Derivative instruments - Summary of Income and Expense Line Items (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Derivative [Line Items]
Total revenues	$ 28,190	$ 26,323	$ 25,979
Other income (expense), net	2,833	(814)	259
Interest expense, net	(2,875)	(1,406)	(1,197)
Cross-currency swap contract gains (losses) | Reclassification out of Accumulated Other Comprehensive Income | Cash flow hedges
Derivative [Line Items]
Other income (expense), net	42	(233)	(245)
Interest rate swap contracts
Derivative [Line Items]
Gains (losses) on fair value hedging relationships, Hedged Items	(118)	716	281
Gains (losses) on fair value hedging relationships, Derivatives designated as hedging instruments	205	(636)	(192)
Total product sales
Derivative [Line Items]
Total revenues	26,910	24,801	24,297
Total product sales | Foreign currency forward contracts | Reclassification out of Accumulated Other Comprehensive Income | Cash flow hedges
Derivative [Line Items]
Total revenues	$ 180	$ 231	$ (8)