Amgen (AMGN) 10-Q27 Apr 232023 Q1 Quarterly reportFinancial data

Company Profile

Cover Page

Cover Page - shares	3 Months Ended
Cover Page - shares	Mar. 31, 2023	Apr. 24, 2023
Entity Information [Line Items]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2023
Document Transition Report	false
Entity File Number	001-37702
Entity Registrant Name	Amgen Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	95-3540776
Entity Address, Address Line One	One Amgen Center Drive
Entity Address, City or Town	Thousand Oaks
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	91320-1799
City Area Code	805
Local Phone Number	447-1000
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		534,326,594
Entity Central Index Key	0000318154
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1
Current Fiscal Year End Date	--12-31
The NASDAQ Global Select Market \| Common Stock
Entity Information [Line Items]
Title of 12(b) Security	Common stock, $0.0001 par value
Trading Symbol	AMGN
Security Exchange Name	NASDAQ
The NASDAQ Global Select Market \| 2.00% Senior Notes Due 2026
Entity Information [Line Items]
Title of 12(b) Security	2.00% Senior Notes due 2026
Trading Symbol	AMGN26
Security Exchange Name	NASDAQ

Condensed Consolidated Statemen

Condensed Consolidated Statements of Comprehensive Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 2,841	$ 1,476
Other comprehensive (loss) income, net of reclassification adjustments and taxes:
Foreign currency translation	28	(51)
Cash flow hedges	(86)	84
Other	21	0
Other comprehensive (loss) income, net of reclassification adjustments and taxes	(37)	33
Comprehensive income	$ 2,804	$ 1,509

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Income - USD ($) shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Revenues:
Total revenues	$ 6,105	$ 6,238
Operating expenses:
Cost of sales	1,720	1,561
Research and development	1,058	959
Selling, general and administrative	1,258	1,228
Other	148	(10)
Total operating expenses	4,184	3,738
Operating income	1,921	2,500
Interest expense, net	(543)	(295)
Other income (expense), net	2,064	(530)
Income before income taxes	3,442	1,675
Provision for income taxes	601	199
Net income	$ 2,841	$ 1,476
Earnings per share:
Basic (in usd per share)	$ 5.32	$ 2.69
Diluted (in usd per share)	$ 5.28	$ 2.68
Shares used in calculation of earnings per share:
Basic (in shares)	534	548
Diluted (in shares)	538	551
Product sales
Revenues:
Total revenues	$ 5,846	$ 5,731
Other revenues
Revenues:
Total revenues	$ 259	$ 507

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 31,560	$ 7,629
Marketable securities	1	1,676
Trade receivables, net	5,736	5,563
Inventories	5,011	4,930
Other current assets	2,395	2,388
Total current assets	44,703	22,186
Property, plant and equipment, net	5,460	5,427
Intangible assets, net	15,393	16,080
Goodwill	15,531	15,529
Other noncurrent assets	7,633	5,899
Total assets	88,720	65,121
Current liabilities:
Accounts payable	1,320	1,572
Accrued liabilities	12,061	12,524
Current portion of long-term debt	834	1,591
Total current liabilities	14,215	15,687
Long-term debt	60,761	37,354
Long-term tax liabilities	5,864	5,757
Other noncurrent liabilities	2,532	2,662
Contingencies and commitments
Stockholders’ equity:
Common stock and additional paid-in capital; $0.0001 par value; 2,750.0 shares authorized; outstanding—534.3 shares in 2023 and 534.0 shares in 2022	32,535	32,514
Accumulated deficit	(26,919)	(28,622)
Accumulated other comprehensive loss	(268)	(231)
Total stockholders’ equity	5,348	3,661
Total liabilities and stockholders’ equity	$ 88,720	$ 65,121

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares shares in Millions	Mar. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Common stock and additional paid-in capital, par value (in usd per share)	$ 0.0001	$ 0.0001
Common stock and additional paid-in capital, shares authorized (in shares)	2,750	2,750
Common stock and additional paid-in capital, shares outstanding (in shares)	534.3	534

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Stockholders' Equity - USD ($) shares in Millions, $ in Millions	Total	Number of shares of common stock	Common stock and additional paid-in capital	Accumulated deficit	Accumulated other comprehensive loss
Beginning Balance (in shares) at Dec. 31, 2021		558.3
Balance as of beginning of period at Dec. 31, 2021	$ 6,700		$ 32,096	$ (24,600)	$ (796)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income for basic and diluted EPS	1,476			1,476
Other comprehensive loss, net of taxes	33				33
Dividends declared on common stock	(1,034)			(1,034)
Issuance of common stock in connection with the Company’s equity award programs (in shares)		0.5
Issuance of common stock in connection with the Company’s equity award programs	18		18
Stock-based compensation expense	78		78
Tax impact related to employee stock-based compensation expense	(45)		(45)
Repurchases of common stock (in shares)		(24.6)
Repurchases of common stock	(6,310)		(900)	(5,410)
Ending Balance (in shares) at Mar. 31, 2022		534.2
Balance as of end of period at Mar. 31, 2022	$ 916		31,247	(29,568)	(763)
Beginning Balance (in shares) at Dec. 31, 2022	534	534
Balance as of beginning of period at Dec. 31, 2022	$ 3,661		32,514	(28,622)	(231)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income for basic and diluted EPS	2,841			2,841
Other comprehensive loss, net of taxes	(37)				(37)
Dividends declared on common stock	(1,138)			(1,138)
Issuance of common stock in connection with the Company’s equity award programs (in shares)		0.3
Issuance of common stock in connection with the Company’s equity award programs	11		11
Stock-based compensation expense	47		47
Tax impact related to employee stock-based compensation expense	$ (37)		(37)
Ending Balance (in shares) at Mar. 31, 2023	534.3	534.3
Balance as of end of period at Mar. 31, 2023	$ 5,348		$ 32,535	$ (26,919)	$ (268)

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Stockholders' Equity (Parenthetical) - $ / shares	1 Months Ended		3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2023	Mar. 31, 2022
Statement of Stockholders' Equity [Abstract]
Common stock, dividends declared per share (in usd per share)	$ 2.13	$ 2.13	$ 2.13	$ 1.94

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Cash flows from operating activities:
Net income	$ 2,841	$ 1,476
Depreciation, amortization and other	900	841
Deferred income taxes	(49)	(251)
Adjustments for equity method investments	(31)	305
(Gains) losses on equity securities	(1,830)	211
Other items, net	(13)	29
Changes in operating assets and liabilities, net of acquisitions:
Trade receivables, net	(144)	(195)
Inventories	(58)	(230)
Other assets	(139)	(43)
Accounts payable	(253)	42
Accrued income taxes, net	443	318
Long-term tax liabilities	107	57
Other liabilities	(710)	(396)
Net cash provided by operating activities	1,064	2,164
Cash flows from investing activities:
Proceeds from sales of marketable securities	1,124	0
Proceeds from maturities of marketable securities	550	32
Purchases of property, plant and equipment	(344)	(190)
Other	28	47
Net cash provided by (used in) investing activities	1,358	(111)
Cash flows from financing activities:
Net proceeds from issuance of debt	23,798	3,952
Extinguishment of debt	(420)	0
Repayment of debt	(704)	0
Repurchases of common stock	0	(6,360)
Dividends paid	(1,137)	(1,080)
Other	(28)	(26)
Net cash provided by (used in) financing activities	21,509	(3,514)
Increase (decrease) in cash and cash equivalents	23,931	(1,461)
Cash and cash equivalents at beginning of period	7,629	7,989
Cash and cash equivalents at end of period	$ 31,560	$ 6,528

Summary of significant accounti

Summary of significant accounting policies	3 Months Ended
Summary of significant accounting policies	Mar. 31, 2023
Accounting Policies [Abstract]
Summary of significant accounting policies	Summary of significant accounting policies Business Amgen Inc. (including its subsidiaries, referred to as “Amgen,” “the Company,” “we,” “our” or “us”) is a global biotechnology pioneer that discovers, develops, manufactures and delivers innovative human therapeutics. We operate in one business segment: human therapeutics. Basis of presentation The financial information for the three months ended March 31, 2023 and 2022, is unaudited but includes all adjustments (consisting of only normal, recurring adjustments unless otherwise indicated), which Amgen considers necessary for a fair presentation of its condensed consolidated results of operations for those periods. Interim results are not necessarily indicative of results for the full fiscal year. The condensed consolidated financial statements should be read in conjunction with our consolidated financial statements and the notes thereto contained in our Annual Report on Form 10-K for the year ended December 31, 2022. Principles of consolidation The condensed consolidated financial statements include the accounts of Amgen as well as its majority-owned subsidiaries. In determining whether we are the primary beneficiary of a variable interest entity, we consider whether we have both the power to direct activities of the entity that most significantly impact the entity’s economic performance and the obligation to absorb losses of, or the right to receive benefits from, the entity that could potentially be significant to that entity. We do not have any significant interests in any variable interest entities of which we are the primary beneficiary. All material intercompany transactions and balances have been eliminated in consolidation. Use of estimates The preparation of condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. Actual results may differ from those estimates. Property, plant and equipment, net Property, plant and equipment is recorded at historical cost, net of accumulated depreciation and amortization, of $9.4 billion and $9.3 billion as of March 31, 2023 and December 31, 2022, respectively. Recent accounting pronouncements No new accounting pronouncements were issued or adopted for the three months ended March 31, 2023, that materially impacted the Company.

Restructuring

Restructuring	3 Months Ended
Restructuring	Mar. 31, 2023
Restructuring and Related Activities [Abstract]
Restructuring	Restructuring In the first quarter of 2023, we initiated a restructuring plan to enhance continued innovation, including investments in first-in-class medicines, while improving our cost structure. As part of the plan, we are reallocating resources to the areas of the business that will enable long-term growth. We estimate that we will incur $300 million to $400 million of pretax charges in 2023 in connection with our restructuring plan, including (i) separation and other headcount-related costs with respect to staff reductions and (ii) asset-related charges that consist primarily of asset impairments, accelerated depreciation and other related costs resulting from the rationalization of our geographic footprint. During the three months ended March 31, 2023, we incurred total separation and other headcount-related costs of $141 million recorded in Other operating expenses in the Condensed Consolidated Statements of Income and asset-related and other charges of $38 million, consisting primarily of asset-related impairments recorded in Cost of sales in the Condensed Consolidated Statements of Income. As of March 31, 2023, the total restructuring liability of $132 million was included in Accrued liabilities in the Condensed Consolidated Balance Sheets.

Acquisitions and divestitures

Acquisitions and divestitures	3 Months Ended
Acquisitions and divestitures	Mar. 31, 2023
Business Combination and Asset Acquisition [Abstract]
Acquisitions and divestitures	Acquisitions and divestitures Proposed acquisition of Horizon Therapeutics plc On December 12, 2022, we announced that we had entered into a transaction agreement under which Amgen will acquire all shares of Horizon for $116.50 per share in cash for a transaction equity value of approximately $27.8 billion. Horizon is a global biotechnology company headquartered in Dublin, Ireland and is focused on the discovery, development and commercialization of medicines that address critical needs for people impacted by rare, autoimmune and severe inflammatory diseases. Horizon has 12 marketed medicines and a pipeline with more than 20 development programs. The closing of this transaction is contingent upon satisfaction of certain regulatory (including FTC review) and other customary closing conditions. On January 30, 2023, the Company and Horizon each received a request for additional information and documentary materials (Second Request) from the FTC in connection with the FTC’s review of the Company’s proposed acquisition of Horizon. We and Horizon have been working cooperatively with the FTC and will continue to do so. Additionally, the Irish High Court set a court hearing date of May 22, 2023, to consider the application to sanction our proposed acquisition of Horizon. The Irish High Court will be informed in advance if the hearing date needs to be adjourned to a later date as a result of a condition to closing, including required regulatory clearances, not having been satisfied by the scheduled hearing date. In connection with our proposed acquisition of Horizon, we entered into several debt and financing arrangements. See Note 10, Financing arrangements. Acquisition of ChemoCentryx, Inc. On October 20, 2022, we acquired all the outstanding stock of ChemoCentryx, a publicly traded biotechnology company focused on orally-administered therapeutics to treat autoimmune diseases, inflammatory disorders and cancer, for $52.00 per share in cash, representing a total consideration of $3.9 billion. The acquisition, which was accounted for as a business combination, includes TAVNEOS, an orally administered selective complement 5a receptor inhibitor that was approved by the FDA in October 2021 as an adjunctive therapy for adults with severe active anti-neutrophil cytoplasmic autoantibody-associated vasculitis (ANCA-associated vasculitis). TAVNEOS is commercialized by us in the United States; for markets outside the United States, TAVNEOS is commercialized by a collaboration partner, and Amgen is entitled to royalties and milestones based off future sales of the product. Upon its acquisition, ChemoCentryx became a wholly owned subsidiary of Amgen, and its operations have been included in our consolidated financial statements commencing on the acquisition date. Measurement period adjustments during the three months ended March 31, 2023, included changes to the purchase price allocation and total consideration, resulting in a net decrease of approximately $4 million to goodwill. The measurement period adjustments resulted primarily from valuation inputs pertaining to the TAVNEOS intangible assets and adjustments to vendor payables based on facts and circumstances that existed as of the acquisition date and did not result from events subsequent to the acquisition date. The adjustments did not have a significant impact on Amgen’s results of operations during the three months ended March 31, 2023, and would not have had a significant impact on prior-period results if the adjustments had been made as of the acquisition date. The following table summarizes the total consideration and allocated acquisition date fair values of assets acquired and liabilities assumed, inclusive of measurement period adjustments (in millions): Amounts Cash and cash equivalents $ 86 Marketable securities 235 Inventories 41 Finite-lived intangible assets – developed-product-technology rights 3,499 Goodwill 663 Other liabilities, net (83) Deferred tax liability, net (516) Total assets acquired, net $ 3,925 The $3.9 billion total consideration consisted of (i) a $3.7 billion cash payment to outstanding common stockholders of ChemoCentryx and (ii) a $181 million cash payment to equity award holders of ChemoCentryx for services rendered prior to the acquisition date of October 20, 2022, under the ChemoCentryx equity award plans. The developed-product-technology rights acquired relates to TAVNEOS, which is approved in the United States and European Union for ANCA-associated vasculitis. The estimated fair values of $3.5 billion were determined by using a multi-period excess earnings income approach that discounts expected future cash flows to present value by applying a discount rate that represents the estimated rate that market participants would use to value the intangible assets. The developed-product-technology rights are being amortized on a straight-line basis over a weighted-average period of approximately 11 years using the straight-line method. The estimated fair value of the acquired inventory of $41 million was determined using the comparative sales method, which uses actual or expected selling prices of inventory as the base amount to which adjustments for selling effort and a profit on the buyer’s effort are applied. The inventory fair value adjustment is being amortized as inventory turns over, which we estimate to be approximately 13 months. A net deferred tax liability of $516 million was recognized on the temporary differences related to the book bases and tax bases of the acquired identifiable assets and assumed liabilities, primarily driven by the intangible assets acquired. The excess of the acquisition date consideration over the fair values assigned to the assets acquired and the liabilities assumed of $663 million was recorded as goodwill, which is not deductible for tax purposes. The goodwill value is primarily attributable to the expected synergies from the TAVNEOS asset. Our accounting for this acquisition is preliminary and will be finalized upon completion of our analysis to determine the acquisition date fair values of certain assets acquired, liabilities assumed and tax-related items as we obtain additional information during the measurement period of up to one year from the acquisition date. Divestiture of Gensenta İlaç Sanayi ve Ticaret A.Ş. On November 2, 2022, we sold our shares in Gensenta, a subsidiary in Turkey, to Eczacıbaşı for net cash proceeds of approximately $130 million. The transaction was accounted for as a sale of a business and did not meet the criteria to be classified as discontinued operations. Upon closing of this transaction, net assets related to Gensenta of $86 million were divested, and during the year ended December 31, 2022, we recognized a loss on divestiture of $567 million, recorded in Other operating expenses in the Consolidated Statements of Income, primarily due to the reclassification of $615 million of cumulative foreign currency translation losses from AOCI into earnings.

Revenues

Revenues	3 Months Ended
Revenues	Mar. 31, 2023
Revenue from Contract with Customer [Abstract]
Revenues	Revenues We operate in one business segment: human therapeutics. Therefore, results of our operations are reported on a consolidated basis for purposes of segment reporting, consistent with internal management reporting. Revenues by product and by geographic area, based on customers’ locations, are presented below. The majority of ROW revenues relates to products sold in Europe. Revenues were as follows (in millions): Three months ended March 31, 2023 2022 U.S. ROW Total U.S. ROW Total Prolia $ 623 $ 304 $ 927 $ 582 $ 270 $ 852 ENBREL 564 15 579 843 19 862 XGEVA 384 152 536 368 134 502 Otezla 294 98 392 350 101 451 Repatha 197 191 388 165 164 329 Nplate 246 116 362 156 110 266 KYPROLIS 234 124 358 196 91 287 Aranesp 115 240 355 137 221 358 EVENITY 164 90 254 110 60 170 Other products (1) 1,154 541 1,695 1,130 524 1,654 Total product sales (2) $ 3,975 $ 1,871 5,846 $ 4,037 $ 1,694 5,731 Other revenues 259 507 Total revenues $ 6,105 $ 6,238 ____________ (1) Consists of product sales of our non-principal products, as well as our Bergamo and Gensenta subsidiaries. (2) Hedging gains and losses, which are included in product sales, were not material for the three months ended March 31, 2023 and 2022.

Income taxes

Income taxes	3 Months Ended
Income taxes	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Income taxes	Income taxes The effective tax rates for the three months ended March 31, 2023 and 2022, were 17.5% and 11.9%, respectively. The increase in our effective tax rate for the three months ended March 31, 2023, was primarily due to the new Puerto Rico income tax beginning in 2023 and an increase in interest expense on tax reserves. The effective tax rates differ from the federal statutory rate primarily as a result of foreign earnings from the Company’s operations conducted in Puerto Rico, a territory of the United States treated as a foreign jurisdiction for U.S. tax purposes, that are currently subject to a tax incentive grant through 2050. In addition, the Company’s operations conducted in Singapore are subject to a tax incentive grant through 2034. These foreign earnings are also subject to U.S. tax at a reduced rate of 10.5%. We are no longer subject to a 4% excise tax in the U.S. territory of Puerto Rico on the gross intercompany purchase price of goods and services from our manufacturer in Puerto Rico. As of January 1, 2023, we qualify for the alternative income tax rate on industrial development income of our Puerto Rico affiliate. In the United States, this income tax qualifies for foreign tax credits. Both this income tax and the associated foreign tax credits are generally recognized in our provision for income taxes. We account for the 2022 excise tax that was capitalized in Inventories as an expense in Cost of sales when the related products are sold in 2023, and a foreign tax credit will not be recognized in 2023 with respect to the excise tax. One or more of our legal entities file income tax returns in the U.S. federal jurisdiction, various U.S. state jurisdictions and certain foreign jurisdictions. Our income tax returns are routinely examined by tax authorities in those jurisdictions. Significant disputes can and have arisen with tax authorities involving issues regarding the timing and amount of deductions, the use of tax credits and allocations of income and expenses among various tax jurisdictions because of differing interpretations of tax laws, regulations and relevant facts. Tax authorities, including the IRS, are becoming more aggressive and are particularly focused on such matters. In 2017, we received an RAR and a modified RAR from the IRS for the years 2010–2012, proposing significant adjustments that primarily relate to the allocation of profits between certain of our entities in the United States and the U.S. territory of Puerto Rico. We disagreed with the proposed adjustments and calculations and pursued resolution with the IRS appeals office but were unable to reach resolution. In July 2021, we filed a petition in the U.S. Tax Court to contest two duplicate Statutory Notices of Deficiency (Notices) for the years 2010–2012 that we received in May and July 2021, which seek to increase our U.S. taxable income for the years 2010–2012 by an amount that would result in additional federal tax of approximately $3.6 billion plus interest. Any additional tax that could be imposed for the years 2010–2012 would be reduced by up to approximately $900 million of repatriation tax previously accrued on our foreign earnings. In 2020, we received an RAR and a modified RAR from the IRS for the years 2013–2015, also proposing significant adjustments that primarily relate to the allocation of profits between certain of our entities in the United States and the U.S. territory of Puerto Rico similar to those proposed for the years 2010–2012. We disagreed with the proposed adjustments and calculations and pursued resolution with the IRS appeals office but were unable to reach resolution. In July 2022, we filed a petition in the U.S. Tax Court to contest a Notice for the years 2013–2015 that we previously reported receiving in April 2022 that seeks to increase our U.S. taxable income for the years 2013–2015 by an amount that would result in additional federal tax of approximately $5.1 billion, plus interest. In addition, the Notice asserts penalties of approximately $2.0 billion. Any additional tax that could be imposed for the years 2013–2015 would be reduced by up to approximately $2.2 billion of repatriation tax previously accrued on our foreign earnings. We firmly believe that the IRS positions set forth in the 2010–2012 and 2013–2015 Notices are without merit. We are contesting the 2010–2012 and 2013–2015 Notices through the judicial process. The two cases were consolidated in the U.S. Tax Court on December 19, 2022. On February 10, 2023, the U.S. Tax Court entered an order setting a trial date of November 4, 2024. We are currently under examination by the IRS for the years 2016–2018 with respect to issues similar to those for the 2010 through 2015 period. In addition, we are under examination by a number of state and foreign tax jurisdictions. Final resolution of these complex matters is not likely within the next 12 months. We continue to believe our accrual for income tax liabilities is appropriate based on past experience, interpretations of tax law, application of the tax law to our facts and judgments about potential actions by tax authorities; however, due to the complexity of the provision for income taxes and uncertain resolution of these matters, the ultimate outcome of any tax matters may result in payments substantially greater than amounts accrued and could have a material adverse impact on our condensed consolidated financial statements. We are no longer subject to U.S. federal income tax examinations for years ended on or before December 31, 2009. See our Annual Report on Form 10-K for the year ended December 31, 2022, Part I, Item 1A, Risk Factors— The adoption and interpretation of new tax legislation or exposure to additional tax liabilities could affect our profitability, for further discussion. During the three months ended March 31, 2023, the gross amounts of our UTBs increased by $60 million as a result of tax positions taken during the current year. Substantially all of the UTBs as of March 31, 2023, if recognized, would affect our effective tax rate.

Earnings per share

Earnings per share	3 Months Ended
Earnings per share	Mar. 31, 2023
Earnings Per Share [Abstract]
Earnings per share	Earnings per share The computation of basic EPS is based on the weighted-average number of our common shares outstanding. The computation of diluted EPS is based on the weighted-average number of our common shares outstanding and dilutive potential common shares, which primarily include shares that may be issued under our stock option, restricted stock and performance unit award programs (collectively, dilutive securities), as determined by using the treasury stock method. The computations for basic and diluted EPS were as follows (in millions, except per-share data): Three months ended 2023 2022 Income (Numerator): Net income for basic and diluted EPS $ 2,841 $ 1,476 Shares (Denominator): Weighted-average shares for basic EPS 534 548 Effect of dilutive securities 4 3 Weighted-average shares for diluted EPS 538 551 Basic EPS $ 5.32 $ 2.69 Diluted EPS $ 5.28 $ 2.68 For the three months ended March 31, 2023 and 2022, the number of antidilutive employee stock-based awards excluded from the computation of diluted EPS was not significant.

Investments

Investments	3 Months Ended
Investments	Mar. 31, 2023
Investments, Debt and Equity Securities [Abstract]
Investments	Investments Available-for-sale investments The amortized cost, gross unrealized gains, gross unrealized losses and fair values of interest-bearing securities, which are considered available-for-sale, by type of security were as follows (in millions): Types of securities as of March 31, 2023 Amortized Gross Gross Fair U.S. Treasury bills $ — $ — $ — $ — Money market mutual funds 31,064 — — 31,064 Other short-term interest-bearing securities 1 — — 1 Total interest-bearing securities $ 31,065 $ — $ — $ 31,065 Types of securities as of December 31, 2022 Amortized Gross Gross Fair U.S. Treasury bills $ 1,676 $ — $ — $ 1,676 Money market mutual funds 2,659 — — 2,659 Other short-term interest-bearing securities — — — — Total interest-bearing securities $ 4,335 $ — $ — $ 4,335 The fair values of interest-bearing securities by location in the Condensed Consolidated Balance Sheets were as follows (in millions): Condensed Consolidated Balance Sheets locations March 31, 2023 December 31, 2022 Cash and cash equivalents $ 31,064 $ 2,659 Marketable securities 1 1,676 Total interest-bearing securities $ 31,065 $ 4,335 Cash and cash equivalents in the above table excludes bank account cash of $496 million and $4,970 million as of March 31, 2023 and December 31, 2022, respectively. Cash and cash equivalents as of March 31, 2023 was $31.6 billion, of which $27.8 billion is anticipated to be used for the proposed acquisition of Horizon. See Note 3, Acquisitions and divestitures. All interest-bearing securities as of March 31, 2023 and December 31, 2022, mature in one year or less. For the three months ended March 31, 2023 and 2022, realized gains and losses on interest-bearing securities were not material. Realized gains and losses on interest-bearing securities are recorded in Other income (expense), net, in the Condensed Consolidated Statements of Income. The cost of securities sold is based on the specific-identification method. The primary objective of our investment portfolio is to maintain safety of principal, prudent levels of liquidity and acceptable levels of risk. Our investment policy limits interest-bearing security investments to certain types of debt and money market instruments issued by institutions with investment-grade credit ratings, and it places restrictions on maturities and concentration by asset class and issuer. Equity securities BeiGene, Ltd. Effective January 30, 2023, we relinquished our right to appoint a director to BeiGene’s Board of Directors. We no longer have the ability to exert significant influence over BeiGene. As a result, in the first quarter of 2023, we began to account for our ownership interest as an equity security with a readily determinable fair value, with changes in fair value recorded in Other income (expense), net. See Note 12, Fair value measurement. During the three months ended March 31, 2023, we recognized a net unrealized gain of $1.9 billion recorded to Other income (expense), net, in our Condensed Consolidated Statements of Income. As of March 31, 2023, the carrying and fair value of our investment in BeiGene was $4.1 billion and was included in Other noncurrent assets in the Condensed Consolidated Balance Sheets. As of December 31, 2022, under the equity method of accounting, the carrying value of our investment in BeiGene was $2.2 billion and was included in Other noncurrent assets in the Condensed Consolidated Balance Sheets, and our ownership percentage was 18.2%. During the three months ended March 31, 2022, under the equity method of accounting, our carrying value in BeiGene was adjusted by our share of BeiGene’s net losses of $108 million and amortization of the basis difference of $47 million. Other equity securities Excluding our equity investment in BeiGene, we held investments in other equity securities with readily determinable fair values (publicly traded securities) of $462 million and $480 million as of March 31, 2023 and December 31, 2022, respectively, which are included in Other noncurrent assets in the Condensed Consolidated Balance Sheets. During the three months ended March 31, 2023 and 2022, net unrealized gains and losses on these publicly traded securities were a gain of $5 million and a loss of $170 million, respectively. Realized gains and losses on sales of publicly traded securities for the three months ended March 31, 2023 and 2022, were not material. We held investments of $250 million and $233 million in equity securities without readily determinable fair values as of March 31, 2023 and December 31, 2022, respectively, which are included in Other noncurrent assets in the Condensed Consolidated Balance Sheets. During the three months ended March 31, 2023 and 2022, upward and downward adjustments on these securities were not material. Adjustments were based on observable price transactions. Equity method investments Neumora Therapeutics, Inc. On September 30, 2021, we acquired an approximately 25.9% ownership interest in Neumora, a privately held company, for $257 million, which is included in Other noncurrent assets in the Condensed Consolidated Balance Sheets, in exchange for a $100 million cash payment and $157 million in noncash consideration primarily related to future services. Although our equity investment provides us with the ability to exercise significant influence over Neumora, we have elected the fair value option to account for our equity investment. Under the fair value option, changes in the fair value of the investment are recognized through earnings each reporting period. We believe the fair value option best reflects the economics of the underlying transaction. As of March 31, 2023 and December 31, 2022, our ownership interest in Neumora was approximately 24.5% and 24.9%, respectively, and the fair values of our investment were $288 million and $335 million, respectively. Accordingly, during the three months ended March 31, 2023 and 2022, we recognized a loss of $47 million and $50 million, respectively, in Other income (expense), net, in the Condensed Consolidated Statements of Income. For information on determination of fair values, see Note 12, Fair value measurement. Limited partnerships We held limited partnership investments of $268 million and $249 million as of March 31, 2023 and December 31, 2022, respectively, which are included in Other noncurrent assets in the Condensed Consolidated Balance Sheets. These investments, primarily investment funds of early-stage biotechnology companies, are accounted for by using the equity method of accounting and are measured by using our proportionate share of the net asset values of the underlying investments held by the limited partnerships as a practical expedient. These investments are typically redeemable only through distributions upon liquidation of the underlying assets. As of March 31, 2023, unfunded additional commitments to be made for these investments during the next several years were $160 million. For the three months ended March 31, 2023 and 2022, we recognized net gains of $20 million and net losses of $160 million, respectively, in Other income (expense), net, in the Condensed Consolidated Statements of Income on these investments.

Inventories

Inventories	3 Months Ended
Inventories	Mar. 31, 2023
Inventory Disclosure [Abstract]
Inventories	Inventories Inventories consisted of the following (in millions): March 31, 2023 December 31, 2022 Raw materials $ 903 $ 828 Work in process 2,978 3,098 Finished goods 1,130 1,004 Total inventories $ 5,011 $ 4,930

Goodwill and other intangible a

Goodwill and other intangible assets	3 Months Ended
Goodwill and other intangible assets	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and other intangible assets	Goodwill and other intangible assets Goodwill The change in the carrying amount of goodwill was as follows (in millions): Three months ended Beginning balance $ 15,529 Adjustments to goodwill resulting from acquisitions and divestitures, net (1) (4) Currency translation adjustment 6 Ending balance $ 15,531 ____________ (1) For the three months ended March 31, 2023, adjustments to goodwill consisted of a measurement period adjustment related to our acquisition of ChemoCentryx. See Note 3, Acquisitions and divestitures. Other intangible assets Other intangible assets consisted of the following (in millions): March 31, 2023 December 31, 2022 Gross Accumulated Other intangible Gross Accumulated Other intangible Finite-lived intangible assets: Developed-product-technology rights $ 29,038 $ (15,679) $ 13,359 $ 29,028 $ (15,045) $ 13,983 Licensing rights 3,864 (3,160) 704 3,864 (3,123) 741 Marketing-related rights 1,326 (1,188) 138 1,326 (1,167) 159 Research and development technology rights 1,387 (1,204) 183 1,378 (1,190) 188 Total finite-lived intangible assets 35,615 (21,231) 14,384 35,596 (20,525) 15,071 Indefinite-lived intangible assets: In-process research and development 1,009 — 1,009 1,009 — 1,009 Total other intangible assets $ 36,624 $ (21,231) $ 15,393 $ 36,605 $ (20,525) $ 16,080 Developed-product-technology rights consists of rights related to marketed products. Licensing rights primarily consists of contractual rights to receive future milestone, royalty and profit-sharing payments; capitalized payments to third parties for milestones related to regulatory approvals to commercialize products; and upfront payments associated with royalty obligations for marketed products. Marketing-related rights primarily consists of rights related to the sale and distribution of marketed products. R&D technology rights pertains to technologies used in R&D that have alternative future uses. IPR&D consists of R&D projects acquired in a business combination that are not complete at the time of acquisition due to remaining technological risks and/or lack of receipt of required regulatory approvals. We review IPR&D projects for impairment annually, whenever events or changes in circumstances indicate that the carrying amounts may not be recoverable and upon the establishment of technological feasibility or regulatory approval. During the three months ended March 31, 2023 and 2022, we recognized amortization associated with our finite-lived intangible assets of $693 million and $637 million, respectively. Amortization of intangible assets is primarily included in Cost of sales in the Condensed Consolidated Statements of Income. The total estimated amortization of our finite-lived intangible assets for the remaining nine months ending December 31, 2023, and the years ending December 31, 2024, 2025, 2026, 2027 and 2028, are $2.1 billion, $2.7 billion, $2.5 billion, $2.2 billion, $2.1 billion and $1.1 billion, respectively.

Financing arrangements

Financing arrangements	3 Months Ended
Financing arrangements	Mar. 31, 2023
Debt Disclosure [Abstract]
Financing arrangements	Financing arrangements Our borrowings consisted of the following (in millions): March 31, 2023 December 31, 2022 0.41% CHF700 million bonds due 2023 (0.41% 2023 Swiss franc Bonds) $ — $ 757 2.25% notes due 2023 (2.25% 2023 Notes) 750 750 3.625% notes due 2024 (3.625% 2024 Notes) 1,400 1,400 1.90% notes due 2025 (1.90% 2025 Notes) 500 500 5.25% notes due 2025 (5.25% 2025 Notes) 2,000 — 3.125% notes due 2025 (3.125% 2025 Notes) 1,000 1,000 2.00% €750 million notes due 2026 (2.00% 2026 euro Notes) 813 803 5.507% notes due 2026 (5.507% 2026 Notes) 1,500 — 2.60% notes due 2026 (2.60% 2026 Notes) 1,250 1,250 5.50% £475 million notes due 2026 (5.50% 2026 pound sterling Notes) 586 574 2.20% notes due 2027 (2.20% 2027 Notes) 1,724 1,724 3.20% notes due 2027 (3.20% 2027 Notes) 1,000 1,000 5.15% notes due 2028 (5.15% 2028 Notes) 3,750 — 1.65% notes due 2028 (1.65% 2028 Notes) 1,234 1,234 3.00% notes due 2029 (3.00% 2029 Notes) 750 750 4.05% notes due 2029 (4.05% 2029 Notes) 1,250 1,250 4.00% £700 million notes due 2029 (4.00% 2029 pound sterling Notes) 864 846 2.45% notes due 2030 (2.45% 2030 Notes) 1,250 1,250 5.25% notes due 2030 (5.25% 2030 Notes) 2,750 — 2.30% notes due 2031 (2.30% 2031 Notes) 1,250 1,250 2.00% notes due 2032 (2.00% 2032 Notes) 1,001 1,051 3.35% notes due 2032 (3.35% 2032 Notes) 1,000 1,000 4.20% notes due 2033 (4.20% 2033 Notes) 750 750 5.25% notes due 2033 (5.25% 2033 Notes) 4,250 — 6.375% notes due 2037 (6.375% 2037 Notes) 478 478 6.90% notes due 2038 (6.90% 2038 Notes) 254 254 6.40% notes due 2039 (6.40% 2039 Notes) 333 333 3.15% notes due 2040 (3.15% 2040 Notes) 1,803 2,000 5.75% notes due 2040 (5.75% 2040 Notes) 373 373 2.80% notes due 2041 (2.80% 2041 Notes) 1,091 1,110 4.95% notes due 2041 (4.95% 2041 Notes) 600 600 5.15% notes due 2041 (5.15% 2041 Notes) 729 729 5.65% notes due 2042 (5.65% 2042 Notes) 415 415 5.60% notes due 2043 (5.60% 2043 Notes) 2,750 — 5.375% notes due 2043 (5.375% 2043 Notes) 185 185 4.40% notes due 2045 (4.40% 2045 Notes) 2,250 2,250 4.563% notes due 2048 (4.563% 2048 Notes) 1,415 1,415 3.375% notes due 2050 (3.375% 2050 Notes) 2,132 2,250 4.663% notes due 2051 (4.663% 2051 Notes) 3,541 3,541 3.00% notes due 2052 (3.00% 2052 Notes) 1,199 1,254 4.20% notes due 2052 (4.20% 2052 Notes) 950 1,000 4.875% notes due 2053 (4.875% 2053 Notes) 1,000 1,000 5.65% notes due 2053 (5.65% 2053 Notes) 4,250 — 2.77% notes due 2053 (2.77% 2053 Notes) 940 940 4.40% notes due 2062 (4.40% 2062 Notes) 1,200 1,250 March 31, 2023 December 31, 2022 5.75% notes due 2063 (5.75% 2063 Notes) 2,750 — Other notes due 2097 100 100 Unamortized bond discounts, premiums and issuance costs, net (1,434) (1,246) Fair value adjustments (343) (437) Other 12 12 Total carrying value of debt 61,595 38,945 Less current portion (834) (1,591) Total long-term debt $ 60,761 $ 37,354 There are no material differences between the effective interest rates and coupon rates of any of our borrowings, except for the 4.563% 2048 Notes, the 4.663% 2051 Notes and the 2.77% 2053 Notes, which have effective interest rates of 6.3%, 5.6% and 5.2%, respectively. Debt issuances and acquisition-related financing During the three months ended March 31, 2023, in connection with the proposed acquisition of Horizon (see Note 3, Acquisitions and divestitures —Proposed acquisition of Horizon Therapeutics plc ), we issued the following series of notes (in millions): Principal Amount 5.25% 2025 Notes $ 2,000 5.507% 2026 Notes 1,500 5.15% 2028 Notes 3,750 5.25% 2030 Notes 2,750 5.25% 2033 Notes 4,250 5.60% 2043 Notes 2,750 5.65% 2053 Notes 4,250 5.75% 2063 Notes 2,750 Total $ 24,000 If the consummation of the proposed acquisition of Horizon does not occur on or before the later of: (i) January 31, 2024, or such later date to which the agreement to acquire Horizon (Transaction Agreement) may be extended in accordance with its terms, (ii) the Transaction Agreement is terminated, or (iii) we otherwise notify the trustee of the notes that consummation of the acquisition will not be pursued, we will be required to redeem each series of notes, other than the 5.75% 2063 Notes, at a price equal to 101% of the principal amount of the notes plus accrued and unpaid interest. In the event of a change-in-control triggering event, as defined in the terms of the notes, we may be required to purchase all or a portion of these notes at a price equal to 101% of the principal amount of the notes plus accrued and unpaid interest. In addition, these notes may be redeemed at any time at our option, in whole or in part, at the principal amount of the notes being redeemed plus accrued and unpaid interest and a make-whole amount, which are defined by the terms of the notes. Except with respect to the 5.25% 2025 Notes, the notes may be redeemed without payment of make-whole amounts if redemption occurs during a specified period of time immediately prior to the maturing of the notes. Such time periods range from two months to six months prior to maturity, except for the 5.507% 2026 Notes, which may be redeemed without payment of the make-whole amount if redemption occurs after two years prior to maturity. In December 2022, in connection with the proposed acquisition of Horizon, we entered into a bridge credit agreement, which provided for borrowings with an aggregate principal amount of $24.5 billion as of December 31, 2022. Subsequent to our March 2023 debt issuance described above, we terminated the bridge credit agreement. Accordingly, during the three months ended March 31, 2023, we recognized $98 million of financing cost associated with the bridge credit agreement, primarily in Other income (expense), net, in the Condensed Consolidated Statements of Income. Also in connection with the proposed acquisition of Horizon, we entered into a $4.0 billion term loan credit agreement in December 2022. No amounts under this agreement were outstanding as of March 31, 2023 and December 31, 2022. Debt extinguishment During the three months ended March 31, 2023, we repurchased portions of the 2.00% 2032 Notes, 3.15% 2040 Notes, 2.80% 2041 Notes, 3.375% 2050 Notes, 3.00% 2052 Notes, 4.20% 2052 Notes and 4.40% 2062 Notes for an aggregate cost of $420 million, which resulted in the recognition of a $113 million gain on extinguishment of debt recorded in Other income (expense), net, in the Condensed Consolidated Statements of Income. Debt repayments During the three months ended March 31, 2023, we repaid the CHF700 million aggregate principal amount ($704 million upon settlement of the related cross-currency swap) of the 0.41% 2023 Swiss franc Bonds. Shelf registration statement and other facilities In February 2023, we filed a shelf registration statement with the SEC that allows us to issue unspecified amounts of debt securities; common stock; preferred stock; warrants to purchase debt securities, common stock, preferred stock or depositary shares; rights to purchase common stock or preferred stock; securities purchase contracts; securities purchase units; and depositary shares. Under this shelf registration statement, all of the securities available for issuance may be offered from time to time with terms to be determined at the time of issuance. This shelf registration statement expires in February 2026. During the three months ended March 31, 2023, we amended and restated our syndicated, unsecured, revolving credit agreement under which we may borrow up to $4.0 billion (increased from $2.5 billion prior to the amendment) for general corporate purposes, including as a liquidity backstop for our commercial paper program. The commitments under the revolving credit agreement may be increased by up to $1.25 billion with the agreement of the banks (increased from $750 million prior to the amendment). Each bank that is a party to the agreement has an initial commitment term of five years. This term may be extended for up to two additional one-year periods with the agreement of the banks. Annual commitment fees for this agreement are 0.09% of the unused portion of the facility based on our current credit rating. Generally, we would be charged interest for any amounts borrowed under this facility, based on our current credit rating, at (i) SOFR plus 1.01% or (ii) the highest of (A) the administrative agent bank base commercial lending rate, (B) the overnight federal funds rate plus 0.50% or (C) one-month SOFR plus 1.1%. As of March 31, 2023 and December 31, 2022, no amounts were outstanding under this facility.

Stockholders' equity

Stockholders' equity	3 Months Ended
Stockholders' equity	Mar. 31, 2023
Equity [Abstract]
Stockholders' equity	Stockholders’ equity Stock repurchase program Activity under our stock repurchase program, on a trade date basis, was as follows (in millions): 2023 2022 Shares Dollars Shares Dollars First quarter — $ — 24.6 $ 5,410 As of March 31, 2023, $7.0 billion of authorization remained available under our stock repurchase program. Dividends In March 2023, the Board of Directors declared a quarterly cash dividend of $2.13 per share, which will be paid in June 2023. In December 2022, the Board of Directors declared a quarterly cash dividend of $2.13 per share, which was paid in March 2023. Accumulated other comprehensive income (loss) The components of AOCI were as follows (in millions): Foreign Cash flow Other AOCI Balance as of December 31, 2022 $ (348) $ 128 $ (11) $ (231) Foreign currency translation adjustments 28 — — 28 Unrealized losses — (71) — (71) Reclassification adjustments to income — (30) — (30) Other — — 21 21 Income taxes — 15 — 15 Balance as of March 31, 2023 $ (320) $ 42 $ 10 $ (268) Reclassifications out of AOCI and into earnings, including related income tax expenses, were as follows (in millions): Three months ended March 31, Components of AOCI 2023 2022 Condensed Consolidated Cash flow hedges: Foreign currency contract gains $ 52 $ 27 Product sales Cross-currency swap contract losses (22) (78) Other income (expense), net 30 (51) Income before income taxes (6) 11 Provision for income taxes $ 24 $ (40) Net income

Fair value measurement

Fair value measurement	3 Months Ended
Fair value measurement	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Fair value measurement	Fair value measurement To estimate the fair value of our financial assets and liabilities, we use valuation approaches within a hierarchy that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that observable inputs be used when available. Observable inputs are inputs that market participants would use in pricing an asset or liability based on market data obtained from sources independent of the Company. Unobservable inputs are inputs that reflect the Company’s assumptions about the inputs that market participants would use in pricing an asset or liability and are developed based on the best information available in the circumstances. The fair value hierarchy is divided into three levels based on the sources of inputs as follows: Level 1 — Valuations based on unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access Level 2 — Valuations for which all significant inputs are observable either directly or indirectly—other than Level 1 inputs Level 3 — Valuations based on inputs that are unobservable and significant to the overall fair value measurement The availability of observable inputs can vary among different types of financial assets and liabilities. To the extent that the valuation is based on models or inputs that are less observable or unobservable in the market, the determination of fair value requires more judgment. In certain cases, inputs used for measuring fair value may fall into different levels of the fair value hierarchy. In such cases, for financial statement disclosure purposes, the level in the fair value hierarchy within which the fair value measurement is categorized is based on the lowest level of input used that is significant to the overall fair value measurement. The fair values of each major class of the Company’s financial assets and liabilities measured at fair value on a recurring basis were as follows (in millions): Quoted prices Significant Significant Fair value measurement as of March 31, 2023, using: Total Assets: Available-for-sale securities: U.S. Treasury bills $ — $ — $ — $ — Money market mutual funds 31,064 — — 31,064 Other short-term interest-bearing securities — 1 — 1 Other investments — 131 — 131 Equity securities 4,545 — 288 4,833 Derivatives: Foreign currency forward contracts — 252 — 252 Cross-currency swap contracts — — — — Total assets $ 35,609 $ 384 $ 288 $ 36,281 Liabilities: Derivatives: Foreign currency forward contracts $ — $ 73 $ — $ 73 Cross-currency swap contracts — 517 — 517 Interest rate swap contracts — 662 — 662 Forward interest rate contracts — — — — Contingent consideration obligations — — 273 273 Total liabilities $ — $ 1,252 $ 273 $ 1,525 Quoted prices Significant Significant Fair value measurement as of December 31, 2022, using: Total Assets: Available-for-sale securities: U.S. Treasury bills $ 1,676 $ — $ — $ 1,676 Money market mutual funds 2,659 — — 2,659 Other short-term interest-bearing securities — — — — Other investments — 130 — 130 Equity securities 480 — 335 815 Derivatives: Foreign currency forward contracts — 287 — 287 Cross-currency swap contracts — 54 — 54 Total assets $ 4,815 $ 471 $ 335 $ 5,621 Liabilities: Derivatives: Foreign currency forward contracts $ — $ 76 $ — $ 76 Cross-currency swap contracts — 541 — 541 Interest rate swap contracts — 776 — 776 Forward interest rate contracts — 5 — 5 Contingent consideration obligations — — 270 270 Total liabilities $ — $ 1,398 $ 270 $ 1,668 Interest-bearing and equity securities The fair values of our U.S. Treasury securities, money market mutual funds and equity investments in publicly traded securities, including our equity investment in BeiGene as of March 31, 2023, are based on quoted market prices in active markets, with no valuation adjustment. Other investments consist of interest-bearing deposits that are valued at amortized cost, which approximates fair value given their near term maturity. The fair value of equity securities without readily determinable fair values is initially valued at the transaction price and subsequently valued based on a combination of observable price transactions when available, market performance and publicly available market information for similar companies that have actively traded equity securities. See Note 7, Investments— Neumora Therapeutics, Inc. As of the first quarter of 2023, we no longer account for our equity investment in BeiGene under the equity method of accounting. As of December 31, 2022, the fair value and carrying value were $4.2 billion and $2.2 billion, respectively. The fair value of our investment in BeiGene was estimated by using Level 1 inputs. See Note 7, Investments— BeiGene, Ltd. Derivatives All of our foreign currency forward contracts, cross-currency swap contracts and interest rate swap contracts are with counterparties that have minimum credit ratings of A– or equivalent by S&P, Moody’s or Fitch. We estimate the fair values of these contracts by taking into consideration valuations obtained from a third-party valuation service that uses an income-based industry-standard valuation model for which all significant inputs are observable either directly or indirectly. These inputs, as applicable, include foreign currency exchange rates, LIBOR, swap rates, obligor credit default swap rates and cross-currency basis swap spreads. Certain inputs, when applicable, are at commonly quoted intervals. See Note 13, Derivative instruments. Contingent consideration obligations As a result of our business acquisitions, we have incurred contingent consideration obligations as discussed below. The contingent consideration obligations are recorded at their fair values by using probability-adjusted discounted cash flows, and we revalue these obligations each reporting period until the related contingencies have been resolved. The fair value measurements of these obligations are based on significant unobservable inputs related to licensing rights and product candidates acquired in business combinations, and they are reviewed quarterly by management in our R&D and commercial sales organizations. The inputs include, as applicable, estimated probabilities and the timing of achieving specified development, regulatory and commercial milestones as well as estimated annual sales. Significant changes that increase or decrease the probabilities of achieving the related development, regulatory and commercial events or that shorten or lengthen the time required to achieve such events or that increase or decrease estimated annual sales would result in corresponding increases or decreases in the fair values of the obligations, as applicable. Changes in the fair values of contingent consideration obligations are recognized in Other operating expenses in the Condensed Consolidated Statements of Income. Changes in the carrying amounts of contingent consideration obligations were as follows (in millions): Three months ended 2023 2022 Beginning balance $ 270 $ 342 Payments (2) (2) Net changes in valuations 5 (10) Ending balance $ 273 $ 330 As of March 31, 2023 and December 31, 2022, our contingent consideration obligations are primarily the result of our acquisition of Teneobio, Inc., in October 2021, which obligates us to pay the former shareholders up to $1.6 billion upon achieving separate development and regulatory milestones with regard to various R&D programs. Summary of the fair values of other financial instruments Cash equivalents The fair values of cash equivalents approximate their carrying values due to the short-term nature of such financial instruments. Borrowings We estimated the fair values of our borrowings by using Level 2 inputs. As of March 31, 2023 and December 31, 2022, the aggregate fair values of our borrowings were $59.8 billion and $35.0 billion, respectively, and the carrying values were $61.6 billion and $38.9 billion, respectively. During the three months ended March 31, 2023 and 2022, there were no transfers of assets or liabilities between fair value measurement levels, and there were no material remeasurements to the fair values of assets and liabilities that are not measured at fair value on a recurring basis.

Derivative instruments

Derivative instruments	3 Months Ended
Derivative instruments	Mar. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative instruments	Derivative instruments The Company is exposed to foreign currency exchange rate and interest rate risks related to its business operations. To reduce our risks related to such exposures, we use or have used certain derivative instruments, including foreign currency forward, foreign currency option, cross-currency swap, forward interest rate and interest rate swap contracts. We have designated certain of our derivatives as cash flow and fair value hedges; we also have derivatives not designated as hedges. We do not use derivatives for speculative-trading purposes. Cash flow hedges We are exposed to possible changes in the values of certain anticipated foreign currency cash flows resulting from changes in foreign currency exchange rates primarily associated with our euro-denominated international product sales. The foreign currency exchange rate fluctuation exposure associated with cash inflows from our international product sales is partially offset by corresponding cash outflows from our international operating expenses. To further reduce our exposure, we enter into foreign currency forward contracts to hedge a portion of our projected international product sales up to a maximum of three years into the future; and at any given point in time, a higher percentage of nearer-term projected product sales is being hedged than in successive periods. As of March 31, 2023 and December 31, 2022, we had outstanding foreign currency forward contracts with aggregate notional amounts of $6.1 billion and $6.0 billion, respectively. We have designated these foreign currency forward contracts, which are primarily euro based, as cash flow hedges. Accordingly, we report the unrealized gains and losses on these contracts in AOCI in the Condensed Consolidated Balance Sheets, and we reclassify them to Product sales in the Condensed Consolidated Statements of Income in the same periods during which the hedged transactions affect earnings. To hedge our exposure to foreign currency exchange rate risk associated with certain of our long-term debt denominated in foreign currencies, we enter into cross-currency swap contracts. Under the terms of such contracts, we paid euros, pounds sterling and Swiss francs and received U.S. dollars for the notional amounts at the inception of the contracts; and based on these notional amounts, we exchange interest payments at fixed rates over the lives of the contracts by paying U.S. dollars and receiving euros, pounds sterling and Swiss francs. In addition, we will pay U.S. dollars to and receive euros, pounds sterling and Swiss francs from the counterparties at the maturities of the contracts for these same notional amounts. The terms of these contracts correspond to the related hedged debt, thereby effectively converting the interest payments and principal repayment on the debt from euros, pounds sterling and Swiss francs to U.S. dollars. We have designated these cross-currency swap contracts as cash flow hedges. Accordingly, the unrealized gains and losses on these contracts are reported in AOCI in the Condensed Consolidated Balance Sheets and reclassified to Other income (expense), net, in the Condensed Consolidated Statements of Income in the same periods during which the hedged debt affects earnings. The notional amounts and interest rates of our cross-currency swaps as of March 31, 2023, were as follows (notional amounts in millions): Foreign currency U.S. dollars Hedged notes Notional amounts Interest rates Notional amounts Interest rates 2.00% 2026 euro Notes € 750 2.0 % $ 833 3.9 % 5.50% 2026 pound sterling Notes £ 475 5.5 % $ 747 6.0 % 4.00% 2029 pound sterling Notes £ 700 4.0 % $ 1,111 4.6 % In connection with the anticipated issuance of long-term fixed-rate debt, we occasionally enter into forward interest rate contracts in order to hedge the variability in cash flows due to changes in the applicable U.S. Treasury rate between the time we enter into these contracts and the time the related debt is issued. Gains and losses on forward interest rate contracts, which are designated as cash flow hedges, are recognized in AOCI i n the Condensed Consolidated Balance Sheets and are amortized into Interest expense, net, in the Condensed Consolidated Statements of Income over the lives of the associated debt issuances. Amounts recognized in connection with forward interest rate contracts during the three months ended March 31, 2023, and amounts expected to be recognized during the subsequent 12 months, are not material. Gains and losses recognized in AOCI for our derivative instruments designated as cash flow hedges were as follows (in millions): Three months ended Derivatives in cash flow hedging relationships 2023 2022 Foreign currency forward contracts $ — $ 78 Cross-currency swap contracts (40) (22) Forward interest rate contracts (31) — Total unrealized (losses) gains $ (71) $ 56 Fair value hedges To achieve a desired mix of fixed-rate and floating-rate debt, we entered into interest rate swap contracts that qualified for and were designated as fair value hedges. These interest rate swap contracts effectively convert fixed-rate coupons to floating-rate LIBOR-based coupons over the terms of the related hedge contracts. As of March 31, 2023 and December 31, 2022, we had interest rate swap contracts with aggregate notional amounts of $6.7 billion that hedge certain portions of our long-term debt issuances. For interest rate swap contracts that qualify for and are designated as fair value hedges, we recognize in Interest expense, net, in the Condensed Consolidated Statements of Income the unrealized gain or loss on the derivative resulting from the change in fair value during the period, as well as the offsetting unrealized loss or gain of the hedged item resulting from the change in fair value during the period attributable to the hedged risk. If a hedging relationship involving an interest rate swap contract is terminated, the gain or loss realized on contract termination is recorded as an adjustment to the carrying value of the debt and amortized into Interest expense, net, over the remaining life of the previously hedged debt. The hedged liabilities and related cumulative-basis adjustments for fair value hedges of those liabilities were recorded in the Condensed Consolidated Balance Sheets as follows (in millions): Carrying amounts of hedged liabilities (1) Cumulative amounts of fair value hedging adjustments related to the carrying amounts of the hedged liabilities (2) Condensed Consolidated Balance Sheets locations March 31, 2023 December 31, 2022 March 31, 2023 December 31, 2022 Current portion of long-term debt $ 82 $ 82 $ 82 $ 82 Long-term debt $ 6,112 $ 6,017 $ (425) $ (519) ____________ (1) Current portion of long-term debt includes $82 million of carrying value with discontinued hedging relationships as of both March 31, 2023 and December 31, 2022. Long-term debt includes $337 million and $357 million of carrying value with discontinued hedging relationships as of March 31, 2023 and December 31, 2022, respectively. (2) Current portion of long-term debt includes $82 million of hedging adjustments on discontinued hedging relationships as of both March 31, 2023 and December 31, 2022. Long-term debt includes $237 million and $257 million of hedging adjustments on discontinued hedging relationships as of March 31, 2023 and December 31, 2022, respectively. Impact of hedging transactions The following tables summarize the amounts recorded in income and expense line items and the effects thereon from fair value and cash flow hedging, including discontinued hedging relationships (in millions): Three months ended March 31, 2023 Product sales Other income (expense), net Interest expense, net Total amounts recorded in income and (expense) line items presented in the Condensed Consolidated Statements of Income $ 5,846 $ 2,064 $ (543) The effects of cash flow and fair value hedging: Gains (losses) on cash flow hedging relationships reclassified out of AOCI: Foreign currency forward contracts $ 52 $ — $ — Cross-currency swap contracts $ — $ (22) $ — (Losses) gains on fair value hedging relationships—interest rate swap agreements: Hedged items (1) $ — $ — $ (88) Derivatives designated as hedging instruments $ — $ — $ 114 Three months ended March 31, 2022 Product sales Other income (expense), net Interest expense, net Total amounts recorded in income and (expense) line items presented in the Condensed Consolidated Statements of Income $ 5,731 $ (530) $ (295) The effects of cash flow and fair value hedging: Gains (losses) on cash flow hedging relationships reclassified out of AOCI: Foreign currency forward contracts $ 27 $ — $ — Cross-currency swap contracts $ — $ (78) $ — Gains (losses) on fair value hedging relationships—interest rate swap agreements: Hedged items (1) $ — $ — $ 337 Derivatives designated as hedging instruments $ — $ — $ (315) __________ (1) Gains on hedged items do not exactly offset losses on the related designated hedging instruments due to amortization of the cumulative amounts of fair value hedging adjustments included in the carrying amount of the hedged debt for discontinued hedging relationships and the recognition of gains on terminated hedges when the corresponding hedged item was paid down in the period. No portions of our cash flow hedge contracts were excluded from the assessment of hedge effectiveness. As of March 31, 2023, we expected to reclassify $97 million of net gains on our foreign currency and cross-currency swap contracts out of AOCI and into earnings during the next 12 months. Derivatives not designated as hedges To reduce our exposure to foreign currency fluctuations in certain assets and liabilities denominated in foreign currencies, we enter into foreign currency forward contracts that are not designated as hedging transactions. Most of these exposures are hedged on a month-to-month basis. As of March 31, 2023 and December 31, 2022, the total notional amounts of these foreign currency forward contracts were $582 million and $517 million, respectively. Gains and losses recognized in earnings for our derivative instruments not designated as hedging instruments were not material for the three months ended March 31, 2023 and 2022. Fair values of derivatives The fair values of derivatives included in the Condensed Consolidated Balance Sheets were as follows (in millions): Derivative assets Derivative liabilities March 31, 2023 Condensed Consolidated Fair values Condensed Consolidated Fair values Derivatives designated as hedging instruments: Foreign currency forward contracts Other current assets/ Other noncurrent assets $ 252 Accrued liabilities/ Other noncurrent liabilities $ 73 Cross-currency swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 517 Interest rate swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 662 Forward interest rate contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities — Total derivatives designated as hedging instruments 252 1,252 Total derivatives $ 252 $ 1,252 Derivative assets Derivative liabilities December 31, 2022 Condensed Consolidated Fair values Condensed Consolidated Fair values Derivatives designated as hedging instruments: Foreign currency forward contracts Other current assets/ Other noncurrent assets $ 287 Accrued liabilities/ Other noncurrent liabilities $ 76 Cross-currency swap contracts Other current assets/ Other noncurrent assets 54 Accrued liabilities/ Other noncurrent liabilities 541 Interest rate swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 776 Forward interest rate contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 5 Total derivatives designated as hedging instruments 341 1,398 Total derivatives $ 341 $ 1,398 For additional information, see Note 12, Fair value measurement. Our derivative contracts that were in liability positions as of March 31, 2023, contain certain credit-risk-related contingent provisions that would be triggered if (i) we were to undergo a change-in-control and (ii) our or the surviving entity’s creditworthiness deteriorates, which is generally defined as having either a credit rating that is below investment grade or a materially weaker creditworthiness after the change-in-control. If these events were to occur, the counterparties would have the right, but not the obligation, to close the contracts under early-termination provisions. In such circumstances, the counterparties could request immediate settlement of these contracts for amounts that approximate the then current fair values of the contracts. In addition, our derivative contracts are not subject to any type of master netting arrangement, and amounts due either to or from a counterparty under the contracts may be offset against other amounts due either to or from the same counterparty only if an event of default or termination, as defined, were to occur. The cash flow effects of our derivative contracts in the Condensed Consolidated Statements of Cash Flows are included in Net cash provided by operating activities, except for the settlement of notional amounts of cross-currency swaps, which are included in Net cash provided by (used in) financing activities.

Contingencies and commitments

Contingencies and commitments	3 Months Ended
Contingencies and commitments	Mar. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Contingencies and commitments	Contingencies and commitments Contingencies In the ordinary course of business, we are involved in various legal proceedings, government investigations and other matters that are complex in nature and have outcomes that are difficult to predict. See our Annual Report on Form 10-K for the year ended December 31, 2022, Part I, Item 1A. Risk Factors— Our business may be affected by litigation and government investigations. We describe our legal proceedings and other matters that are significant or that we believe could become significant in this footnote; and in Note 19, Contingencies and commitments, to the consolidated financial statements in our Annual Report on Form 10-K for the year ended December 31, 2022. We record accruals for loss contingencies to the extent that we conclude it is probable that a liability has been incurred and the amount of the related loss can be reasonably estimated. We evaluate, on a quarterly basis, developments in legal proceedings and other matters that could cause an increase or decrease in the amount of the liability that has been accrued previously. Our legal proceedings involve various aspects of our business and a variety of claims, some of which present novel factual allegations and/or unique legal theories. In each of the matters described in this filing; and in Note 19, Contingencies and commitments, to the consolidated financial statements in our Annual Report on Form 10-K for the year ended December 31, 2022, in which we could incur a liability, our opponents seek an award of a not-yet-quantified amount of damages or an amount that is not material. In addition, a number of the matters pending against us are at very early stages of the legal process, which in complex proceedings of the sort we face often extend for several years. As a result, none of the matters described in this filing; and in Note 19, Contingencies and commitments, to the consolidated financial statements in our Annual Report on Form 10-K for the year ended December 31, 2022, in which we could incur a liability, have progressed sufficiently through discovery and/or the development of important factual information and legal issues to enable us to estimate a range of possible loss, if any, or such amounts are not material. While it is not possible to accurately predict or determine the eventual outcomes of these matters, an adverse determination in one or more of these matters currently pending could have a material adverse effect on our consolidated results of operations, financial position or cash flows. Certain recent developments concerning our legal proceedings and other matters are discussed below: ANDA Patent Litigation Otezla ANDA Patent Litigation Amgen Inc. v. Sandoz Inc., et al. On April 19, 2023, the U.S. Court of Appeals for the Federal Circuit affirmed the permanent injunction entered by the U.S. District Court for the District of New Jersey prohibiting Sandoz and Zydus Pharmaceuticals (USA) Inc. from making, using, selling, offering to sell, or importing each of the generic versions of Otezla until February 2028. Repatha Patent Litigation Amgen Inc., et al. v. Sanofi, et al. Oral argument before the U.S. Supreme Court took place on March 27, 2023. Patent Disputes in the International Region In Amgen’s counterclaim litigation alleging that PRALUENT ® infringes Amgen’s European Patent No. 2,641,917 (the ’917 Patent), on February 27, 2023, Amgen filed a notice of appeal of the European Patent Office’s Opposition Division order invalidating the claims of the ’917 Patent. On March 13, 2023, Amgen appealed to the Japanese Supreme Court the High Court’s decision that Amgen’s Japanese patent claims relating to PCSK9 were invalid for lacking adequate support. On April 24, 2023, Amgen filed its Grounds for Acceptance of Appeal and Grounds for Appeal with the Japanese Supreme Court. ABP 654 (ustekinumab) Patent Litigation Janssen Biotech, Inc. v. Amgen Inc. On February 21, 2023, Janssen filed a first amended complaint adding, among other things, a request for declaratory judgment that four additional patents, together with the two patents it previously asserted, would be infringed by Amgen’s submission of an application for FDA licensure of ABP 654, Amgen’s biosimilar version of Janssen’s STELARA ® (ustekinumab). On March 5, 2023, Janssen filed a motion for preliminary injunction based on the alleged infringement of the two patents it had originally asserted, specifically U.S. Patent Nos. 9,217,168 and 9,475,858, seeking to enjoin Amgen from manufacturing or using in commercial quantities, offering to sell, or selling within the United States, or importing for commercial purposes into the United States, ABP 654. On March 23, 2023, the District Court Judge issued a scheduling order for this preliminary injunction proceedings, setting such hearing for August 4, 2023. Janssen Biotech Inc. v. Amgen Technology (Ireland) Unlimited Company On March 22, 2023, Janssen initiated an action in the Irish High Court alleging infringement of Irish Supplementary Protection Certificate No. 2009/015, indicating intent to seek an interlocutory injunction restraining ABP 654 manufacturing activities in Ireland. The trial date for preliminary Supplementary Protection Certificate issues, potentially followed by a hearing with respect to interlocutory injunction, has been set to begin on July 4, 2023. Antitrust Actions Sensipar Antitrust Class Actions On February 16, 2023, the U.S. District Court for the District of Delaware (the Delaware District Court) denied Amgen’s motion for interlocutory appeal. On March 2, 2023, Amgen filed a motion for reargument, which the Delaware District Court denied while also certifying a question regarding whether the current judge has the authority to certify a question decided by a predecessor judge. On April 17, 2023, Amgen filed a petition with the U.S. Court of Appeals for the Third Circuit, seeking a grant of our request for interlocutory appeal of the certified question as well as the Delaware District Court’s denial of our motion to dismiss the reverse payment claim. Amgen’s response to the class action complaints are due 30 days after resolution or denial of the interlocutory appeal. Regeneron Pharmaceuticals, Inc. Antitrust Action On February 10, 2023, the Delaware District Court denied Amgen’s motion to stay this action but left open the possibility of Amgen re-raising the motion if the U.S. Supreme Court rules in Amgen’s favor in its patent infringement cases against Sanofi and Regeneron Pharmaceuticals, Inc. On March 21, 2023, the Delaware District Court denied Amgen’s motion to dismiss the complaint. U.S. Tax Litigation Amgen Inc. & Subsidiaries v. Commissioner of Internal Revenue See Note 5, Income taxes, for discussion of the IRS tax dispute and the Company’s petitions in the U.S. Tax Court. Securities Class Action Litigation On March 13, 2023, Roofers Local No. 149 Pension Fund filed a purported class action against Amgen, Robert Bradway and Peter Griffith. The action was brought on behalf of an alleged class of Amgen shareholders who owned stock between July 29, 2020 and April 27, 2022 (the alleged class period). Plaintiffs allege that the defendants made a series of materially false and misleading statements and omissions during the alleged class period regarding the failure to timely disclose the potential tax liability claimed by the IRS. Plaintiffs further allege that they and other purported class members suffered losses and damages resulting from declines in the market value of Amgen’s common stock after the potential tax liability claimed by the IRS was disclosed. On April 4, 2023, the U.S. District Court for the Southern District of New York entered an order setting May 12, 2023 as the deadline for filing motions for appointment of lead counsel. ChemoCentryx, Inc. Securities Class Action Litigation

Summary of significant accoun_2

Summary of significant accounting policies (Policies)	3 Months Ended
Summary of significant accounting policies (Policies)	Mar. 31, 2023
Accounting Policies [Abstract]
Business	Business Amgen Inc. (including its subsidiaries, referred to as “Amgen,” “the Company,” “we,” “our” or “us”) is a global biotechnology pioneer that discovers, develops, manufactures and delivers innovative human therapeutics. We operate in one business segment: human therapeutics.
Basis of presentation	Basis of presentation The financial information for the three months ended March 31, 2023 and 2022, is unaudited but includes all adjustments (consisting of only normal, recurring adjustments unless otherwise indicated), which Amgen considers necessary for a fair presentation of its condensed consolidated results of operations for those periods. Interim results are not necessarily indicative of results for the full fiscal year. The condensed consolidated financial statements should be read in conjunction with our consolidated financial statements and the notes thereto contained in our Annual Report on Form 10-K for the year ended December 31, 2022.
Principles of consolidation	Principles of consolidation The condensed consolidated financial statements include the accounts of Amgen as well as its majority-owned subsidiaries. In determining whether we are the primary beneficiary of a variable interest entity, we consider whether we have both the power to direct activities of the entity that most significantly impact the entity’s economic performance and the obligation to absorb losses of, or the right to receive benefits from, the entity that could potentially be significant to that entity. We do not have any significant interests in any variable interest entities of which we are the primary beneficiary. All material intercompany transactions and balances have been eliminated in consolidation.
Use of estimates	Use of estimates The preparation of condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the condensed consolidated financial statements and accompanying notes. Actual results may differ from those estimates.
Property, plant and equipment, net	Property, plant and equipment, net Property, plant and equipment is recorded at historical cost, net of accumulated depreciation and amortization, of $9.4 billion and $9.3 billion as of March 31, 2023 and December 31, 2022, respectively.
Recent accounting pronouncements	Recent accounting pronouncements No new accounting pronouncements were issued or adopted for the three months ended March 31, 2023, that materially impacted the Company.

Acquisitions and divestitures (

Acquisitions and divestitures (Tables)	3 Months Ended
Acquisitions and divestitures (Tables)	Mar. 31, 2023
Business Combination and Asset Acquisition [Abstract]
Schedule of Business Acquisitions, by Acquisition	The following table summarizes the total consideration and allocated acquisition date fair values of assets acquired and liabilities assumed, inclusive of measurement period adjustments (in millions): Amounts Cash and cash equivalents $ 86 Marketable securities 235 Inventories 41 Finite-lived intangible assets – developed-product-technology rights 3,499 Goodwill 663 Other liabilities, net (83) Deferred tax liability, net (516) Total assets acquired, net $ 3,925

Revenues (Tables)

Revenues (Tables)	3 Months Ended
Revenues (Tables)	Mar. 31, 2023
Revenue from Contract with Customer [Abstract]
Disaggregation of revenue by product and by geographic area	Revenues were as follows (in millions): Three months ended March 31, 2023 2022 U.S. ROW Total U.S. ROW Total Prolia $ 623 $ 304 $ 927 $ 582 $ 270 $ 852 ENBREL 564 15 579 843 19 862 XGEVA 384 152 536 368 134 502 Otezla 294 98 392 350 101 451 Repatha 197 191 388 165 164 329 Nplate 246 116 362 156 110 266 KYPROLIS 234 124 358 196 91 287 Aranesp 115 240 355 137 221 358 EVENITY 164 90 254 110 60 170 Other products (1) 1,154 541 1,695 1,130 524 1,654 Total product sales (2) $ 3,975 $ 1,871 5,846 $ 4,037 $ 1,694 5,731 Other revenues 259 507 Total revenues $ 6,105 $ 6,238 ____________ (1) Consists of product sales of our non-principal products, as well as our Bergamo and Gensenta subsidiaries. (2) Hedging gains and losses, which are included in product sales, were not material for the three months ended March 31, 2023 and 2022.

Earnings per share (Tables)

Earnings per share (Tables)	3 Months Ended
Earnings per share (Tables)	Mar. 31, 2023
Earnings Per Share [Abstract]
Computation for basic and diluted earnings per share	The computations for basic and diluted EPS were as follows (in millions, except per-share data): Three months ended 2023 2022 Income (Numerator): Net income for basic and diluted EPS $ 2,841 $ 1,476 Shares (Denominator): Weighted-average shares for basic EPS 534 548 Effect of dilutive securities 4 3 Weighted-average shares for diluted EPS 538 551 Basic EPS $ 5.32 $ 2.69 Diluted EPS $ 5.28 $ 2.68

Investments (Tables)

Investments (Tables)	3 Months Ended
Investments (Tables)	Mar. 31, 2023
Investments, Debt and Equity Securities [Abstract]
Amortized cost, gross unrealized gains, gross unrealized losses and estimated fair values of available-for-sale investments by type of security	The amortized cost, gross unrealized gains, gross unrealized losses and fair values of interest-bearing securities, which are considered available-for-sale, by type of security were as follows (in millions): Types of securities as of March 31, 2023 Amortized Gross Gross Fair U.S. Treasury bills $ — $ — $ — $ — Money market mutual funds 31,064 — — 31,064 Other short-term interest-bearing securities 1 — — 1 Total interest-bearing securities $ 31,065 $ — $ — $ 31,065 Types of securities as of December 31, 2022 Amortized Gross Gross Fair U.S. Treasury bills $ 1,676 $ — $ — $ 1,676 Money market mutual funds 2,659 — — 2,659 Other short-term interest-bearing securities — — — — Total interest-bearing securities $ 4,335 $ — $ — $ 4,335
Fair values of available-for-sale investments by classification in the Consolidated Balance Sheets	The fair values of interest-bearing securities by location in the Condensed Consolidated Balance Sheets were as follows (in millions): Condensed Consolidated Balance Sheets locations March 31, 2023 December 31, 2022 Cash and cash equivalents $ 31,064 $ 2,659 Marketable securities 1 1,676 Total interest-bearing securities $ 31,065 $ 4,335

Inventories (Tables)

Inventories (Tables)	3 Months Ended
Inventories (Tables)	Mar. 31, 2023
Inventory Disclosure [Abstract]
Inventories	Inventories consisted of the following (in millions): March 31, 2023 December 31, 2022 Raw materials $ 903 $ 828 Work in process 2,978 3,098 Finished goods 1,130 1,004 Total inventories $ 5,011 $ 4,930

Goodwill and other intangible_2

Goodwill and other intangible assets (Tables)	3 Months Ended
Goodwill and other intangible assets (Tables)	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of goodwill	The change in the carrying amount of goodwill was as follows (in millions): Three months ended Beginning balance $ 15,529 Adjustments to goodwill resulting from acquisitions and divestitures, net (1) (4) Currency translation adjustment 6 Ending balance $ 15,531 ____________ (1) For the three months ended March 31, 2023, adjustments to goodwill consisted of a measurement period adjustment related to our acquisition of ChemoCentryx. See Note 3, Acquisitions and divestitures.
Schedule of identifiable intangible assets	Other intangible assets consisted of the following (in millions): March 31, 2023 December 31, 2022 Gross Accumulated Other intangible Gross Accumulated Other intangible Finite-lived intangible assets: Developed-product-technology rights $ 29,038 $ (15,679) $ 13,359 $ 29,028 $ (15,045) $ 13,983 Licensing rights 3,864 (3,160) 704 3,864 (3,123) 741 Marketing-related rights 1,326 (1,188) 138 1,326 (1,167) 159 Research and development technology rights 1,387 (1,204) 183 1,378 (1,190) 188 Total finite-lived intangible assets 35,615 (21,231) 14,384 35,596 (20,525) 15,071 Indefinite-lived intangible assets: In-process research and development 1,009 — 1,009 1,009 — 1,009 Total other intangible assets $ 36,624 $ (21,231) $ 15,393 $ 36,605 $ (20,525) $ 16,080

Financing arrangements (Tables)

Financing arrangements (Tables)	3 Months Ended
Financing arrangements (Tables)	Mar. 31, 2023
Debt Disclosure [Abstract]
Schedule of borrowings	Our borrowings consisted of the following (in millions): March 31, 2023 December 31, 2022 0.41% CHF700 million bonds due 2023 (0.41% 2023 Swiss franc Bonds) $ — $ 757 2.25% notes due 2023 (2.25% 2023 Notes) 750 750 3.625% notes due 2024 (3.625% 2024 Notes) 1,400 1,400 1.90% notes due 2025 (1.90% 2025 Notes) 500 500 5.25% notes due 2025 (5.25% 2025 Notes) 2,000 — 3.125% notes due 2025 (3.125% 2025 Notes) 1,000 1,000 2.00% €750 million notes due 2026 (2.00% 2026 euro Notes) 813 803 5.507% notes due 2026 (5.507% 2026 Notes) 1,500 — 2.60% notes due 2026 (2.60% 2026 Notes) 1,250 1,250 5.50% £475 million notes due 2026 (5.50% 2026 pound sterling Notes) 586 574 2.20% notes due 2027 (2.20% 2027 Notes) 1,724 1,724 3.20% notes due 2027 (3.20% 2027 Notes) 1,000 1,000 5.15% notes due 2028 (5.15% 2028 Notes) 3,750 — 1.65% notes due 2028 (1.65% 2028 Notes) 1,234 1,234 3.00% notes due 2029 (3.00% 2029 Notes) 750 750 4.05% notes due 2029 (4.05% 2029 Notes) 1,250 1,250 4.00% £700 million notes due 2029 (4.00% 2029 pound sterling Notes) 864 846 2.45% notes due 2030 (2.45% 2030 Notes) 1,250 1,250 5.25% notes due 2030 (5.25% 2030 Notes) 2,750 — 2.30% notes due 2031 (2.30% 2031 Notes) 1,250 1,250 2.00% notes due 2032 (2.00% 2032 Notes) 1,001 1,051 3.35% notes due 2032 (3.35% 2032 Notes) 1,000 1,000 4.20% notes due 2033 (4.20% 2033 Notes) 750 750 5.25% notes due 2033 (5.25% 2033 Notes) 4,250 — 6.375% notes due 2037 (6.375% 2037 Notes) 478 478 6.90% notes due 2038 (6.90% 2038 Notes) 254 254 6.40% notes due 2039 (6.40% 2039 Notes) 333 333 3.15% notes due 2040 (3.15% 2040 Notes) 1,803 2,000 5.75% notes due 2040 (5.75% 2040 Notes) 373 373 2.80% notes due 2041 (2.80% 2041 Notes) 1,091 1,110 4.95% notes due 2041 (4.95% 2041 Notes) 600 600 5.15% notes due 2041 (5.15% 2041 Notes) 729 729 5.65% notes due 2042 (5.65% 2042 Notes) 415 415 5.60% notes due 2043 (5.60% 2043 Notes) 2,750 — 5.375% notes due 2043 (5.375% 2043 Notes) 185 185 4.40% notes due 2045 (4.40% 2045 Notes) 2,250 2,250 4.563% notes due 2048 (4.563% 2048 Notes) 1,415 1,415 3.375% notes due 2050 (3.375% 2050 Notes) 2,132 2,250 4.663% notes due 2051 (4.663% 2051 Notes) 3,541 3,541 3.00% notes due 2052 (3.00% 2052 Notes) 1,199 1,254 4.20% notes due 2052 (4.20% 2052 Notes) 950 1,000 4.875% notes due 2053 (4.875% 2053 Notes) 1,000 1,000 5.65% notes due 2053 (5.65% 2053 Notes) 4,250 — 2.77% notes due 2053 (2.77% 2053 Notes) 940 940 4.40% notes due 2062 (4.40% 2062 Notes) 1,200 1,250 March 31, 2023 December 31, 2022 5.75% notes due 2063 (5.75% 2063 Notes) 2,750 — Other notes due 2097 100 100 Unamortized bond discounts, premiums and issuance costs, net (1,434) (1,246) Fair value adjustments (343) (437) Other 12 12 Total carrying value of debt 61,595 38,945 Less current portion (834) (1,591) Total long-term debt $ 60,761 $ 37,354 During the three months ended March 31, 2023, in connection with the proposed acquisition of Horizon (see Note 3, Acquisitions and divestitures —Proposed acquisition of Horizon Therapeutics plc ), we issued the following series of notes (in millions): Principal Amount 5.25% 2025 Notes $ 2,000 5.507% 2026 Notes 1,500 5.15% 2028 Notes 3,750 5.25% 2030 Notes 2,750 5.25% 2033 Notes 4,250 5.60% 2043 Notes 2,750 5.65% 2053 Notes 4,250 5.75% 2063 Notes 2,750 Total $ 24,000

Stockholders' equity (Tables)

Stockholders' equity (Tables)	3 Months Ended
Stockholders' equity (Tables)	Mar. 31, 2023
Equity [Abstract]
Summary of activity under our stock repurchase program	Activity under our stock repurchase program, on a trade date basis, was as follows (in millions): 2023 2022 Shares Dollars Shares Dollars First quarter — $ — 24.6 $ 5,410
Components of accumulated other comprehensive income	The components of AOCI were as follows (in millions): Foreign Cash flow Other AOCI Balance as of December 31, 2022 $ (348) $ 128 $ (11) $ (231) Foreign currency translation adjustments 28 — — 28 Unrealized losses — (71) — (71) Reclassification adjustments to income — (30) — (30) Other — — 21 21 Income taxes — 15 — 15 Balance as of March 31, 2023 $ (320) $ 42 $ 10 $ (268)
Reclassifications out of accumulated other comprehensive income	Reclassifications out of AOCI and into earnings, including related income tax expenses, were as follows (in millions): Three months ended March 31, Components of AOCI 2023 2022 Condensed Consolidated Cash flow hedges: Foreign currency contract gains $ 52 $ 27 Product sales Cross-currency swap contract losses (22) (78) Other income (expense), net 30 (51) Income before income taxes (6) 11 Provision for income taxes $ 24 $ (40) Net income

Fair value measurement (Tables)

Fair value measurement (Tables)	3 Months Ended
Fair value measurement (Tables)	Mar. 31, 2023
Fair Value Disclosures [Abstract]
Fair value of each major class of financial assets and liabilities measured at fair value on a recurring basis	The fair values of each major class of the Company’s financial assets and liabilities measured at fair value on a recurring basis were as follows (in millions): Quoted prices Significant Significant Fair value measurement as of March 31, 2023, using: Total Assets: Available-for-sale securities: U.S. Treasury bills $ — $ — $ — $ — Money market mutual funds 31,064 — — 31,064 Other short-term interest-bearing securities — 1 — 1 Other investments — 131 — 131 Equity securities 4,545 — 288 4,833 Derivatives: Foreign currency forward contracts — 252 — 252 Cross-currency swap contracts — — — — Total assets $ 35,609 $ 384 $ 288 $ 36,281 Liabilities: Derivatives: Foreign currency forward contracts $ — $ 73 $ — $ 73 Cross-currency swap contracts — 517 — 517 Interest rate swap contracts — 662 — 662 Forward interest rate contracts — — — — Contingent consideration obligations — — 273 273 Total liabilities $ — $ 1,252 $ 273 $ 1,525 Quoted prices Significant Significant Fair value measurement as of December 31, 2022, using: Total Assets: Available-for-sale securities: U.S. Treasury bills $ 1,676 $ — $ — $ 1,676 Money market mutual funds 2,659 — — 2,659 Other short-term interest-bearing securities — — — — Other investments — 130 — 130 Equity securities 480 — 335 815 Derivatives: Foreign currency forward contracts — 287 — 287 Cross-currency swap contracts — 54 — 54 Total assets $ 4,815 $ 471 $ 335 $ 5,621 Liabilities: Derivatives: Foreign currency forward contracts $ — $ 76 $ — $ 76 Cross-currency swap contracts — 541 — 541 Interest rate swap contracts — 776 — 776 Forward interest rate contracts — 5 — 5 Contingent consideration obligations — — 270 270 Total liabilities $ — $ 1,398 $ 270 $ 1,668
Schedule of Business Acquisitions by Acquisition, Contingent Consideration	Changes in the carrying amounts of contingent consideration obligations were as follows (in millions): Three months ended 2023 2022 Beginning balance $ 270 $ 342 Payments (2) (2) Net changes in valuations 5 (10) Ending balance $ 273 $ 330

Derivative instruments (Tables)

Derivative instruments (Tables)	3 Months Ended
Derivative instruments (Tables)	Mar. 31, 2023
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of notional amounts and interest rates for cross-currency swaps	The notional amounts and interest rates of our cross-currency swaps as of March 31, 2023, were as follows (notional amounts in millions): Foreign currency U.S. dollars Hedged notes Notional amounts Interest rates Notional amounts Interest rates 2.00% 2026 euro Notes € 750 2.0 % $ 833 3.9 % 5.50% 2026 pound sterling Notes £ 475 5.5 % $ 747 6.0 % 4.00% 2029 pound sterling Notes £ 700 4.0 % $ 1,111 4.6 %
Unrealized gain (loss) recognized in Other Comprehensive Income for our derivative instruments designated as cash flow hedges	Gains and losses recognized in AOCI for our derivative instruments designated as cash flow hedges were as follows (in millions): Three months ended Derivatives in cash flow hedging relationships 2023 2022 Foreign currency forward contracts $ — $ 78 Cross-currency swap contracts (40) (22) Forward interest rate contracts (31) — Total unrealized (losses) gains $ (71) $ 56
Derivatives in fair value hedging relationships	The hedged liabilities and related cumulative-basis adjustments for fair value hedges of those liabilities were recorded in the Condensed Consolidated Balance Sheets as follows (in millions): Carrying amounts of hedged liabilities (1) Cumulative amounts of fair value hedging adjustments related to the carrying amounts of the hedged liabilities (2) Condensed Consolidated Balance Sheets locations March 31, 2023 December 31, 2022 March 31, 2023 December 31, 2022 Current portion of long-term debt $ 82 $ 82 $ 82 $ 82 Long-term debt $ 6,112 $ 6,017 $ (425) $ (519) ____________ (1) Current portion of long-term debt includes $82 million of carrying value with discontinued hedging relationships as of both March 31, 2023 and December 31, 2022. Long-term debt includes $337 million and $357 million of carrying value with discontinued hedging relationships as of March 31, 2023 and December 31, 2022, respectively. (2) Current portion of long-term debt includes $82 million of hedging adjustments on discontinued hedging relationships as of both March 31, 2023 and December 31, 2022. Long-term debt includes $237 million and $257 million of hedging adjustments on discontinued hedging relationships as of March 31, 2023 and December 31, 2022, respectively.
Summary of amounts of income and expense line items	The following tables summarize the amounts recorded in income and expense line items and the effects thereon from fair value and cash flow hedging, including discontinued hedging relationships (in millions): Three months ended March 31, 2023 Product sales Other income (expense), net Interest expense, net Total amounts recorded in income and (expense) line items presented in the Condensed Consolidated Statements of Income $ 5,846 $ 2,064 $ (543) The effects of cash flow and fair value hedging: Gains (losses) on cash flow hedging relationships reclassified out of AOCI: Foreign currency forward contracts $ 52 $ — $ — Cross-currency swap contracts $ — $ (22) $ — (Losses) gains on fair value hedging relationships—interest rate swap agreements: Hedged items (1) $ — $ — $ (88) Derivatives designated as hedging instruments $ — $ — $ 114 Three months ended March 31, 2022 Product sales Other income (expense), net Interest expense, net Total amounts recorded in income and (expense) line items presented in the Condensed Consolidated Statements of Income $ 5,731 $ (530) $ (295) The effects of cash flow and fair value hedging: Gains (losses) on cash flow hedging relationships reclassified out of AOCI: Foreign currency forward contracts $ 27 $ — $ — Cross-currency swap contracts $ — $ (78) $ — Gains (losses) on fair value hedging relationships—interest rate swap agreements: Hedged items (1) $ — $ — $ 337 Derivatives designated as hedging instruments $ — $ — $ (315) __________ (1) Gains on hedged items do not exactly offset losses on the related designated hedging instruments due to amortization of the cumulative amounts of fair value hedging adjustments included in the carrying amount of the hedged debt for discontinued hedging relationships and the recognition of gains on terminated hedges when the corresponding hedged item was paid down in the period.
Fair values of derivatives included in the Condensed Consolidated Balance Sheets	The fair values of derivatives included in the Condensed Consolidated Balance Sheets were as follows (in millions): Derivative assets Derivative liabilities March 31, 2023 Condensed Consolidated Fair values Condensed Consolidated Fair values Derivatives designated as hedging instruments: Foreign currency forward contracts Other current assets/ Other noncurrent assets $ 252 Accrued liabilities/ Other noncurrent liabilities $ 73 Cross-currency swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 517 Interest rate swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 662 Forward interest rate contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities — Total derivatives designated as hedging instruments 252 1,252 Total derivatives $ 252 $ 1,252 Derivative assets Derivative liabilities December 31, 2022 Condensed Consolidated Fair values Condensed Consolidated Fair values Derivatives designated as hedging instruments: Foreign currency forward contracts Other current assets/ Other noncurrent assets $ 287 Accrued liabilities/ Other noncurrent liabilities $ 76 Cross-currency swap contracts Other current assets/ Other noncurrent assets 54 Accrued liabilities/ Other noncurrent liabilities 541 Interest rate swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 776 Forward interest rate contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 5 Total derivatives designated as hedging instruments 341 1,398 Total derivatives $ 341 $ 1,398

Summary of significant accoun_3

Summary of significant accounting policies (Details) $ in Billions	3 Months Ended
	Mar. 31, 2023 USD ($) segment	Dec. 31, 2022 USD ($)
Accounting Policies [Abstract]
Number of operating segments \| segment	1
Accumulated depreciation and amortization on property, plant and equipment \| $	$ 9.4	$ 9.3

Restructuring (Details)

Restructuring (Details) $ in Millions	Mar. 31, 2023 USD ($)
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve	$ 132
Minimum
Restructuring Cost and Reserve [Line Items]
Expected pre-tax accounting charges	300
Maximum
Restructuring Cost and Reserve [Line Items]
Expected pre-tax accounting charges	400
Employee Severance
Restructuring Cost and Reserve [Line Items]
Total costs incurred to date	141
Other Restructuring
Restructuring Cost and Reserve [Line Items]
Total costs incurred to date	$ 38

Acquisitions and divestitures -

Acquisitions and divestitures - Narrative: Proposed Acquisition of Horizon Therapeutics plc (Details) - Horizon Therapeutics $ / shares in Units, $ in Billions	3 Months Ended
	Mar. 31, 2023 USD ($)	Dec. 12, 2022 program product $ / shares
Business Acquisition [Line Items]
Business acquisition, share price (in dollars per share) \| $ / shares		$ 116.50
Cash payment \| $	$ 27.8
Approved products \| product		12
Development programs \| program		20

Acquisitions and divestitures_2

Acquisitions and divestitures - Narrative: Acquisition of ChemoCentryx Inc (Details) - USD ($) $ / shares in Units, $ in Millions		3 Months Ended
	Oct. 20, 2022	Mar. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Goodwill		$ 15,531	$ 15,529
ChemoCentryx, Inc.
Business Acquisition [Line Items]
Business acquisition, share price (in dollars per share)	$ 52
Business asset acquisition, consideration transferred	$ 3,900
Goodwill increase (decrease)		(4)
Cash payment	3,700
Business acquisition, cash consideration paid to equity holders for pre-acquisition services	$ 181
Finite-lived intangible assets – developed-product-technology rights		3,499
Inventories		$ 41
Business combination, turnover period of inventory acquired		13 months
Deferred tax liability		$ 516
Goodwill		663
ChemoCentryx, Inc. \| Developed Technology Rights
Business Acquisition [Line Items]
Finite-lived intangible assets – developed-product-technology rights		$ 3,500
Weighted average period of amortization		11 years

Acquisitions and divestitures_3

Acquisitions and divestitures - Aggregate Consideration Paid (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Goodwill	$ 15,531	$ 15,529
ChemoCentryx, Inc.
Business Acquisition [Line Items]
Cash and cash equivalents	86
Marketable securities	235
Inventories	41
Finite-lived intangible assets – developed-product-technology rights	3,499
Goodwill	663
Other liabilities, net	(83)
Deferred tax liability, net	(516)
Total assets acquired, net	$ 3,925

Acquisitions and divestitures_4

Acquisitions and divestitures - Narrative: Divestiture of Gensenta Ilac Sanayi ve Ticaret A.s. (Details) - Gensenta - USD ($) $ in Millions		12 Months Ended
	Nov. 02, 2022	Dec. 31, 2022
Business Acquisition [Line Items]
Proceeds from Divestiture of Businesses	$ 130
Including discontinued operation, assets	$ 86
Foreign currency translation, loss on divestiture of a business		$ 615
Other general expense
Business Acquisition [Line Items]
Gain (Loss) on Disposition of Business		$ 567

Revenues - Narrative (Details)

Revenues - Narrative (Details)	3 Months Ended
Revenues - Narrative (Details)	Mar. 31, 2023 segment
Revenue from Contract with Customer [Abstract]
Number of operating segments	1

Revenues - Summary of Revenues

Revenues - Summary of Revenues (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Revenue from External Customer [Line Items]
Total revenues	$ 6,105	$ 6,238
Product sales
Revenue from External Customer [Line Items]
Total revenues	5,846	5,731
Product sales \| U.S.
Revenue from External Customer [Line Items]
Total revenues	3,975	4,037
Product sales \| ROW
Revenue from External Customer [Line Items]
Total revenues	1,871	1,694
Prolia
Revenue from External Customer [Line Items]
Total revenues	927	852
Prolia \| U.S.
Revenue from External Customer [Line Items]
Total revenues	623	582
Prolia \| ROW
Revenue from External Customer [Line Items]
Total revenues	304	270
ENBREL
Revenue from External Customer [Line Items]
Total revenues	579	862
ENBREL \| U.S.
Revenue from External Customer [Line Items]
Total revenues	564	843
ENBREL \| ROW
Revenue from External Customer [Line Items]
Total revenues	15	19
XGEVA
Revenue from External Customer [Line Items]
Total revenues	536	502
XGEVA \| U.S.
Revenue from External Customer [Line Items]
Total revenues	384	368
XGEVA \| ROW
Revenue from External Customer [Line Items]
Total revenues	152	134
Otezla
Revenue from External Customer [Line Items]
Total revenues	392	451
Otezla \| U.S.
Revenue from External Customer [Line Items]
Total revenues	294	350
Otezla \| ROW
Revenue from External Customer [Line Items]
Total revenues	98	101
Repatha
Revenue from External Customer [Line Items]
Total revenues	388	329
Repatha \| U.S.
Revenue from External Customer [Line Items]
Total revenues	197	165
Repatha \| ROW
Revenue from External Customer [Line Items]
Total revenues	191	164
Nplate
Revenue from External Customer [Line Items]
Total revenues	362	266
Nplate \| U.S.
Revenue from External Customer [Line Items]
Total revenues	246	156
Nplate \| ROW
Revenue from External Customer [Line Items]
Total revenues	116	110
KYPROLIS
Revenue from External Customer [Line Items]
Total revenues	358	287
KYPROLIS \| U.S.
Revenue from External Customer [Line Items]
Total revenues	234	196
KYPROLIS \| ROW
Revenue from External Customer [Line Items]
Total revenues	124	91
Aranesp
Revenue from External Customer [Line Items]
Total revenues	355	358
Aranesp \| U.S.
Revenue from External Customer [Line Items]
Total revenues	115	137
Aranesp \| ROW
Revenue from External Customer [Line Items]
Total revenues	240	221
EVENITY
Revenue from External Customer [Line Items]
Total revenues	254	170
EVENITY \| U.S.
Revenue from External Customer [Line Items]
Total revenues	164	110
EVENITY \| ROW
Revenue from External Customer [Line Items]
Total revenues	90	60
Other products
Revenue from External Customer [Line Items]
Total revenues	1,695	1,654
Other products \| U.S.
Revenue from External Customer [Line Items]
Total revenues	1,154	1,130
Other products \| ROW
Revenue from External Customer [Line Items]
Total revenues	541	524
Other revenues
Revenue from External Customer [Line Items]
Total revenues	$ 259	$ 507

Income taxes (Details)

Income taxes (Details) $ in Millions	3 Months Ended
Income taxes (Details) $ in Millions	Mar. 31, 2023 USD ($)	Mar. 31, 2022	Dec. 19, 2022 Case	Apr. 28, 2022 USD ($)	May 31, 2021 USD ($)
Income Tax Examination [Line Items]
Effective income tax rate	17.50%	11.90%
Increase in unrecognized tax benefits resulting from tax positions taken during the current period	$ 60
Domestic Tax Authority
Income Tax Examination [Line Items]
Proposed additional income tax					$ 3,600
Repatriation tax on proposed additional tax					$ 900
Proposed additional income tax 2013-2015				$ 5,100
Penalties on proposed additional income tax 2013-2015				2,000
Repatriation tax on proposed additional tax 2013-2015				$ 2,200
Number Of Notices Consolidated \| Case			2

Earnings per share (Details)

Earnings per share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Income (Numerator):
Net income for basic and diluted EPS	$ 2,841	$ 1,476
Shares (Denominator):
Weighted-average shares for basic EPS (in shares)	534	548
Effect of dilutive securities (in shares)	4	3
Weighted-average shares for diluted EPS (in shares)	538	551
Basic EPS (in usd per share)	$ 5.32	$ 2.69
Diluted EPS (in usd per share)	$ 5.28	$ 2.68

Investments - Amortized Cost, G

Investments - Amortized Cost, Gross Unrealized Gains & Losses, and Fair Value of Interest-bearing Securities (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Amortized cost	$ 31,065	$ 4,335
Gross unrealized gains	0	0
Gross unrealized losses	0	0
Fair values	31,065	4,335
U.S. Treasury bills
Debt Securities, Available-for-sale [Line Items]
Amortized cost	0	1,676
Gross unrealized gains	0	0
Gross unrealized losses	0	0
Fair values	0	1,676
Money market mutual funds
Debt Securities, Available-for-sale [Line Items]
Amortized cost	31,064	2,659
Gross unrealized gains	0	0
Gross unrealized losses	0	0
Fair values	31,064	2,659
Other short-term interest-bearing securities
Debt Securities, Available-for-sale [Line Items]
Amortized cost	1	0
Gross unrealized gains	0	0
Gross unrealized losses	0	0
Fair values	$ 1	$ 0

Investments - Fair Values of In

Investments - Fair Values of Interest-bearing Securities by Balance Sheet Location (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Marketable securities	$ 1	$ 1,676
Total interest-bearing securities	31,065	4,335
Available-for-sale investments
Debt Securities, Available-for-sale [Line Items]
Cash and cash equivalents	31,064	2,659
Marketable securities	1	1,676
Total interest-bearing securities	$ 31,065	$ 4,335

Investments - Narrative_ Availa

Investments - Narrative: Available-for-sale Investments (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Cash	$ 496	$ 4,970
Cash and Cash Equivalents, at Carrying Value	31,560	$ 7,629
Horizon Therapeutics
Debt Securities, Available-for-sale [Line Items]
Cash payment	$ 27,800

Investments - Narrative_ Equity

Investments - Narrative: Equity Securities (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Equity Securities, FV-NI, Unrealized Gain (Loss)	$ 5	$ (170)
Equity securities	4,833		$ 815
Adjustments for equity method investments	(31)	305
BeiGene
Debt Securities, Available-for-sale [Line Items]
Carrying value of equity method investment			2,200
Adjustments for equity method investments		108
Amortization of the basis difference		$ 47
Other Noncurrent Assets
Debt Securities, Available-for-sale [Line Items]
Equity securities	462		480
Equity securities without readily determinable fair value	250		$ 233
BeiGene
Debt Securities, Available-for-sale [Line Items]
Equity Securities, FV-NI, Unrealized Gain (Loss)	1,900
Ownership percentage			18.20%
BeiGene \| Other Noncurrent Assets
Debt Securities, Available-for-sale [Line Items]
Equity securities	$ 4,100

Investments - Narrative_ Equi_2

Investments - Narrative: Equity Method Investments (Details) - USD ($) $ in Millions		3 Months Ended
	Sep. 30, 2021	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Fair Value Measured at Net Asset Value Per Share \| Limited Partnership
Net Investment Income [Line Items]
Alternative investments		$ 268		$ 249
Unfunded additional commitments		160
Net gains (losses) from limited partnership investments		$ 20	$ (160)
Neumora Therapeutics, Inc.
Net Investment Income [Line Items]
Ownership percentage	25.90%	24.50%		24.90%
Aggregate cost	$ 257
Cash payment	100
Noncash consideration	$ 157
Fair value of investments		$ 288		$ 335
Change in carrying value		$ 47	$ 50

Inventories (Details)

Inventories (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Raw materials	$ 903	$ 828
Work in process	2,978	3,098
Finished goods	1,130	1,004
Total inventories	$ 5,011	$ 4,930

Goodwill and other intangible_3

Goodwill and other intangible assets (Goodwill Roll Forward) (Details) $ in Millions	3 Months Ended
	Mar. 31, 2023 USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 15,529
Adjustments to goodwill resulting from acquisitions and divestitures, net	(4)
Currency translation adjustment	6
Ending balance	$ 15,531

Goodwill and other intangible_4

Goodwill and other intangible assets (Identifiable Intangible Assets) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Gross carrying amounts	$ 35,615		$ 35,596
Accumulated amortization	(21,231)		(20,525)
Other intangible assets, net	14,384		15,071
Gross carrying amount	36,624		36,605
Accumulated amortization	(21,231)		(20,525)
Intangible assets, net	15,393		16,080
Amortization charges associated with finite-lived intangible assets	693	$ 637
In-process research and development
Indefinite-lived Intangible Assets [Line Items]
Indefinite-lived intangible assets:	1,009		1,009
Developed-product-technology rights
Finite-Lived Intangible Assets [Line Items]
Gross carrying amounts	29,038		29,028
Accumulated amortization	(15,679)		(15,045)
Other intangible assets, net	13,359		13,983
Licensing rights
Finite-Lived Intangible Assets [Line Items]
Gross carrying amounts	3,864		3,864
Accumulated amortization	(3,160)		(3,123)
Other intangible assets, net	704		741
Marketing-related rights
Finite-Lived Intangible Assets [Line Items]
Gross carrying amounts	1,326		1,326
Accumulated amortization	(1,188)		(1,167)
Other intangible assets, net	138		159
Research and development technology rights
Finite-Lived Intangible Assets [Line Items]
Gross carrying amounts	1,387		1,378
Accumulated amortization	(1,204)		(1,190)
Other intangible assets, net	$ 183		$ 188

Goodwill and other intangible_5

Goodwill and other intangible assets (Details Textual) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization charges associated with finite-lived intangible assets	$ 693	$ 637
Total estimated amortization of finite-lived intangible assets for the remainder of the year	2,100
Total estimated amortization of finite-lived intangible assets for year one	2,700
Total estimated amortization of finite-lived intangible assets for year two	2,500
Total estimated amortization of finite-lived intangible assets for year three	2,200
Total estimated amortization of finite-lived intangible assets for year four	2,100
Total estimated amortization of finite-lived intangible assets for year five	$ 1,100

Financing arrangements (Princip

Financing arrangements (Principal Amounts and Carrying Value of Long-term Borrowings) (Details)	Mar. 31, 2023 USD ($)	Mar. 31, 2023 EUR (€)	Mar. 31, 2023 GBP (£)	Mar. 31, 2023 CHF (SFr)	Dec. 31, 2022 USD ($)
Debt Instrument [Line Items]
Unamortized bond discounts, premiums and issuance costs, net	$ (1,434,000,000)				$ (1,246,000,000)
Fair value adjustments	(343,000,000)				(437,000,000)
Other	12,000,000				12,000,000
Total carrying value of debt	61,595,000,000				38,945,000,000
Less current portion	(834,000,000)				(1,591,000,000)
Total long-term debt	60,761,000,000				37,354,000,000
Face amount	$ 24,000,000,000
Notes \| 0.41% CHF700 million bonds due 2023 (0.41% 2023 Swiss franc Bonds)
Debt Instrument [Line Items]
Interest rate, stated percentage	0.41%	0.41%	0.41%	0.41%
Long-term debt, gross					757,000,000
Face amount \| SFr				SFr 700,000,000
Notes \| 2.25% notes due 2023 (2.25% 2023 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2.25%	2.25%	2.25%	2.25%
Long-term debt, gross	$ 750,000,000				750,000,000
Notes \| 3.625% notes due 2024 (3.625% 2024 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3.625%	3.625%	3.625%	3.625%
Long-term debt, gross	$ 1,400,000,000				1,400,000,000
Notes \| 1.90% notes due 2025 (1.90% 2025 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	1.90%	1.90%	1.90%	1.90%
Long-term debt, gross	$ 500,000,000				500,000,000
Notes \| 5.25% notes due 2025 (5.25% 2025 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.25%	5.25%	5.25%	5.25%
Long-term debt, gross	$ 2,000,000,000
Face amount	$ 2,000,000,000
Notes \| 3.125% notes due 2025 (3.125% 2025 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3.125%	3.125%	3.125%	3.125%
Long-term debt, gross	$ 1,000,000,000				1,000,000,000
Notes \| 2.00% €750 million notes due 2026 (2.00% 2026 euro Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	2%	2%	2%	2%
Long-term debt, gross	$ 813,000,000				803,000,000
Face amount \| €		€ 750,000,000
Notes \| 5.507% notes due 2026 (5.507% 2026 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.507%	5.507%	5.507%	5.507%
Long-term debt, gross	$ 1,500,000,000
Face amount	$ 1,500,000,000
Notes \| 2.60% notes due 2026 (2.60% 2026 notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2.60%	2.60%	2.60%	2.60%
Long-term debt, gross	$ 1,250,000,000				1,250,000,000
Notes \| 5.50% £475 million notes due 2026 (5.50% 2026 pound sterling Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.50%	5.50%	5.50%	5.50%
Long-term debt, gross	$ 586,000,000				574,000,000
Face amount \| £			£ 475,000,000
Notes \| 2.20% notes due 2027 (2.20% 2027 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2.20%	2.20%	2.20%	2.20%
Long-term debt, gross	$ 1,724,000,000				1,724,000,000
Notes \| 3.20% notes due 2027 (3.20% 2027 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3.20%	3.20%	3.20%	3.20%
Long-term debt, gross	$ 1,000,000,000				1,000,000,000
Notes \| 5.15% notes due 2028 (5.15% 2028 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.15%	5.15%	5.15%	5.15%
Long-term debt, gross	$ 3,750,000,000				0
Face amount	$ 3,750,000,000
Notes \| 1.65% notes due 2028 (1.65% 2028 Notes) [Member}
Debt Instrument [Line Items]
Interest rate, stated percentage	1.65%	1.65%	1.65%	1.65%
Long-term debt, gross	$ 1,234,000,000				1,234,000,000
Notes \| 3.00% 2029 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3%	3%	3%	3%
Long-term debt, gross	$ 750,000,000				750,000,000
Notes \| 4.05% 2029 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.05%	4.05%	4.05%	4.05%
Long-term debt, gross	$ 1,250,000,000				1,250,000,000
Notes \| 4.00% £700 million notes due 2029 (4.00% 2029 pound sterling Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	4%	4%	4%	4%
Long-term debt, gross	$ 864,000,000				846,000,000
Face amount \| £			£ 700,000,000
Notes \| 2.45% notes due 2030 (2.45% 2030 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2.45%	2.45%	2.45%	2.45%
Long-term debt, gross	$ 1,250,000,000				1,250,000,000
Notes \| 5.25% notes due 2030 (5.25% 2030 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.25%	5.25%	5.25%	5.25%
Long-term debt, gross	$ 2,750,000,000
Face amount	$ 2,750,000,000
Notes \| 2.30% notes due 2031 (2.30% 2031 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2.30%	2.30%	2.30%	2.30%
Long-term debt, gross	$ 1,250,000,000				1,250,000,000
Notes \| 2.00% notes due 2032 (2.00% 2032 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2%	2%	2%	2%
Long-term debt, gross	$ 1,001,000,000				1,051,000,000
Notes \| 3.35% 2032 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3.35%	3.35%	3.35%	3.35%
Long-term debt, gross	$ 1,000,000,000				1,000,000,000
Notes \| 4.20% 2033 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.20%	4.20%	4.20%	4.20%
Long-term debt, gross	$ 750,000,000				750,000,000
Notes \| 5.25% notes due 2033 (5.25% 2033 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.25%	5.25%	5.25%	5.25%
Long-term debt, gross	$ 4,250,000,000				0
Face amount	$ 4,250,000,000
Notes \| 6.375% notes due 2037 (6.375% 2037 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	6.375%	6.375%	6.375%	6.375%
Long-term debt, gross	$ 478,000,000				478,000,000
Notes \| 6.90% notes due 2038 (6.90% 2038 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	6.90%	6.90%	6.90%	6.90%
Long-term debt, gross	$ 254,000,000				254,000,000
Notes \| 6.40% notes due 2039 (6.40% 2039 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	6.40%	6.40%	6.40%	6.40%
Long-term debt, gross	$ 333,000,000				333,000,000
Notes \| 3.15% notes due 2040 (3.15% 2040 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3.15%	3.15%	3.15%	3.15%
Long-term debt, gross	$ 1,803,000,000				2,000,000,000
Notes \| 5.75% notes due 2040 (5.75% 2040 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.75%	5.75%	5.75%	5.75%
Long-term debt, gross	$ 373,000,000				373,000,000
Notes \| 2.80% notes due 2041 (2.80% 2041 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2.80%	2.80%	2.80%	2.80%
Long-term debt, gross	$ 1,091,000,000				1,110,000,000
Notes \| 4.95% notes due 2041 (4.95% 2041 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.95%	4.95%	4.95%	4.95%
Long-term debt, gross	$ 600,000,000				600,000,000
Notes \| 5.15% notes due 2041 (5.15% 2041 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.15%	5.15%	5.15%	5.15%
Long-term debt, gross	$ 729,000,000				729,000,000
Notes \| 5.65% notes due 2042 (5.65% 2042 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.65%	5.65%	5.65%	5.65%
Long-term debt, gross	$ 415,000,000				415,000,000
Notes \| 5.60% notes due 2043 (5.60% 2043 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.60%	5.60%	5.60%	5.60%
Long-term debt, gross	$ 2,750,000,000				0
Face amount	$ 2,750,000,000
Notes \| 5.375% notes due 2043 (5.375% 2043 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.375%	5.375%	5.375%	5.375%
Long-term debt, gross	$ 185,000,000				185,000,000
Notes \| 4.40% notes due 2045 (4.40% 2045 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.40%	4.40%	4.40%	4.40%
Long-term debt, gross	$ 2,250,000,000				2,250,000,000
Notes \| 4.563% notes due 2048 (4.563% 2048 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.563%	4.563%	4.563%	4.563%
Long-term debt, gross	$ 1,415,000,000				1,415,000,000
Notes \| 3.375% notes due 2050 (3.375% 2050 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3.375%	3.375%	3.375%	3.375%
Long-term debt, gross	$ 2,132,000,000				2,250,000,000
Notes \| 4.663% notes due 2051 (4.663% 2051 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.663%	4.663%	4.663%	4.663%
Long-term debt, gross	$ 3,541,000,000				3,541,000,000
Notes \| 3.00% notes due 2052 (3.00% 2052 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	3%	3%	3%	3%
Long-term debt, gross	$ 1,199,000,000				1,254,000,000
Notes \| 4.20% 2052 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.20%	4.20%	4.20%	4.20%
Long-term debt, gross	$ 950,000,000				1,000,000,000
Notes \| 4.875% 2053 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.875%	4.875%	4.875%	4.875%
Long-term debt, gross	$ 1,000,000,000				1,000,000,000
Notes \| 5.65% notes due 2053 (5.65% 2053 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.65%	5.65%	5.65%	5.65%
Long-term debt, gross	$ 4,250,000,000				0
Face amount	$ 4,250,000,000
Notes \| 2.77% notes due 2053 (2.77% 2053 Notes) {Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2.77%	2.77%	2.77%	2.77%
Long-term debt, gross	$ 940,000,000				940,000,000
Notes \| 4.40% 2062 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.40%	4.40%	4.40%	4.40%
Long-term debt, gross	$ 1,200,000,000				1,250,000,000
Notes \| 5.75% notes due 2063 (5.75% 2063 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	5.75%	5.75%	5.75%	5.75%
Long-term debt, gross	$ 2,750,000,000				0
Face amount	2,750,000,000
Notes \| Other notes due 2097 [Member]
Debt Instrument [Line Items]
Long-term debt, gross	$ 100,000,000				$ 100,000,000

Financing arrangements (Narrati

Financing arrangements (Narrative) (Details)	3 Months Ended	12 Months Ended
Financing arrangements (Narrative) (Details)	Mar. 31, 2023 USD ($) renewal_option	Dec. 31, 2022 USD ($)	Mar. 31, 2023 CHF (SFr)
Debt Instrument [Line Items]
Face amount	$ 24,000,000,000
Extinguishment of debt	420,000,000
Gain (loss) on extinguishment of debt	$ 113,000,000
Line of Credit Facility, Commitment Fee Percentage	0.09%
Horizon Therapeutics
Debt Instrument [Line Items]
Bridge credit, reduced amount		$ 24,500,000,000
term loan credit agreement, total amount	$ 4,000,000,000	4,000,000,000
Horizon Therapeutics \| Other Nonoperating Income (Expense)
Debt Instrument [Line Items]
Amortization of Other Deferred Charges	98,000,000
0.41% CHF700 million bonds due 2023 (0.41% 2023 Swiss franc Bonds) \| Cross-currency swap contracts \| Cash flow hedge
Debt Instrument [Line Items]
Notional amounts	$ 704,000,000
Notes \| 4.563% notes due 2048 (4.563% 2048 Notes) [Member]
Debt Instrument [Line Items]
Effective interest rate	6.30%		6.30%
Interest rate, stated percentage	4.563%		4.563%
Notes \| 4.663% notes due 2051 (4.663% 2051 Notes) [Member]
Debt Instrument [Line Items]
Effective interest rate	5.60%		5.60%
Interest rate, stated percentage	4.663%		4.663%
Notes \| 2.77% notes due 2053 (2.77% 2053 Notes) {Member]
Debt Instrument [Line Items]
Effective interest rate	5.20%		5.20%
Interest rate, stated percentage	2.77%		2.77%
Notes \| 3.00% 2029 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3%		3%
Notes \| 3.35% 2032 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3.35%		3.35%
Notes \| 4.20% 2052 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.20%		4.20%
Notes \| 4.40% 2062 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.40%		4.40%
Notes \| 4.05% 2029 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.05%		4.05%
Notes \| 4.20% 2033 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.20%		4.20%
Notes \| 4.875% 2053 Notes [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	4.875%		4.875%
Notes \| 2.20% notes due 2027 (2.20% 2027 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2.20%		2.20%
Notes \| 1.65% notes due 2028 (1.65% 2028 Notes) [Member}
Debt Instrument [Line Items]
Interest rate, stated percentage	1.65%		1.65%
Notes \| 2.00% notes due 2032 (2.00% 2032 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2%		2%
Notes \| 2.80% notes due 2041 (2.80% 2041 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	2.80%		2.80%
Notes \| 3.00% notes due 2052 (3.00% 2052 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	3%		3%
Notes \| 5.25% notes due 2025 (5.25% 2025 Notes) [Member]
Debt Instrument [Line Items]
Face amount	$ 2,000,000,000
Percentage of Principal Amount of Notes that may be Paid if Horizon Acquisition Does Not Occur	101%
Percentage of Principal Amount of Notes that may be Paid Upon Occurrence of Change in Control Triggering Event	101%
Interest rate, stated percentage	5.25%		5.25%
Notes \| 5.15% notes due 2028 (5.15% 2028 Notes) [Member]
Debt Instrument [Line Items]
Face amount	$ 3,750,000,000
Percentage of Principal Amount of Notes that may be Paid if Horizon Acquisition Does Not Occur	101%
Percentage of Principal Amount of Notes that may be Paid Upon Occurrence of Change in Control Triggering Event	101%
Interest rate, stated percentage	5.15%		5.15%
Notes \| 5.25% notes due 2030 (5.25% 2030 Notes) [Member]
Debt Instrument [Line Items]
Face amount	$ 2,750,000,000
Percentage of Principal Amount of Notes that may be Paid if Horizon Acquisition Does Not Occur	101%
Percentage of Principal Amount of Notes that may be Paid Upon Occurrence of Change in Control Triggering Event	101%
Interest rate, stated percentage	5.25%		5.25%
Notes \| 5.25% notes due 2033 (5.25% 2033 Notes) [Member]
Debt Instrument [Line Items]
Face amount	$ 4,250,000,000
Percentage of Principal Amount of Notes that may be Paid if Horizon Acquisition Does Not Occur	101%
Percentage of Principal Amount of Notes that may be Paid Upon Occurrence of Change in Control Triggering Event	101%
Interest rate, stated percentage	5.25%		5.25%
Notes \| 5.60% notes due 2043 (5.60% 2043 Notes) [Member]
Debt Instrument [Line Items]
Face amount	$ 2,750,000,000
Percentage of Principal Amount of Notes that may be Paid if Horizon Acquisition Does Not Occur	101%
Percentage of Principal Amount of Notes that may be Paid Upon Occurrence of Change in Control Triggering Event	101%
Interest rate, stated percentage	5.60%		5.60%
Notes \| 5.65% notes due 2053 (5.65% 2053 Notes) [Member]
Debt Instrument [Line Items]
Face amount	$ 4,250,000,000
Percentage of Principal Amount of Notes that may be Paid if Horizon Acquisition Does Not Occur	101%
Percentage of Principal Amount of Notes that may be Paid Upon Occurrence of Change in Control Triggering Event	101%
Interest rate, stated percentage	5.65%		5.65%
Notes \| 5.75% notes due 2063 (5.75% 2063 Notes) [Member]
Debt Instrument [Line Items]
Face amount	$ 2,750,000,000
Percentage of Principal Amount of Notes that may be Paid Upon Occurrence of Change in Control Triggering Event	101%
Interest rate, stated percentage	5.75%		5.75%
Notes \| 6.90% notes due 2038 (6.90% 2038 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	6.90%		6.90%
Notes \| 0.41% CHF700 million bonds due 2023 (0.41% 2023 Swiss franc Bonds)
Debt Instrument [Line Items]
Face amount \| SFr			SFr 700,000,000
Interest rate, stated percentage	0.41%		0.41%
Notes \| 5.507% notes due 2026 (5.507% 2026 Notes) [Member]
Debt Instrument [Line Items]
Face amount	$ 1,500,000,000
Percentage of Principal Amount of Notes that may be Paid if Horizon Acquisition Does Not Occur	101%
Percentage of Principal Amount of Notes that may be Paid Upon Occurrence of Change in Control Triggering Event	101%
Interest rate, stated percentage	5.507%		5.507%
Notes \| 3.15% notes due 2040 (3.15% 2040 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3.15%		3.15%
Notes \| 3.375% notes due 2050 (3.375% 2050 Notes) [Member]
Debt Instrument [Line Items]
Interest rate, stated percentage	3.375%		3.375%
Debt Securities Payable \| 5.507% notes due 2026 (5.507% 2026 Notes) [Member]
Debt Instrument [Line Items]
Debt Instrument, Redemption Period without Payment of Make Whole Amount	2 years
Line of Credit
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity	$ 4,000,000,000
Amount by which borrowing capacity under a syndicated unsecured revolving credit agreement may be increased upon our request at discretion of banks	$ 1,250,000,000
Line of Credit Facility, Initial Commitment Term	5 years
Line of Credit Facility, Number Of Renewal Options \| renewal_option	2
Line of Credit Facility, Extension of Commitment Term	1 year
Long-Term Line of Credit	$ 0	0
Line of Credit \| Secured overnight financing rate \| Variable Rate Component One
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	1.01%
Line of Credit \| Secured overnight financing rate \| Variable Rate Component Two
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	1.10%
Line of Credit \| Federal Funds Purchased
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	0.50%
prior line of credit
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity		2,500,000,000
Amount by which borrowing capacity under a syndicated unsecured revolving credit agreement may be increased upon our request at discretion of banks		750,000,000
bridge credit agreement \| Horizon Therapeutics
Debt Instrument [Line Items]
Bridge credit agreement amount	$ 0	$ 0
Minimum \| Debt Securities Payable
Debt Instrument [Line Items]
Debt Instrument, Redemption Period without Payment of Make Whole Amount	2 months
Maximum \| Debt Securities Payable
Debt Instrument [Line Items]
Debt Instrument, Redemption Period without Payment of Make Whole Amount	6 months

Stockholders' equity (Share Rep

Stockholders' equity (Share Repurchase Program) (Details) - USD ($) shares in Millions, $ in Millions	3 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Equity [Abstract]
Stock repurchased (in shares)	0	24.6
Stock repurchased	$ 0	$ 5,410

Stockholders' equity (Narrative

Stockholders' equity (Narrative) (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	1 Months Ended			3 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2023	Sep. 30, 2022	Mar. 31, 2022	Sep. 30, 2021
Class of Stock [Line Items]
Stock repurchased (in shares)					0		24.6
Stock repurchased					$ 0		$ 5,410
Repurchases of common stock						$ 6,310
Amount available for stock repurchases under a board approved stock repurchase plan		$ 7,000		$ 7,000
Dividends declared per share (in usd per share)		$ 2.13	$ 2.13	$ 2.13		$ 1.94
Dividends paid per share (in usd per share)		$ 2.13
Accumulated deficit
Class of Stock [Line Items]
Repurchases of common stock						$ 5,410
Common stock and additional paid-in capital
Class of Stock [Line Items]
Repurchases of common stock						$ 900
Forecast
Class of Stock [Line Items]
Dividends paid per share (in usd per share)	$ 2.13

Stockholders' equity (Component

Stockholders' equity (Components of AOCI) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Increase (Decrease) in AOCI [Roll Forward]
Balance as of beginning of period	$ 3,661	$ 6,700
Foreign currency translation adjustments	28	(51)
Balance as of end of period	5,348	916
Foreign currency translation
Increase (Decrease) in AOCI [Roll Forward]
Balance as of beginning of period	(348)
Foreign currency translation adjustments	28
Income taxes	0
Balance as of end of period	(320)
Cash flow hedges
Increase (Decrease) in AOCI [Roll Forward]
Balance as of beginning of period	128
Unrealized losses	(71)
Reclassification adjustments to income	(30)
Income taxes	15
Balance as of end of period	42
Other
Increase (Decrease) in AOCI [Roll Forward]
Balance as of beginning of period	(11)
Unrealized losses	0
Other	21
Balance as of end of period	10
AOCI
Increase (Decrease) in AOCI [Roll Forward]
Balance as of beginning of period	(231)	(796)
Foreign currency translation adjustments	28
Unrealized losses	(71)
Reclassification adjustments to income	(30)
Other	21
Income taxes	15
Balance as of end of period	$ (268)	$ (763)

Stockholders' equity (Reclassif

Stockholders' equity (Reclassifications out of AOCI) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Total revenues	$ 6,105	$ 6,238
Other income (expense), net	2,064	(530)
Income before income taxes	3,442	1,675
Provision for income taxes	(601)	(199)
Net income	2,841	1,476
Product sales
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Total revenues	5,846	5,731
Reclassification out of Accumulated Other Comprehensive Income \| Cash flow hedges
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Income before income taxes	30	(51)
Provision for income taxes	(6)	11
Net income	24	(40)
Reclassification out of Accumulated Other Comprehensive Income \| Foreign currency contract gains \| Cash flow hedges \| Product sales
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Total revenues	52	27
Reclassification out of Accumulated Other Comprehensive Income \| Cross-currency swap contract losses \| Cash flow hedges
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Other income (expense), net	(22)	(78)
Reclassification out of Accumulated Other Comprehensive Income \| Cash flow hedges \| Foreign currency contract gains \| Cash flow hedges \| Product sales
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Total revenues	52	27
Reclassification out of Accumulated Other Comprehensive Income \| Cash flow hedges \| Cross-currency swap contract losses \| Cash flow hedges
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Other income (expense), net	$ (22)	$ (78)

Fair value measurement (Details

Fair value measurement (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2021
Assets:
Interest-bearing securities	$ 31,065	$ 4,335
Other investments	131	130
Equity securities	4,833	815
Derivatives:
Total assets	36,281	5,621
Derivatives:
Contingent consideration obligations	273	270	$ 330	$ 342
Total liabilities	1,525	1,668
Derivative Liability	1,252	1,398
Foreign currency forward contracts
Derivatives:
Foreign currency and cross-currency swap contracts	252	287
Derivatives:
Foreign currency and cross-currency swap contracts	73	76
Cross-currency swap contracts
Derivatives:
Foreign currency and cross-currency swap contracts	0	54
Derivatives:
Foreign currency and cross-currency swap contracts	517	541
Interest rate swap contracts
Derivatives:
Interest rate swap contracts	662	776
Forward Interest Rate Contracts
Derivatives:
Derivative Liability	0	5
Quoted prices in active markets for identical assets (Level 1)
Assets:
Other investments	0	0
Equity securities	4,545	480
Derivatives:
Total assets	35,609	4,815
Derivatives:
Contingent consideration obligations	0	0
Total liabilities	0	0
Quoted prices in active markets for identical assets (Level 1) \| Foreign currency forward contracts
Derivatives:
Foreign currency and cross-currency swap contracts	0	0
Derivatives:
Foreign currency and cross-currency swap contracts	0	0
Quoted prices in active markets for identical assets (Level 1) \| Cross-currency swap contracts
Derivatives:
Foreign currency and cross-currency swap contracts	0	0
Derivatives:
Foreign currency and cross-currency swap contracts	0	0
Quoted prices in active markets for identical assets (Level 1) \| Interest rate swap contracts
Derivatives:
Interest rate swap contracts	0	0
Quoted prices in active markets for identical assets (Level 1) \| Forward Interest Rate Contracts
Derivatives:
Derivative Liability	0	0
Significant other observable inputs (Level 2)
Assets:
Other investments	131	130
Equity securities	0	0
Derivatives:
Total assets	384	471
Derivatives:
Contingent consideration obligations	0	0
Total liabilities	1,252	1,398
Significant other observable inputs (Level 2) \| Foreign currency forward contracts
Derivatives:
Foreign currency and cross-currency swap contracts	252	287
Derivatives:
Foreign currency and cross-currency swap contracts	73	76
Significant other observable inputs (Level 2) \| Cross-currency swap contracts
Derivatives:
Foreign currency and cross-currency swap contracts	0	54
Derivatives:
Foreign currency and cross-currency swap contracts	517	541
Significant other observable inputs (Level 2) \| Interest rate swap contracts
Derivatives:
Interest rate swap contracts	662	776
Significant other observable inputs (Level 2) \| Forward Interest Rate Contracts
Derivatives:
Derivative Liability	0	5
Significant unobservable inputs (Level 3)
Assets:
Other investments	0	0
Equity securities	288	335
Derivatives:
Total assets	288	335
Derivatives:
Contingent consideration obligations	273	270
Total liabilities	273	270
Significant unobservable inputs (Level 3) \| Foreign currency forward contracts
Derivatives:
Foreign currency and cross-currency swap contracts	0	0
Derivatives:
Foreign currency and cross-currency swap contracts	0	0
Significant unobservable inputs (Level 3) \| Cross-currency swap contracts
Derivatives:
Foreign currency and cross-currency swap contracts	0	0
Derivatives:
Foreign currency and cross-currency swap contracts	0	0
Significant unobservable inputs (Level 3) \| Interest rate swap contracts
Derivatives:
Interest rate swap contracts	0	0
Significant unobservable inputs (Level 3) \| Forward Interest Rate Contracts
Derivatives:
Derivative Liability	0	0
U.S. Treasury bills
Assets:
Interest-bearing securities	0	1,676
U.S. Treasury bills \| Quoted prices in active markets for identical assets (Level 1)
Assets:
Interest-bearing securities	0	1,676
U.S. Treasury bills \| Significant other observable inputs (Level 2)
Assets:
Interest-bearing securities	0	0
U.S. Treasury bills \| Significant unobservable inputs (Level 3)
Assets:
Interest-bearing securities	0	0
Money market mutual funds
Assets:
Interest-bearing securities	31,064	2,659
Money market mutual funds \| Quoted prices in active markets for identical assets (Level 1)
Assets:
Interest-bearing securities	31,064	2,659
Money market mutual funds \| Significant other observable inputs (Level 2)
Assets:
Interest-bearing securities	0	0
Money market mutual funds \| Significant unobservable inputs (Level 3)
Assets:
Interest-bearing securities	0	0
Other short-term interest-bearing securities
Assets:
Interest-bearing securities	1	0
Other short-term interest-bearing securities \| Quoted prices in active markets for identical assets (Level 1)
Assets:
Interest-bearing securities	0	0
Other short-term interest-bearing securities \| Significant other observable inputs (Level 2)
Assets:
Interest-bearing securities	1	0
Other short-term interest-bearing securities \| Significant unobservable inputs (Level 3)
Assets:
Interest-bearing securities	$ 0	$ 0

Fair value measurement (Detai_2

Fair value measurement (Details Textual) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Long-term debt, fair value	$ 59,800	$ 35,000
Carrying value of debt	61,595	38,945
Teneobio Inc.
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Maximum additional consideration due contingent on certain milestones	$ 1,600	1,600
BeiGene
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Equity Method Investments,Quoted Market Price		4,200
Carrying value of equity method investment		$ 2,200

Fair value measurement (Conting

Fair value measurement (Contingent Consideration Obligations) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Business Combination, Contingent Consideration [Roll Forward]
Beginning balance	$ 270	$ 342
Payments	(2)	(2)
Net changes in valuations	5	(10)
Ending balance	$ 273	$ 330

Derivative instruments (Narrati

Derivative instruments (Narrative) (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Derivative Instruments, Gain (Loss) [Line Items]
Amounts expected to be reclassified from AOCI into earnings over the next 12 months, foreign currency and cross-currency swaps	$ 97
Forward Contracts \| Designated as Hedging Instrument
Derivative Instruments, Gain (Loss) [Line Items]
Notional amounts	6,100	$ 6,000
Forward Contracts \| Derivatives not designated as hedging instrument
Derivative Instruments, Gain (Loss) [Line Items]
Notional amounts	582	517
Interest Rate Swap \| Designated as Hedging Instrument
Derivative Instruments, Gain (Loss) [Line Items]
Notional amounts	$ 6,700	$ 6,700

Derivative instruments (Cross-c

Derivative instruments (Cross-currency Swaps) (Details) - Cash flow hedge - Cross-currency swap contracts € in Millions, £ in Millions, $ in Millions	Mar. 31, 2023 USD ($)	Mar. 31, 2023 EUR (€)	Mar. 31, 2023 GBP (£)
0.41% 2023 Swiss franc Bonds
Derivative [Line Items]
Notional amounts	$ 704
2.00% 2026 euro Notes
Derivative [Line Items]
Notional amounts	833	€ 750
5.50% 2026 pound sterling Notes
Derivative [Line Items]
Notional amounts	747		£ 475
4.00% 2029 pound sterling Notes
Derivative [Line Items]
Notional amounts	$ 1,111		£ 700
Euro Member Countries, Euro \| 2.00% 2026 euro Notes
Derivative [Line Items]
Interest rates	2%	2%	2%
United Kingdom, Pounds \| 5.50% 2026 pound sterling Notes
Derivative [Line Items]
Interest rates	5.50%	5.50%	5.50%
United Kingdom, Pounds \| 4.00% 2029 pound sterling Notes
Derivative [Line Items]
Interest rates	4%	4%	4%
United States of America, Dollars \| 2.00% 2026 euro Notes
Derivative [Line Items]
Interest rates	3.90%	3.90%	3.90%
United States of America, Dollars \| 5.50% 2026 pound sterling Notes
Derivative [Line Items]
Interest rates	6%	6%	6%
United States of America, Dollars \| 4.00% 2029 pound sterling Notes
Derivative [Line Items]
Interest rates	4.60%	4.60%	4.60%

Derivative instruments (Effecti

Derivative instruments (Effective Portion of Unrealized Gain (Loss)) (Details) - Cash flow hedge - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Derivative Instruments, Gain (Loss) [Line Items]
Total unrealized gains (losses)	$ (71)	$ 56
Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Total unrealized gains (losses)	0	78
Cross-currency swap contracts
Derivative Instruments, Gain (Loss) [Line Items]
Total unrealized gains (losses)	(40)	(22)
Forward Interest Rate Contracts
Derivative Instruments, Gain (Loss) [Line Items]
Total unrealized gains (losses)	$ (31)	$ 0

Derivative instruments (Hedged

Derivative instruments (Hedged Liabilities and Cumulative Amount) (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Derivative [Line Items]
Cumulative amounts of fair value hedging adjustments related to the carrying amounts of the hedged liabilities	$ (343)	$ (437)
Current portion of long-term debt
Derivative [Line Items]
Hedged Liability, Fair Value Hedge	82	82
Cumulative amounts of fair value hedging adjustments related to the carrying amounts of the hedged liabilities	82	82
Carrying value with discontinued hedging relationships	82	82
Hedging adjustments on discontinued hedging relationships	82	82
Long-term debt
Derivative [Line Items]
Hedged Liability, Fair Value Hedge	6,112	6,017
Cumulative amounts of fair value hedging adjustments related to the carrying amounts of the hedged liabilities	(425)	(519)
Carrying value with discontinued hedging relationships	337	357
Hedging adjustments on discontinued hedging relationships	$ 237	$ 257

Derivative instruments (Summary

Derivative instruments (Summary of Income and Expense Line Items) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Derivative Instruments, Gain (Loss) [Line Items]
Total revenues	$ 6,105	$ 6,238
Other income (expense), net	2,064	(530)
Interest expense, net	(543)	(295)
Interest rate swap agreements
Derivative Instruments, Gain (Loss) [Line Items]
Gains (losses) on fair value hedging relationships, Hedged items	(88)	337
Gains (losses) on fair value hedging relationships, Derivatives designated as hedging instruments	114	(315)
Reclassification out of Accumulated Other Comprehensive Income \| Cash flow hedges \| Cross-currency swap contracts
Derivative Instruments, Gain (Loss) [Line Items]
Other income (expense), net	(22)	(78)
Product sales
Derivative Instruments, Gain (Loss) [Line Items]
Total revenues	5,846	5,731
Product sales \| Reclassification out of Accumulated Other Comprehensive Income \| Cash flow hedges \| Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Total revenues	$ 52	$ 27

Derivative instruments (Fair Va

Derivative instruments (Fair Value of Derivatives) (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Derivatives Fair Value [Line Items]
Derivative Asset	$ 252	$ 341
Derivative Liability	1,252	1,398
Forward Interest Rate Contracts
Derivatives Fair Value [Line Items]
Derivative Liability	0	5
Derivatives designated as hedging instrument
Derivatives Fair Value [Line Items]
Derivative Asset	252	341
Derivative Liability	1,252	1,398
Derivatives designated as hedging instrument \| Foreign currency forward contracts
Derivatives Fair Value [Line Items]
Derivative Asset	252	287
Derivative Liability	73	76
Derivatives designated as hedging instrument \| Cross-currency swap contracts
Derivatives Fair Value [Line Items]
Derivative Asset	0	54
Derivative Liability	517	541
Derivatives designated as hedging instrument \| Interest rate swap contracts
Derivatives Fair Value [Line Items]
Derivative Asset	0	0
Derivative Liability	662	776
Derivatives designated as hedging instrument \| Forward Interest Rate Contracts
Derivatives Fair Value [Line Items]
Derivative Asset	0	0
Derivatives designated as hedging instrument \| Forward Contracts
Derivatives Fair Value [Line Items]
Derivative Liability	$ 0	$ 5

Contingencies and commitments (

Contingencies and commitments (Narrative) (Details)	Feb. 21, 2023 patent	Feb. 20, 2023 patent	May 31, 2021 numberOfNotices
Domestic Tax Authority
Loss Contingencies [Line Items]
Number of notices on proposed additional tax \| numberOfNotices			2
Janseen Biotech, Inc Patent Litigation \| Pending Litigation
Loss Contingencies [Line Items]
Number of patents allegedly infringed upon \| patent	4	2