CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash flows from operating activities:
Net income	$ 4,338.4	$ 8,075.3	$ 3,513.2
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	341.4	286.2	235.9
Stock-based compensation expense	725.0	601.7	432.0
Losses (gains) on marketable and other securities, net	36.8	(387.0)	(221.8)
Other non-cash items, net	368.0	568.7	86.8
Deferred income taxes	(746.4)	(147.1)	75.6
Acquired in-process research and development in connection with asset acquisition	195.0	0.0	0.0
Changes in assets and liabilities:
Decrease (increase) in accounts receivable	707.8	(1,927.4)	(1,356.1)
Increase in inventories	(696.5)	(494.3)	(529.4)
(Increase) decrease in prepaid expenses and other assets	(148.6)	(240.7)	114.9
Increase (decrease) in deferred revenue	32.4	(120.2)	148.1
(Decrease) increase in accounts payable, accrued expenses, and other liabilities	(138.4)	866.1	118.9
Total adjustments	676.5	(994.0)	(895.1)
Net cash provided by operating activities	5,014.9	7,081.3	2,618.1
Cash flows from investing activities:
Purchases of marketable and other securities	(7,487.9)	(7,048.1)	(3,241.0)
Sales or maturities of marketable and other securities	5,550.5	2,215.3	3,785.0
Capital expenditures	(590.1)	(551.9)	(614.6)
Payments for Libtayo intangible asset	(1,026.8)	0.0	0.0
Asset acquisition, net of cash acquired	(230.3)	0.0	0.0
Net cash used in investing activities	(3,784.6)	(5,384.7)	(70.6)
Cash flows from financing activities:
Proceeds from issuance of Common Stock	1,519.5	1,672.3	2,575.2
Payments in connection with Common Stock tendered for employee tax obligations	(445.7)	(1,032.7)	(680.8)
Repurchases of Common Stock	(2,082.8)	(1,645.4)	(5,846.8)
Proceeds from issuance of long-term debt	0.0	0.0	1,981.9
Proceeds from bridge loan facility	0.0	0.0	1,500.0
Repayment of bridge loan facility	0.0	0.0	(1,500.0)
Net cash used in financing activities	(1,009.0)	(1,005.8)	(1,970.5)
Net increase in cash, cash equivalents, and restricted cash	221.3	690.8	577.0
Cash, cash equivalents, and restricted cash at beginning of period	2,898.1	2,207.3	1,630.3
Cash, cash equivalents, and restricted cash at end of period	3,119.4	2,898.1	2,207.3
Supplemental disclosure of cash flow information
Cash paid for interest (net of amounts capitalized)	53.7	55.8	23.2
Cash paid for income taxes	$ 1,502.4	$ 1,218.4	$ 188.1