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Segmentation of key figures - Net sales by region (Details 7) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 48,659 $ 47,445 $ 44,751
Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 3.00% 6.00%  
Europe [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 18,715 $ 17,933 17,259
Europe [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 4.00% 4.00%  
US      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 16,484 $ 16,280 14,618
US | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 1.00% 11.00%  
Asia/Africa/Australasia [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 10,219 $ 9,799 9,460
Asia/Africa/Australasia [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 4.00% 4.00%  
Canada and Latin America [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 3,241 $ 3,433 3,414
Canada and Latin America [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % (6.00%) 1.00%  
Established Markets [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 36,732 $ 35,684 33,491
Established Markets [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 3.00% 7.00%  
Emerging Growth Markets [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 11,927 $ 11,761 11,260
Emerging Growth Markets [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 1.00% 4.00%  
Innovative Medicines | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 3.00% 8.00%  
Innovative Medicines | Europe [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 13,484 $ 12,818 12,296
Innovative Medicines | Europe [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 5.00% 4.00%  
Innovative Medicines | US      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 14,342 $ 13,789 11,864
Innovative Medicines | US | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 4.00% 16.00%  
Innovative Medicines | Asia/Africa/Australasia [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 8,718 $ 8,458 8,097
Innovative Medicines | Asia/Africa/Australasia [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 3.00% 4.00%  
Innovative Medicines | Canada and Latin America [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 2,469 $ 2,649 2,635
Innovative Medicines | Canada and Latin America [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % (7.00%) 1.00%  
Innovative Medicines | Established Markets [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 29,643 $ 28,573 26,258
Innovative Medicines | Established Markets [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 4.00% 9.00%  
Innovative Medicines | Emerging Growth Markets [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 9,370 $ 9,141 8,634
Innovative Medicines | Emerging Growth Markets [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 3.00% 6.00%  
Sandoz      
Disclosure of operating segments [line items]      
Net sales, change in % (1.00%) (1.00%)  
Sandoz | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % (1.00%) (1.00%)  
Sandoz | Europe [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 5,231 $ 5,115 4,963
Sandoz | Europe [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 2.00% 3.00%  
Sandoz | US      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 2,142 $ 2,491 2,754
Sandoz | US | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % (14.00%) (10.00%)  
Sandoz | Asia/Africa/Australasia [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 1,501 $ 1,341 1,363
Sandoz | Asia/Africa/Australasia [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 12.00% (2.00%)  
Sandoz | Canada and Latin America [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 772 $ 784 779
Sandoz | Canada and Latin America [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % (2.00%) 1.00%  
Sandoz | Established Markets [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 7,089 $ 7,111 7,233
Sandoz | Established Markets [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % 0.00% (2.00%)  
Sandoz | Emerging Growth Markets [member]      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 2,557 $ 2,620 2,626
Sandoz | Emerging Growth Markets [member] | Change to prior year-end [member]      
Disclosure of operating segments [line items]      
Net sales, change in % (2.00%) 0.00%  
Operating segments [member] | Innovative Medicines      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 39,013 $ 37,714 34,892
Net sales, change in % 3.00% 8.00%  
Operating segments [member] | Sandoz      
Disclosure of operating segments [line items]      
Net sales to third parties from continuing operations $ 9,646 $ 9,731 $ 9,859