Income Taxes (Tables)

12 Months Ended

Dec. 31, 2017

Income Tax Disclosure [Abstract]

Schedule of earnings before income taxes

Earnings Before Income Tax Expense

years ended December 31 (in millions)	2017			2016			2015
Domestic	$	(2,678	)	$	(1,651	)	$	(1,038	)
Foreign	10,405			9,535			7,683
Total earnings before income tax expense	$	7,727		$	7,884		$	6,645

Schedule of income tax expense

Income Tax Expense

years ended December 31 (in millions)	2017			2016			2015
Current
Domestic	$	6,204		$	2,229		$	1,036
Foreign	376			498			313
Total current taxes	$	6,580		$	2,727		$	1,349
Deferred
Domestic	$	(4,898	)	$	(792	)	$	141
Foreign	736			(4		)	11
Total deferred taxes	$	(4,162	)	$	(796	)	$	152
Total income tax expense	$	2,418		$	1,931		$	1,501

Summary of effective tax rate reconciliation

Effective Tax Rate Reconciliation

years ended December 31	2017		2016		2015
Statutory tax rate	35.0	%	35.0	%	35.0	%
Effect of foreign operations	(12.2	)	(10.3	)	(9.4	)
U.S. tax credits	(4.0	)	(4.4	)	(4.5	)
Impacts related to U.S. tax reform	12.0		—		—
Tax law change related to foreign currency	—		2.4		—
All other, net	0.5		1.8		1.5
Effective tax rate	31.3	%	24.5	%	22.6	%

Schedule of deferred tax assets and liabilities

Deferred Tax Assets and Liabilities

as of December 31 (in millions)	2017			2016
Deferred tax assets
Compensation and employee benefits	$	556		$	718
Accruals and reserves	315			425
Chargebacks and rebates	305			473
Deferred revenue	219			391
Net operating losses and other credit carryforwards	208			151
Other	429			289
Total deferred tax assets	2,032			2,447
Valuation allowances	(108		)	(76		)
Total net deferred tax assets	1,924			2,371
Deferred tax liabilities
Excess of book basis over tax basis of intangible assets	(3,762		)	(5,487		)
Excess of book basis over tax basis in investments	(181		)	(3,367		)
Other	(203		)	(182		)
Total deferred tax liabilities	(4,146		)	(9,036		)
Net deferred tax liabilities	$	(2,222	)	$	(6,665	)

Schedule of unrecognized tax benefits

Unrecognized Tax Benefits

years ended December 31 (in millions)	2017			2016			2015
Beginning balance	$	1,168		$	954		$	421
Increase due to current year tax positions	1,768			118			187
Increase due to prior year tax positions	16			111			369
Decrease due to prior year tax positions	(2		)	(7		)	(15		)
Settlements	(233		)	—			—
Lapse of statutes of limitations	(16		)	(8		)	(8		)
Ending balance	$	2,701		$	1,168		$	954