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Post-employment benefits for employees (Details 2) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Amounts recognized in the consolidated balance sheet [abstract]    
Prepaid benefit cost $ 491 $ 1,415
Pension plans    
Defined benefit plan, change in net liability [roll forward]    
Net liability at beginning of period (1,225) (3,336)
Current service cost (348) (415)
Net interest expense (31) (47)
Administrative expenses (23) (24)
Past service cost and settlements 39 (70)
Remeasurements 2,400 2,071
Currency translation effects 35 145
Novartis Group contributions 424 490
Effect of acquisitions, divestments or transfers 1 (23)
Change in limitation on recognition of fund surplus (2,504) (16)
Net liability at end of period (1,232) (1,225)
Amounts recognized in the consolidated balance sheet [abstract]    
Prepaid benefit cost 491 1,415
Accrued benefit liability (1,723) (2,640)
Other post-employment benefit plans    
Defined benefit plan, change in net liability [roll forward]    
Net liability at beginning of period (487) (543)
Current service cost (12) (11)
Net interest expense (15) (14)
Past service cost and settlements (1) 3
Remeasurements 110 70
Currency translation effects 2 1
Novartis Group contributions 41 7
Net liability at end of period (362) (487)
Amounts recognized in the consolidated balance sheet [abstract]    
Accrued benefit liability $ (362) $ (487)