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Goodwill and intangible assets (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period $ 63,777    
Additions 2,093 $ 1,736  
Intangible assets and goodwill at end of period 60,945 63,777  
Goodwill      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 29,595 29,999  
Impact of business combinations 161 238  
Disposals and derecognitions (28)    
Currency translation effects (427) (642)  
Intangible assets and goodwill at end of period 29,301 29,595 $ 29,999
Intangible Assets other than Goodwill      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 34,182 36,809  
Impact of business combinations 1,209 652  
Additions 2,093 1,736  
Disposals and derecognitions (100) (37)  
Amortization charge (3,982) (3,903)  
Impairment charge (1,326) (403) (914)
Currency translation effects (432) (672)  
Intangible assets and goodwill at end of period 31,644 34,182 36,809
Acquired research and development [member]      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 5,499 4,700  
Impact of business combinations 1,209 262  
Reclassifications (1,429) (20)  
Additions 330 958  
Disposals and derecognitions (95)    
Impairment charge (917) (350)  
Currency translation effects (176) (51)  
Intangible assets and goodwill at end of period 4,421 5,499 4,700
Technologies      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 177 230  
Reclassifications 2 15  
Amortization charge (37) (41)  
Impairment charge (15) (17)  
Currency translation effects (6) (10)  
Intangible assets and goodwill at end of period 121 177 230
Currently marketed products      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 27,106 30,767  
Impact of business combinations   292  
Reclassifications 1,403 5  
Additions 1,175 270  
Disposals and derecognitions (3) (36)  
Amortization charge (3,603) (3,607)  
Impairment charge (322) (1)  
Currency translation effects (243) (584)  
Intangible assets and goodwill at end of period 25,513 27,106 30,767
Other intangible assets      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 1,400 1,112  
Impact of business combinations   98  
Reclassifications 24    
Additions 588 508  
Disposals and derecognitions (2) (1)  
Amortization charge (342) (255)  
Impairment charge (72) (35)  
Currency translation effects (7) (27)  
Intangible assets and goodwill at end of period 1,589 1,400 1,112
Gross carrying amount | Goodwill      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 29,900 30,321  
Intangible assets and goodwill at end of period 29,596 29,900 30,321
Gross carrying amount | Intangible Assets other than Goodwill      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 68,211 67,725  
Intangible assets and goodwill at end of period 69,684 68,211 67,725
Gross carrying amount | Acquired research and development [member]      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 8,013 6,893  
Intangible assets and goodwill at end of period 7,092 8,013 6,893
Gross carrying amount | Technologies      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 1,080 1,115  
Intangible assets and goodwill at end of period 1,038 1,080 1,115
Gross carrying amount | Currently marketed products      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 56,213 57,333  
Intangible assets and goodwill at end of period 58,249 56,213 57,333
Gross carrying amount | Other intangible assets      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period 2,905 2,384  
Intangible assets and goodwill at end of period 3,305 2,905 2,384
Accumulated depreciation, amortisation and impairment | Goodwill      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period (305) (322)  
Intangible assets and goodwill at end of period (295) (305) (322)
Accumulated depreciation, amortisation and impairment | Intangible Assets other than Goodwill      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period (34,029) (30,916)  
Intangible assets and goodwill at end of period (38,040) (34,029) (30,916)
Accumulated depreciation, amortisation and impairment | Acquired research and development [member]      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period (2,514) (2,193)  
Intangible assets and goodwill at end of period (2,671) (2,514) (2,193)
Accumulated depreciation, amortisation and impairment | Technologies      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period (903) (885)  
Intangible assets and goodwill at end of period (917) (903) (885)
Accumulated depreciation, amortisation and impairment | Currently marketed products      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period (29,107) (26,566)  
Intangible assets and goodwill at end of period (32,736) (29,107) (26,566)
Accumulated depreciation, amortisation and impairment | Other intangible assets      
Disclosure of detailed information about intangible assets [line items]      
Intangible assets and goodwill at beginning of period (1,505) (1,272)  
Intangible assets and goodwill at end of period $ (1,716) $ (1,505) $ (1,272)