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Associated companies (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Disclosure of associates [line items]      
Net income statement effect $ 673 $ 659 $ 6,438
Other comprehensive income effect (56) (94) (482)
Total comprehensive income effect 617 565 5,956
Recycling of the Novartis share of other comprehensive income from associated companies     (511)
Roche Holding AG, Switzerland      
Disclosure of associates [line items]      
Net income statement effect 677 662 526
Other comprehensive income effect (56) (94) 75
Total comprehensive income effect 621 568 601
GlaxoSmithKline Consumer Healthcare Holdings Ltd., UK      
Disclosure of associates [line items]      
Net income statement effect     5,910
Other comprehensive income effect     (557)
Total comprehensive income effect     5,353
Others      
Disclosure of associates [line items]      
Net income statement effect (4) (3) 2
Total comprehensive income effect $ (4) $ (3) $ 2