Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Revenue (Note 2)	$ 34,124.1	$ 28,541.4	$ 28,318.4
Costs, expenses, and other:
Cost of sales	7,082.2	6,629.8	7,312.8
Research and development	9,313.4	7,190.8	6,930.7
Marketing, selling, and administrative	7,403.1	6,440.4	6,431.6
Acquired in-process research and development (Note 3)	3,799.8	908.5	970.1
Asset impairment, restructuring, and other special charges (Note 5)	67.7	244.6	316.1
Other—net, (income) expense (Note 18)	(96.7)	320.9	201.6
Costs, expenses, and other	27,569.5	21,735.0	22,162.9
Income before income taxes	6,554.6	6,806.4	6,155.5
Income taxes (Note 14)	1,314.2	561.6	573.8
Net income	$ 5,240.4	$ 6,244.8	$ 5,581.7
Earnings per share:
Basic (in dollars per share)	$ 5.82	$ 6.93	$ 6.15
Diluted (in dollars per share)	$ 5.80	$ 6.90	$ 6.12
Shares used in calculation of earnings per share:
Basic (in shares)	900,181	901,736	906,963
Diluted (in shares)	903,284	904,619	911,681