 20 14  
Two years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 6 28  
Three years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 8 34  
Four years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 23 62  
Five years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 51 164  
More than five years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 5,691 2,339  
Not subject to expiry [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 1,006 345  
Capitalized [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 3,025 2,338  
Capitalized [member] | One year [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets   0  
Capitalized [member] | Two years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 5 0  
Capitalized [member] | Three years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 6 6  
Capitalized [member] | Four years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets   46  
Capitalized [member] | Five years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 40 37  
Capitalized [member] | More than five years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 2,291 2,214  
Capitalized [member] | Not subject to expiry [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 683 35  
Not capitalized [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 3,780 648  
Not capitalized [member] | One year [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 20 14  
Not capitalized [member] | Two years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 1 28  
Not capitalized [member] | Three years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 2 28  
Not capitalized [member] | Four years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 23 16  
Not capitalized [member] | Five years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 11 127  
Not capitalized [member] | More than five years [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets 3,400 125  
Tax loss carry forwards 3,200    
Not capitalized [member] | More than five years [member] | The Medicines Company      
Statement [line items]      
Tax loss carry forwards 1,600    
Not capitalized [member] | Not subject to expiry [member]      
Statement [line items]      
Gross Value of tax loss carryforwards that have or have not been capitalized as deferred tax assets $ 323 $ 310