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Consolidated cash flow statements - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Statement [line items]      
Net income $ 6,955 $ 24,018 $ 8,071
Reversal of non-cash items and other adjustments 11,546 (5,299) 9,881
Dividends received from associated companies and others 1 525 490
Interest received 254 13 47
Interest paid (696) (664) (703)
Other financial receipts 71   464
Other financial payments (32) (302) (39)
Income taxes paid (1,975) (2,342) (1,833)
Net cash flows from operating activities before working capital and provision changes 16,124 15,949 16,378
Payments out of provisions and other net cash movements in non-current liabilities (885) (1,119) (2,437)
Change in net current assets and other operating cash flow items (1,003) 241 (291)
Net cash flows from operating activities 14,236 15,071 13,650
Purchases of property, plant and equipment (1,198) (1,378) (1,275)
Proceeds from sale of property, plant and equipment 167 240 88
Purchases of intangible assets (1,473) (1,593) (1,310)
Proceeds from sale of intangible assets 202 748 380
Purchases of financial assets (121) (191) (230)
Proceeds from sale of financial assets 133 442 723
Purchases of other non-current assets (1) (61) (61)
Proceeds from sale of other non-current assets   4 2
Acquisitions and divestments of interests in associated companies, net (24) 20,669 (7)
Acquisitions and divestments of businesses, net (879) (567) (9,957)
Purchases of marketable securities, commodities and time deposits (34,695) (16,403) (1,900)
Proceeds from sale of marketable securities, commodities and time deposits 39,357 2,298 492
Net cash flows from/(used in) investing activities from continuing operations 1,468 4,208 (13,055)
Net cash flows used in investing activities from discontinued operations     (127)
Net cash flows from/(used in) investing activities 1,468 4,208 (13,182)
Dividends paid to shareholders of Novartis AG (7,506) (7,368) (6,987)
Acquisitions of treasury shares (10,652) (3,057) (2,842)
Proceeds from exercised options and other treasury share transactions, net 100 53 748
Increase in non-current financial debts 16 16 7,126
Repayments of the current portion of non-current financial debts (2,575) (2,162) (2,003)
Change in current financial debts 295 (3,524) 2,261
Payments of lease liabilities (295) (316) (312)
Impact of change in ownership of consolidated entities   (3) (2)
Other financing cash flows, net 55 97 (147)
Net cash flows used in financing activities from continuing operations (20,562) (16,264) (2,158)
Net cash flows used in financing activities from discontinued operations     (50)
Net cash flows used in financing activities (20,562) (16,264) (2,208)
Net change in cash and cash equivalents before effect of exchange rate changes (4,858) 3,015 (1,740)
Effect of exchange rate changes on cash and cash equivalents (32) (266) 286
Net change in cash and cash equivalents (4,890) 2,749 (1,454)
Cash and cash equivalents at beginning of period 12,407 9,658 11,112
Cash and cash equivalents at end of period $ 7,517 $ 12,407 $ 9,658