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Consolidated cash flow statements - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Statement [line items]      
Net income from continuing operations $ 8,071 $ 7,147 $ 12,800
Reversal of non-cash items and other adjustments 9,881 9,122 1,486
Dividends received from associated companies and others 490 463 719
Interest received 47 214 241
Interest paid (703) (793) (816)
Other financial receipts 464 28 218
Other financial payments (39) (33) (31)
Taxes paid (1,833) (1,876) (1,506)
Net cash flows from operating activities from continuing operations before working capital and provision changes 16,378 14,272 13,111
Payments out of provisions and other net cash movements in non-current liabilities (2,437) (924) (638)
Change in net current assets and other operating cash flow items (291) 199 576
Net cash flows from operating activities from continuing operations 13,650 13,547 13,049
Net cash flows from operating activities from discontinued operations   78 1,223
Total net cash flows from operating activities 13,650 13,625 14,272
Purchases of property, plant and equipment (1,275) (1,379) (1,254)
Proceeds from sale of property, plant and equipment 88 857 102
Purchases of intangible assets (1,310) (878) (1,394)
Proceeds from sale of intangible assets 380 973 823
Purchases of financial assets (230) (302) (205)
Proceeds from sale of financial assets 723 1,152 165
Purchases of other non-current assets (61) (60) (39)
Proceeds from sale of other non-current assets 2 3 9
Acquisitions and divestments of interests in associated companies, net (7) (6) 12,854
Acquisitions and divestments of businesses, net (9,957) (3,760) (13,683)
Purchases of marketable securities and commodities (1,900) (228) (2,440)
Proceeds from sale of marketable securities and commodities 492 2,561 472
Net cash flows used in investing activities from continuing operations (13,055) (1,067) (4,590)
Net cash flows used in investing activities from discontinued operations (127) (1,159) (1,001)
Total net cash flows used in investing activities (13,182) (2,226) (5,591)
Dividends paid to shareholders of Novartis AG (6,987) (6,645) (6,966)
Acquisitions of treasury shares (2,842) (5,533) (2,036)
Proceeds from exercised options and other treasury share transactions, net 748 201 700
Increase in non-current financial debts 7,126 93 2,856
Repayments of non-current financial debts (2,003) (3,195) (366)
Change in current financial debts 2,261 (1,582) 1,687
Payments of lease liabilities, net (312) (273)  
Impact of change in ownership of consolidated entities (2) (6) (19)
Other financing cash flows, net (147) 56 67
Net cash flows used in financing activities from continuing operations (2,158) (16,884) (4,077)
Net cash flows used in/from financing activities from discontinued operations (50) 3,257 (167)
Total net cash flows used in financing activities (2,208) (13,627) (4,244)
Net change in cash and cash equivalents before effect of exchange rate changes (1,740) (2,228) 4,437
Effect of exchange rate changes on cash and cash equivalents 286 69 (26)
Total net change in cash and cash equivalents (1,454) (2,159) 4,411
Cash and cash equivalents at beginning of period 11,112 13,271 8,860
Cash and cash equivalents at end of period $ 9,658 $ 11,112 $ 13,271