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Post-employment benefits for employees (Details 1) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Pension plans      
Defined benefit plan, change in benefit obligation [roll forward]      
Benefit obligation at beginning of period $ 23,583 $ 25,602  
Current service cost 348 415  
Interest cost 249 151  
Past service cost and settlements (40) 63  
Administrative expenses 23 24  
Remeasurement losses/(gains) arising from changes in financial assumptions (5,046) (713)  
Remeasurement (gains) arising from changes in demographic assumptions (53) (377)  
Experience-related remeasurement losses/(gains) 199 531  
Currency translation effects (650) (865)  
Benefit payments (1,253) (1,450)  
Contributions of associates 174 179  
Effect of acquisitions, divestments or transfers (1) 23  
Benefit obligation at end of period 17,533 23,583  
Defined benefit plan, change in fair value of plan assets [roll forward]      
Fair value of plan assets at beginning of period 22,420 22,317  
Interest income 220 105  
Return on plan assets excluding interest income (2,500) 1,512  
Currency translation effects (539) (726)  
Novartis Group contributions 424 490  
Contributions of associates 174 179  
Settlements (1) (7)  
Benefit payments (1,253) (1,450)  
Fair value of plan assets at end of period 18,945 22,420  
Funded status 1,412 (1,163)  
Defined benefit plan, change in limitation on recognition of fund surplus [roll forward]      
Limitation on recognition of fund surplus at beginning of period (62) (51)  
Change in limitation on recognition of fund surplus (2,504) (16)  
Currency translation effects (76) 6  
Interest income on limitation of fund surplus (2) (1)  
Limitation on recognition of fund surplus at end of period (2,644) (62)  
Net liability in the balance sheet at end of period (1,232) (1,225) $ (3,336)
Pension plans | Switzerland      
Defined benefit plan, change in benefit obligation [roll forward]      
Benefit obligation at beginning of period 15,268    
Benefit obligation at end of period 11,824 15,268  
Defined benefit plan, change in fair value of plan assets [roll forward]      
Fair value of plan assets at beginning of period 16,436    
Fair value of plan assets at end of period 14,701 16,436  
Funded status 2,877 1,168  
Defined benefit plan, change in limitation on recognition of fund surplus [roll forward]      
Limitation on recognition of fund surplus at end of period 2,587    
Other post-employment benefit plans      
Defined benefit plan, change in benefit obligation [roll forward]      
Benefit obligation at beginning of period 560 632  
Current service cost 12 11  
Interest cost 17 16  
Past service cost and settlements 1 (3)  
Remeasurement losses/(gains) arising from changes in financial assumptions (94) (20)  
Remeasurement (gains) arising from changes in demographic assumptions   4  
Experience-related remeasurement losses/(gains) (28) (47)  
Currency translation effects (2) (1)  
Benefit payments (44) (32)  
Benefit obligation at end of period 422 560  
Defined benefit plan, change in fair value of plan assets [roll forward]      
Fair value of plan assets at beginning of period 73 89  
Interest income 2 2  
Return on plan assets excluding interest income (12) 7  
Novartis Group contributions 41 7  
Benefit payments (44) (32)  
Fair value of plan assets at end of period 60 73  
Funded status (362) (487)  
Defined benefit plan, change in limitation on recognition of fund surplus [roll forward]      
Net liability in the balance sheet at end of period $ (362) $ (487) $ (543)