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Discontinued operations (Details) - USD ($)
$ in Millions
 12 Months Ended
Apr. 08, 2019
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Statement [line items]        
Net sales to third parties of discontinued operations   $ 48,659 $ 47,445 $ 44,751
Sales to continuing and discontinued segments     53 82
Net sales   48,659 47,498 44,833
Cost of goods sold   (15,121) (14,425) (14,510)
Gross profit   34,777 34,252 31,589
Selling, general and administration   (14,197) (14,369) (13,717)
Research and development   (8,980) (9,402) (8,489)
Other income   1,742 2,031 1,629
Other expense   (3,190) (3,426) (2,609)
Operating income of discontinued operations   10,152 9,086 8,403
Interest expense   (869) (850) (932)
Other financial income and expense   (78) 45 186
Income before taxes   9,878 8,940 14,095
Taxes   (1,807) (1,793) (1,295)
Net income/loss from discontinued operations before gain on distribution     (101) (186)
Gain on distribution of Alcon Inc. to Novartis AG shareholders $ 4,691   4,691  
Net income/loss from discontinued operations     4,590 (186)
Continuing operations        
Statement [line items]        
Income before taxes   9,878 8,940 14,095
Taxes   $ (1,807) (1,793) (1,295)
Discontinued operations        
Statement [line items]        
Net sales to third parties of discontinued operations     1,777 7,149
Sales to continuing and discontinued segments     32 4
Net sales     1,809 7,153
Cost of goods sold     (860) (3,983)
Gross profit     949 3,170
Selling, general and administration     (638) (2,754)
Research and development     (142) (585)
Other income     15 61
Other expense     (113) (126)
Operating income of discontinued operations     71 (234)
Interest expense     (10) (25)
Other financial income and expense     (3) (1)
Income before taxes     58 (260)
Taxes     (159) 74
Net income/loss from discontinued operations before gain on distribution     (101) (186)
Gain on distribution of Alcon Inc. to Novartis AG shareholders     4,691  
Net income/loss from discontinued operations     $ 4,590 $ (186)