Goodwill and other intangible assets - Schedule of Identifiable Intangible Assets (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Finite-lived intangible assets:
Gross carrying amounts	$ 55,229	$ 35,596
Accumulated amortization	(23,806)	(20,525)
Other intangible assets, net	31,423	15,071
Indefinite-lived intangible assets:
Identifiable intangible assets	56,447	36,605
Accumulated amortization	(23,806)	(20,525)
Identifiable intangible assets, net	32,641	16,080
IPR&D
Indefinite-lived intangible assets:
Indefinite-lived intangible assets	1,218	1,009
Developed-product-technology rights
Finite-lived intangible assets:
Gross carrying amounts	48,631	29,028
Accumulated amortization	(18,049)	(15,045)
Other intangible assets, net	30,582	13,983
Licensing rights
Finite-lived intangible assets:
Gross carrying amounts	3,865	3,864
Accumulated amortization	(3,265)	(3,123)
Other intangible assets, net	600	741
Marketing-related rights
Finite-lived intangible assets:
Gross carrying amounts	1,339	1,326
Accumulated amortization	(1,264)	(1,167)
Other intangible assets, net	75	159
R&D technology rights
Finite-lived intangible assets:
Gross carrying amounts	1,394	1,378
Accumulated amortization	(1,228)	(1,190)
Other intangible assets, net	$ 166	$ 188