Property, plant and equipment - Components of Property, Plant and Equipment (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 15,749	$ 14,710
Less accumulated depreciation and amortization	(9,808)	(9,283)
Property, plant and equipment, net	5,941	5,427
Depreciation and amortization charges associated with property, plant and equipment	685	661	$ 644
Land
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	339	292
Buildings and improvements
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 4,507	4,201
Buildings and improvements | Minimum
Property, Plant and Equipment [Line Items]
Useful life (in years)	10 years
Buildings and improvements | Maximum
Property, Plant and Equipment [Line Items]
Useful life (in years)	40 years
Manufacturing equipment
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 3,220	3,105
Manufacturing equipment | Minimum
Property, Plant and Equipment [Line Items]
Useful life (in years)	8 years
Manufacturing equipment | Maximum
Property, Plant and Equipment [Line Items]
Useful life (in years)	12 years
Laboratory equipment
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 1,346	1,277
Laboratory equipment | Minimum
Property, Plant and Equipment [Line Items]
Useful life (in years)	8 years
Laboratory equipment | Maximum
Property, Plant and Equipment [Line Items]
Useful life (in years)	12 years
Fixed equipment
Property, Plant and Equipment [Line Items]
Useful life (in years)	12 years
Property, plant and equipment, gross	$ 2,526	2,478
Capitalized software
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 1,320	1,215
Capitalized software | Minimum
Property, Plant and Equipment [Line Items]
Useful life (in years)	3 years
Capitalized software | Maximum
Property, Plant and Equipment [Line Items]
Useful life (in years)	5 years
Other
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 941	929
Other | Minimum
Property, Plant and Equipment [Line Items]
Useful life (in years)	5 years
Other | Maximum
Property, Plant and Equipment [Line Items]
Useful life (in years)	10 years
Construction in progress
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 1,550	$ 1,213