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Financing arrangements - Debt Issuances and Acquisition-Related Financing (Details) - USD ($)	1 Months Ended	3 Months Ended
	Oct. 31, 2023	Mar. 31, 2023	Dec. 31, 2023	Oct. 06, 2023	Dec. 31, 2022	Dec. 31, 2021
Notes
Debt Instrument [Line Items]
Face amount		$ 24,000,000,000			$ 7,000,000,000	$ 5,000,000,000
Notes \| 3.00% notes due 2029 (3.00% 2029 Notes)
Debt Instrument [Line Items]
Face amount					$ 750,000,000
Interest rate, stated percentage			3.00%		3.00%
Notes \| 4.05% notes due 2029 (4.05% 2029 Notes)
Debt Instrument [Line Items]
Face amount					$ 1,250,000,000
Interest rate, stated percentage			4.05%		4.05%
Notes \| 3.35% notes due 2032 (3.35% 2032 Notes)
Debt Instrument [Line Items]
Face amount					$ 1,000,000,000
Interest rate, stated percentage			3.35%		3.35%
Notes \| 4.20% notes due 2033 (4.20% 2033 Notes)
Debt Instrument [Line Items]
Face amount					$ 750,000,000
Interest rate, stated percentage			4.20%		4.20%
Notes \| 4.20% notes due 2052 (4.20% 2052 Notes)
Debt Instrument [Line Items]
Face amount					$ 1,000,000,000
Interest rate, stated percentage			4.20%		4.20%
Notes \| 4.875% notes due 2053 (4.875% 2053 Notes)
Debt Instrument [Line Items]
Face amount					$ 1,000,000,000
Interest rate, stated percentage			4.875%		4.875%
Notes \| 4.40% notes due 2062 (4.40% 2062 Notes)
Debt Instrument [Line Items]
Face amount					$ 1,250,000,000
Interest rate, stated percentage			4.40%		4.40%
Notes \| 1.65% notes due in 2028 (1.65% 2028 Notes)
Debt Instrument [Line Items]
Face amount						$ 1,250,000,000
Interest rate, stated percentage			1.65%		1.65%	1.65%
Notes \| 2.00% notes due 2032 (2.00% 2032 Notes)
Debt Instrument [Line Items]
Face amount						$ 1,250,000,000
Interest rate, stated percentage						2.00%
Notes \| 2.80% notes due 2041 (2.80% 2041 Notes)
Debt Instrument [Line Items]
Face amount						$ 1,150,000,000
Interest rate, stated percentage						2.80%
Notes \| 3.00% notes due 2052 (3.00% 2052 Notes)
Debt Instrument [Line Items]
Face amount						$ 1,350,000,000
Interest rate, stated percentage			3.00%		3.00%	3.00%
Variable Rate Component Three \| term loan credit agreement \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable rate	1.225%
Horizon Therapeutics
Debt Instrument [Line Items]
Bridge credit reduced amount					$ 24,500,000,000
Term loan credit agreement, total amount					4,000,000,000
Term loan credit agreement, total borrowed				$ 4,000,000,000
Term loan credit agreement, due in April 2025				2,000,000,000
Term loan credit agreement, due in October 2026				$ 2,000,000,000
Term loan, outstanding					$ 0
Horizon Therapeutics \| Other Nonoperating Income (Expense)
Debt Instrument [Line Items]
Amortization of other deferred charges		$ 98,000,000