Quarterly financial data (unaudited) (Details) (USD $) In Millions, except Per Share data, unless otherwise specified	3 Months Ended								12 Months Ended
	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Quarterly Financial Information Disclosure [Abstract]
Product sales	$ 5,174	$ 4,848	$ 4,949	$ 4,356	$ 4,799	$ 4,647	$ 4,595	$ 4,151	$ 19,327	$ 18,192	$ 16,639
Gross profit from product sales	3,991	3,780	3,868	3,266	3,770	3,859	3,810	3,407
Net income	$ 1,294	$ 1,244	$ 1,547	$ 1,073	$ 1,021	$ 1,368	$ 1,258	$ 1,434	$ 5,158	$ 5,081	$ 4,345
Earnings per share:
Basic (in usd per share)	$ 1.70	$ 1.63	$ 2.04	$ 1.42	$ 1.35	$ 1.81	$ 1.67	$ 1.91	$ 6.80	$ 6.75	$ 5.61
Diluted (in usd per share)	$ 1.68	$ 1.61	$ 2.01	$ 1.40	$ 1.33	$ 1.79	$ 1.65	$ 1.88	$ 6.70	$ 6.64	$ 5.52