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Significant transactions (Details)
€ in Millions, shares in Millions
 1 Months Ended 12 Months Ended
Feb. 17, 2022
USD ($)
Dec. 22, 2021
USD ($)
Oct. 08, 2021
USD ($)
Jan. 31, 2020
USD ($)
Jan. 31, 2020
EUR (€)
Jan. 06, 2020
USD ($)
Nov. 23, 2019
USD ($)
Mar. 31, 2020
USD ($)
Dec. 31, 2022
USD ($)
Dec. 31, 2021
USD ($)
shares
Dec. 31, 2020
USD ($)
Dec. 31, 2022
SFr / shares
Feb. 10, 2021
Jan. 31, 2020
EUR (€)
Sep. 06, 2018
USD ($)
Disclosure of detailed information about business combination [line items]                              
Identifiable assets acquired (liabilities assumed)                 $ 1,077,000,000 $ 735,000,000 $ 10,173,000,000        
Par value per share | SFr / shares                       SFr 0.50      
Deferred tax liability (asset)                 (1,053,000,000) (673,000,000) (792,000,000)        
Intangible assets other than goodwill                 31,644,000,000 34,182,000,000          
Revenue from sale of goods                 50,545,000,000 51,626,000,000 48,659,000,000        
Borrowings                 22,485,000,000 25,523,000,000          
Depreciation, property, plant and equipment                 1,163,000,000 1,208,000,000          
Innovative Medicines                              
Disclosure of detailed information about business combination [line items]                              
Revenue from sale of goods                 42,121,000,000 42,790,000,000 39,805,000,000        
Sandoz                              
Disclosure of detailed information about business combination [line items]                              
Revenue from sale of goods                 9,454,000,000 9,811,000,000 9,835,000,000        
Corporate                              
Disclosure of detailed information about business combination [line items]                              
Revenue from sale of goods                 $ (1,030,000,000) (975,000,000) $ (981,000,000)        
Roche Holding AG, Switzerland                              
Disclosure of detailed information about business combination [line items]                              
Proceeds from disposal of non-current assets or disposal groups classified as held for sale and discontinued operations                   $ 20,700,000,000          
Number of bearer shares | shares                   53.3          
Gain on divestment of interests in associated companies                   $ 14,556,000,000          
Sandoz | Sandoz                              
Disclosure of detailed information about business combination [line items]                              
Consideration transferred, divestment-date fair value                             $ 800,000,000
Depreciation, property, plant and equipment               $ 38,000,000              
Amortisation, intangible assets other than goodwill               102,000,000              
Impairment loss recognised in profit or loss, intangible assets and goodwill               $ (42,000,000)              
Aspen Global Incorporated | Sandoz                              
Disclosure of detailed information about business combination [line items]                              
Consideration transferred, acquisition-date fair value       $ 324,000,000                   € 294.0  
Portion of consideration paid consisting of cash and cash equivalents upfront payment       (303,000,000) € (274.0)                    
Identifiable assets acquired (liabilities assumed)       238,000,000                      
Additional recognition, goodwill       86,000,000                      
Other net assets       26,000,000                      
Deferred tax liability (asset)       16,000,000                      
Intangible assets other than goodwill       196,000,000                      
Potential milestone maximum payments       77,000,000 70.0                    
Customary purchase price adjustment       30,000,000 € 27.0                    
Cash transferred       273,000,000                   247.0  
Contingent consideration recognised as of acquisition date       $ 51,000,000                   € 47.0  
The Medicines Company | Innovative Medicines                              
Disclosure of detailed information about business combination [line items]                              
Consideration transferred, acquisition-date fair value           $ 9,600,000,000                  
Portion of consideration paid (received) consisting of cash and cash equivalents             $ (9,600,000,000)                
Identifiable assets acquired (liabilities assumed)           7,100,000,000                  
Additional recognition, goodwill           2,500,000,000                  
Cash offer per ordinary share             $ 85                
Deferred tax liability (asset)           1,400,000,000                  
Intangible assets other than goodwill           $ 8,500,000,000                  
GlaxoSmithKline plc (GSK) | Sandoz                              
Disclosure of detailed information about business combination [line items]                              
Consideration transferred, acquisition-date fair value     $ 415,000,000                        
Portion of consideration paid consisting of cash and cash equivalents upfront payment     (350,000,000)                        
Identifiable assets acquired (liabilities assumed)     308,000,000                        
Additional recognition, goodwill     107,000,000                        
Deferred tax liability (asset)     16,000,000                        
Intangible assets other than goodwill     292,000,000                        
Number of brands in portfolio to acquire                         3    
Number of markets for the acquired brands                         100    
Potential milestone maximum payments     150,000,000                        
Cash transferred     351,000,000                        
Contingent consideration recognised as of acquisition date     $ 64,000,000                        
Gyroscope Therapeutics Holdings plc. | Innovative Medicines                              
Disclosure of detailed information about business combination [line items]                              
Consideration transferred, acquisition-date fair value $ 1,000,000,000.0                            
Portion of consideration paid consisting of cash and cash equivalents upfront payment (800,000,000) $ (800,000,000)                          
Identifiable assets acquired (liabilities assumed) 900,000,000                            
Additional recognition, goodwill 100,000,000                            
Deferred tax liability (asset) 200,000,000                            
Intangible assets other than goodwill 1,100,000,000                            
Potential milestone maximum payments   $ 700,000,000                          
Contingent consideration recognised as of acquisition date $ 200,000,000                            
Subsidiaries [member] | The Medicines Company                              
Disclosure of detailed information about business combination [line items]                              
Proportion of ownership interest in subsidiary                 100.00%