Amgen (AMGN) 10-Q2 May 242024 Q1 Quarterly reportFinancial data

Company Profile

Cover Page

Cover Page - shares	3 Months Ended
Cover Page - shares	Mar. 31, 2024	Apr. 29, 2024
Entity Information [Line Items]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2024
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		536,434,692
Entity Central Index Key	0000318154
Amendment Flag	false
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Current Fiscal Year End Date	--12-31
Common Stock
Entity Information [Line Items]
Title of 12(b) Security	Common stock, $0.0001 par value
Trading Symbol	AMGN
Security Exchange Name	NASDAQ
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 (Loss) Income - USD ($) shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenues:
Total revenues	$ 7,447	$ 6,105
Operating expenses:
Cost of sales	3,200	1,720
Research and development	1,343	1,058
Selling, general and administrative	1,808	1,258
Other	105	148
Total operating expenses	6,456	4,184
Operating income	991	1,921
Other income (expense):
Interest expense, net	(824)	(543)
Other (expense) income, net	(235)	2,064
(Loss) income before income taxes	(68)	3,442
Provision for income taxes	45	601
Net (loss) income	$ (113)	$ 2,841
(Loss) earnings per share:
Basic (in usd per share)	$ (0.21)	$ 5.32
Diluted (in usd per share)	$ (0.21)	$ 5.28
Shares used in calculation of (loss) earnings per share:
Basic (in shares)	536	534
Diluted (in shares)	536	538
Product sales
Revenues:
Total revenues	$ 7,118	$ 5,846
Other revenues
Revenues:
Total revenues	$ 329	$ 259

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Statement of Comprehensive Income [Abstract]
Net (loss) income	$ (113)	$ 2,841
Other comprehensive income (loss), net of reclassification adjustments and taxes:
Foreign currency translation	(24)	28
Cash flow hedges	126	(86)
Other	(3)	21
Other comprehensive income (loss), net of reclassification adjustments and taxes	99	(37)
Comprehensive (loss) income	$ (14)	$ 2,804

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 9,708	$ 10,944
Trade receivables, net	6,776	7,268
Inventories	8,724	9,518
Other current assets	2,821	2,602
Total current assets	28,029	30,332
Property, plant and equipment, net	6,002	5,941
Intangible assets, net	31,372	32,641
Goodwill	18,570	18,629
Other noncurrent assets	9,007	9,611
Total assets	92,980	97,154
Current liabilities:
Accounts payable	1,628	1,590
Accrued liabilities	14,127	15,359
Current portion of long-term debt	3,959	1,443
Total current liabilities	19,714	18,392
Long-term debt	60,061	63,170
Long-term deferred tax liabilities	1,862	2,354
Long-term tax liabilities	3,964	4,680
Other noncurrent liabilities	2,357	2,326
Contingencies and commitments
Stockholders’ equity:
Common stock and additional paid-in capital; $0.0001 par value; 2,750.0 shares authorized; outstanding—536.4 shares in 2024 and 535.4 shares in 2023	33,082	33,070
Accumulated deficit	(27,870)	(26,549)
Accumulated other comprehensive loss	(190)	(289)
Total stockholders’ equity	5,022	6,232
Total liabilities and stockholders’ equity	$ 92,980	$ 97,154

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - $ / shares shares in Millions	Mar. 31, 2024	Dec. 31, 2023
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)	536.4	535.4

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, 2022		534
Beginning balance at Dec. 31, 2022	$ 3,661		$ 32,514	$ (28,622)	$ (231)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	2,841			2,841
Other comprehensive income (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
Ending balance at Mar. 31, 2023	$ 5,348		32,535	(26,919)	(268)
Beginning balance (in shares) at Dec. 31, 2023	535.4	535.4
Beginning balance at Dec. 31, 2023	$ 6,232		33,070	(26,549)	(289)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net (loss) income	(113)			(113)
Other comprehensive income (loss), net of taxes	99				99
Dividends declared on common stock	(1,208)			(1,208)
Issuance of common stock in connection with the Company’s equity award programs (in shares)		1
Issuance of common stock in connection with the Company’s equity award programs	34		34
Stock-based compensation expense	103		103
Tax impact related to employee stock-based compensation expense	$ (125)		(125)
Ending balance (in shares) at Mar. 31, 2024	536.4	536.4
Ending balance at Mar. 31, 2024	$ 5,022		$ 33,082	$ (27,870)	$ (190)

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Stockholders' Equity (Parenthetical) - $ / shares	1 Months Ended		3 Months Ended
	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2024	Mar. 31, 2023
Statement of Stockholders' Equity [Abstract]
Common stock, dividends declared per share (in usd per share)	$ 2.25	$ 2.25	$ 2.25	$ 2.13

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Cash flows from operating activities:
Net (loss) income	$ (113)	$ 2,841
Depreciation, amortization and other	1,399	900
Stock-based compensation expense	103	47
Deferred income taxes	(401)	(49)
Adjustments for equity method investments	(27)	(31)
Losses (gains) on equity securities	515	(1,830)
Other items, net	(95)	(60)
Changes in operating assets and liabilities, net of acquisitions:
Trade receivables, net	486	(144)
Inventories	806	(58)
Other assets	(89)	(139)
Accounts payable	23	(253)
Accrued income taxes, net	223	443
Long-term tax liabilities	(715)	107
Accrued liabilities	(1,054)	(230)
Accrued sales incentives and allowance	(316)	(402)
Other liabilities	(56)	(78)
Net cash provided by operating activities	689	1,064
Cash flows from investing activities:
Proceeds from sales of marketable securities	0	1,124
Proceeds from maturities of marketable securities	0	550
Purchases of property, plant and equipment	(230)	(344)
Other	13	28
Net cash (used in) provided by investing activities	(217)	1,358
Cash flows from financing activities:
Net proceeds from issuance of debt	0	23,798
Extinguishment of debt	(410)	(420)
Repayment of debt	0	(704)
Dividends paid	(1,208)	(1,137)
Other	(90)	(28)
Net cash (used in) provided by financing activities	(1,708)	21,509
(Decrease) increase in cash and cash equivalents	(1,236)	23,931
Cash and cash equivalents at beginning of period	10,944	7,629
Cash and cash equivalents at end of period	$ 9,708	$ 31,560

Summary of significant accounti

Summary of significant accounting policies	3 Months Ended
Summary of significant accounting policies	Mar. 31, 2024
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, 2024 and 2023, 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, 2023. 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. Certain reclassifications have been made to prior periods in the condensed consolidated financial statements and accompanying notes to conform with the current presentation. 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 $9.9 billion and $9.8 billion as of March 31, 2024 and December 31, 2023, respectively. Recent accounting pronouncements In November 2023, the Financial Accounting Standards Board (FASB) issued a new accounting standard that improves reportable segment disclosure requirements. The new standard requires enhanced disclosures about a public company’s significant segment expenses and more timely and detailed segment information reporting throughout the fiscal period, including for companies with a single reportable segment. The standard is effective for public business entities for annual periods beginning after December 15, 2023 and interim periods beginning after December 15, 2024, and early adoption is permitted. We are currently evaluating the impact of this new standard on our related disclosures. In December 2023, the FASB issued a new accounting standard that improves income tax disclosure requirements. The new standard requires more detailed information on several income tax disclosures, such as income taxes paid and the income tax rate reconciliation table. The standard is effective for public business entities for annual periods beginning after December 15, 2024, and early adoption is permitted. We are currently evaluating the impact of this new standard on our related disclosures.

Acquisitions

Acquisitions	3 Months Ended
Acquisitions	Mar. 31, 2024
Business Combination and Asset Acquisition [Abstract]
Acquisitions and divestitures	Acquisitions Acquisition of Horizon Therapeutics plc On October 6, 2023, Amgen completed its acquisition of Horizon for $116.50 per share in cash, representing a total consideration of approximately $27.8 billion. Horizon is a global biotechnology company focused on the discovery, development and commercialization of medicines that address critical needs of patients impacted by rare, autoimmune and severe inflammatory diseases. The acquisition, which was accounted for as a business combination, aligns with Amgen’s core strategy of delivering innovative medicines that make a significant difference for patients suffering from serious diseases and strengthens Amgen’s leading rare disease portfolio by adding first-in-class, early-in-lifecycle medicines, including TEPEZZA for thyroid eye disease, KRYSTEXXA for chronic refractory gout and UPLIZNA for neuromyelitis optica spectrum disorder. Upon its acquisition, Horizon 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, 2024, included changes to the purchase price allocation, resulting in a net decrease of approximately $49 million to goodwill. The measurement period adjustments resulted primarily from adjustments to acquired assets and liabilities, including sales reserve and allowances as well as right-of-use assets and liabilities 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, 2024, 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 $ 681 Inventories 5,025 Property, plant and equipment, net 318 Finite-lived intangible assets – developed-product-technology rights 19,590 IPR&D 1,060 Goodwill 3,062 Deferred tax asset 834 Deferred tax liability (2,492) Other assets and liabilities, net (245) Total assets acquired, net $ 27,833 The $27.8 billion total consideration for this transaction consisted of (i) cash consideration transferred to common shareholders of $26.7 billion; (ii) cash consideration transferred to vested and outstanding options, outstanding restricted stock unit (RSU) awards, and outstanding performance share unit (PSU) awards of $523 million; (iii) fair value of Amgen replacement awards (based on conversion of outstanding employee RSU awards) of $180 million representing non-cash consideration; and (iv) a portion of Horizon’s debt, settled by Amgen on the closing date, of $382 million. Amgen issued 1.7 million replacement equity awards with the original vesting conditions, and fair value was determined based on acquisition date fair value based on the conversion calculation. The estimated fair values of $20.7 billion for the developed-product-technology rights and IPR&D intangible assets were determined 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 projected cash flows were based on certain assumptions attributable to the respective intangible asset, including estimates of future revenues and expenses, the time and resources needed to complete development and the probabilities of obtaining marketing approval from the FDA and other regulatory agencies. The developed-product-technology rights are being amortized on a straight-line basis over a weighted-average period of approximately 10 years from the acquisition date using the straight-line methodology. The estimated fair value of the acquired inventory of $5.0 billion 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 using a weighted-average inventory turnover, which we estimate to approximate 27 months from the acquisition date. A deferred tax liability of $2.5 billion 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, as well as associated deferred tax asset for anticipatory foreign tax credits of $834 million. The excess of the acquisition date consideration over the fair values assigned to the assets acquired and the liabilities assumed of $3.1 billion was recorded as goodwill, which is not deductible for tax purposes. The goodwill value represents expected synergies from the marketed products acquired and other benefits. 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. Supplemental Pro Forma Financial Information The following table presents the unaudited supplemental pro forma results of a hypothetical combined Amgen and Horizon entity for the three months ended March 31, 2023, as if the acquisition of Horizon had occurred on January 1, 2022 (in millions): Three months ended Total revenue $ 6,941 Net income $ 2,182 The unaudited supplemental pro forma combined financial information was prepared using the acquisition method of accounting and was based on the historical financial information of Amgen and Horizon. In order to reflect the occurrence of the acquisition on January 1, 2022, the unaudited supplemental pro forma financial information includes adjustments to reflect the following: (i) incremental amortization expense based on the current preliminary fair values of the identifiable intangible assets and inventory step-up; (ii) the additional interest expense associated with the issuance of debt to finance the acquisition; and (iii) the income tax impact using an estimated effective tax rate applied to the combined entity. The unaudited supplemental pro forma financial information is not necessarily indicative of what the condensed consolidated results of operations would have been had the acquisition been completed on January 1, 2022. In addition, the unaudited supplemental pro forma financial information is not a projection of future results of operations of the combined company, nor does it reflect the expected realization of any synergies or cost savings associated with the acquisition.

Revenues

Revenues	3 Months Ended
Revenues	Mar. 31, 2024
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, 2024 2023 U.S. ROW Total U.S. ROW Total Prolia $ 657 $ 342 $ 999 $ 623 $ 304 $ 927 ENBREL 561 6 567 564 15 579 XGEVA 366 195 561 384 152 536 Repatha 273 244 517 197 191 388 TEPEZZA (1) 419 5 424 — — — Otezla 293 101 394 294 98 392 KYPROLIS 234 142 376 234 124 358 Aranesp 100 249 349 115 240 355 EVENITY 236 106 342 164 90 254 Nplate 190 127 317 246 116 362 Vectibix 120 127 247 111 122 233 BLINCYTO 153 91 244 126 68 194 KRYSTEXXA (1) 235 — 235 — — — TEZSPIRE (2) 173 — 173 96 — 96 Other products (3) 963 410 1,373 821 351 1,172 Total product sales (4) $ 4,973 $ 2,145 7,118 $ 3,975 $ 1,871 5,846 Other revenues 329 259 Total revenues $ 7,447 $ 6,105 ____________ (1) TEPEZZA and KRYSTEXXA were acquired from the acquisition of Horizon on October 6, 2023, and include product sales in the periods after the acquisition date. (2) TEZSPIRE is marketed by our collaborator AstraZeneca outside the United States. (3) Consists of product sales of our non-principal products. (4) Hedging gains and losses, which are included in product sales, were not material for the three months ended March 31, 2024 and 2023.

Income taxes

Income taxes	3 Months Ended
Income taxes	Mar. 31, 2024
Income Tax Disclosure [Abstract]
Income taxes	Income taxes The income tax provisions for the three months ended March 31, 2024 and 2023, were tax expenses of $45 million and $601 million, respectively, on a pretax loss of $68 million and a pretax income of $3,442 million, respectively. The effective tax rates for the three months ended March 31, 2024 and 2023, were (66.2)% and 17.5%, respectively. The decrease in our effective tax rate for the three months ended March 31, 2024, was primarily due to the earnings mix as a result of the inclusion of the Horizon business, amortization of Horizon acquired assets and the first quarter 2024 unrealized loss on our BeiGene investment. See Note 6, Investments —BeiGene, Ltd . The effective tax rates differ from the federal statutory rate primarily due to impacts of the jurisdictional mix of income and expenses. Substantially all of the benefit to our effective tax rate from foreign earnings results from locations where the Company has significant manufacturing operations, including Singapore, Ireland and Puerto Rico, a territory of the United States that is treated as a foreign jurisdiction for U.S. tax purposes. Our operations in Puerto Rico are subject to a tax incentive grant through 2050. Additionally, the Company’s operations conducted in Singapore are subject to a tax incentive grant through 2036. Our foreign earnings are also subject to U.S. tax at a reduced rate of 10.5%. Additionally, effective January 1, 2024, selected individual countries, including the United Kingdom and EU member countries, have enacted the global minimum tax agreement. Our legal entities in such countries, along with their direct and indirect subsidiaries, are now subject to a 15% minimum tax rate on adjusted financial statement income. Beginning on January 1, 2023, we were 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. We qualify for and are subject to 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 accounted for the 2022 excise tax that was capitalized in Inventories as an expense in Cost of sales when the related products were sold in the first half of 2023, and a foreign tax credit was not recognized with respect to the excise tax expense in 2023. We do not have this excise tax exposure in 2024. 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. The trial is currently scheduled to begin on 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. During the three months ended March 31, 2024, the gross amounts of our UTBs increased by $40 million as a result of tax positions taken during the current year. Substantially all of the UTBs as of March 31, 2024, if recognized, would affect our effective tax rate.

Earnings per share

Earnings per share	3 Months Ended
Earnings per share	Mar. 31, 2024
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. As the Company recorded a net loss for the three months ended March 31, 2024, 5 million shares of employee stock-based awards were excluded in the computation of diluted loss per share because the effect would have been antidilutive. The computations for basic and diluted (loss) earnings per share were as follows (in millions, except per-share data): Three months ended 2024 2023 Income (Numerator): Net (loss) income for basic and diluted (loss) earnings per share $ (113) $ 2,841 Shares (Denominator): Weighted-average shares for basic (loss) earnings per share 536 534 Effect of dilutive securities — 4 Weighted-average shares for diluted (loss) earnings per share 536 538 Basic (loss) earnings per share $ (0.21) $ 5.32 Diluted (loss) earnings per share $ (0.21) $ 5.28 For the three months ended March 31, 2023, 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, 2024
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, 2024 Amortized Gross Gross Fair Money market mutual funds $ 9,099 $ — $ — $ 9,099 Other short-term interest-bearing securities 138 — — 138 Total interest-bearing securities $ 9,237 $ — $ — $ 9,237 Types of securities as of December 31, 2023 Amortized Gross Gross Fair Money market mutual funds $ 10,266 $ — $ — $ 10,266 Other short-term interest-bearing securities 138 — — 138 Total interest-bearing securities $ 10,404 $ — $ — $ 10,404 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, 2024 December 31, 2023 Cash and cash equivalents $ 9,237 $ 10,404 Total interest-bearing securities $ 9,237 $ 10,404 Cash and cash equivalents in the above table excludes bank account cash of $471 million and $540 million as of March 31, 2024 and December 31, 2023, respectively. All interest-bearing securities as of March 31, 2024 and December 31, 2023, mature in one year or less. For the three months ended March 31, 2024 and 2023, realized gains and losses on interest-bearing securities were not material. Realized gains and losses on interest-bearing securities are recorded in Other (expense) income, net, in the Condensed Consolidated Statements of (Loss) 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 (expense) income, net. See Note 11, Fair value measurement. During the three months ended March 31, 2024 and 2023, we recognized an unrealized loss of $454 million and an unrealized gain of $1.9 billion, respectively, recorded in Other (expense) income, net, in our Condensed Consolidated Statements of (Loss) Income. As of March 31, 2024 and December 31, 2023, the carrying and fair values of our equity investment in BeiGene were $3.0 billion and $3.4 billion, respectively, and were included in Other noncurrent assets in the Condensed Consolidated Balance Sheets. Subject to certain exceptions or otherwise agreed to by BeiGene, while Amgen holds at least 5.0% of BeiGene’s outstanding common stock, (A) we may only sell our BeiGene equity investment via: (i) a registered public offering, (ii) a sale under Rule 144 of the Securities Act of 1933 (the “Securities Act”) or (iii) a private sale exempt from registration requirements under the Securities Act, and (B) we may not sell more than 5.0% of BeiGene’s outstanding common stock in any rolling 12-month period. Other equity securities Excluding our equity investments in BeiGene and Neumora (discussed below), we held investments in other equity securities with readily determinable fair values (publicly traded securities) of $536 million and $494 million as of March 31, 2024 and December 31, 2023, respectively, which are included in Other noncurrent assets in the Condensed Consolidated Balance Sheets. During the three months ended March 31, 2024 and 2023, net unrealized gains on these publicly traded securities were $50 million and $5 million, respectively. Realized gains and losses on sales of publicly traded securities for the three months ended March 31, 2024 and 2023, were not material. We held investments of $333 million and $309 million in equity securities without readily determinable fair values as of March 31, 2024 and December 31, 2023, respectively, which are included in Other noncurrent assets in the Condensed Consolidated Balance Sheets. During the three months ended March 31, 2024 and 2023, upward and downward adjustments on these securities were not material. Adjustments were based on observable price transactions. Equity method investments Neumora Therapeutics, Inc. As of March 31, 2024 and December 31, 2023, our ownership interests in Neumora were approximately 22.3% and 23.2%, respectively, and the fair values of our investment were $486 million and $603 million, respectively. During the three months ended March 31, 2024 and 2023, we recognized net losses of $117 million and $47 million, respectively. Although our equity investment qualifies us for the equity method of accounting, we have elected the fair value option to account for our investment. Under the fair value option, changes in the fair value of the investment are recognized through earnings in Other (expense) income, net, in our Condensed Consolidated Statements of (Loss) Income each reporting period. See Note 11, Fair value measurement. We believe the fair value option best reflects the economics of the underlying transaction. We are contractually restricted from selling more than 5.0% of Neumora’s outstanding common stock in any rolling 12-month period for as long as we hold at least 10.0% of their outstanding common stock, subject to certain exceptions or otherwise agreed to by Neumora. Limited partnerships We held limited partnership investments

Inventories

Inventories	3 Months Ended
Inventories	Mar. 31, 2024
Inventory Disclosure [Abstract]
Inventories	Inventories Inventories consisted of the following (in millions): March 31, 2024 December 31, 2023 Raw materials $ 928 $ 993 Work in process 5,270 5,747 Finished goods 2,526 2,778 Total inventories $ 8,724 $ 9,518

Goodwill and other intangible a

Goodwill and other intangible assets	3 Months Ended
Goodwill and other intangible assets	Mar. 31, 2024
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 $ 18,629 Adjustments to goodwill resulting from acquisitions (1) (49) Currency translation adjustment (10) Ending balance $ 18,570 ____________ (1) For the three months ended March 31, 2024, adjustments to goodwill consisted of a measurement period adjustment related to our Horizon acquisition. See Note 2, Acquisitions. Other intangible assets Other intangible assets consisted of the following (in millions): March 31, 2024 December 31, 2023 Gross Accumulated Other intangible Gross Accumulated Other intangible Finite-lived intangible assets: Developed-product-technology rights $ 48,625 $ (19,184) $ 29,441 $ 48,631 $ (18,049) $ 30,582 Licensing rights 3,864 (3,297) 567 3,865 (3,265) 600 Marketing-related rights 1,203 (1,148) 55 1,339 (1,264) 75 Research and development technology rights 1,388 (1,229) 159 1,394 (1,228) 166 Total finite-lived intangible assets 55,080 (24,858) 30,222 55,229 (23,806) 31,423 Indefinite-lived intangible assets: In-process research and development 1,150 — 1,150 1,218 — 1,218 Total other intangible assets $ 56,230 $ (24,858) $ 31,372 $ 56,447 $ (23,806) $ 32,641 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, 2024 and 2023, we recognized amortization associated with our finite-lived intangible assets of $1.2 billion and $693 million, respectively. Amortization of intangible assets is primarily included in Cost of sales in the Condensed Consolidated Statements of (Loss) Income. As of March 31, 2024, the total estimated amortization of our finite-lived intangible assets for the remaining nine months ending December 31, 2024, and the years ending December 31, 2025, 2026, 2027, 2028 and 2029, are $3.6 billion, $4.5 billion, $3.9 billion, $3.9 billion, $2.9 billion and $2.2 billion, respectively.

Financing arrangements

Financing arrangements	3 Months Ended
Financing arrangements	Mar. 31, 2024
Debt Disclosure [Abstract]
Financing arrangements	Financing arrangements Our borrowings consisted of the following (in millions): March 31, 2024 December 31, 2023 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 2,000 Term loan due April 2025 2,000 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) 809 828 5.507% notes due 2026 (5.507% 2026 Notes) 1,500 1,500 2.60% notes due 2026 (2.60% 2026 Notes) 1,250 1,250 Term loan due October 2026 2,000 2,000 5.50% £475 million notes due 2026 (5.50% 2026 pound sterling Notes) 600 605 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 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) 884 892 2.45% notes due 2030 (2.45% 2030 Notes) 1,250 1,250 5.25% notes due 2030 (5.25% 2030 Notes) 2,750 2,750 2.30% notes due 2031 (2.30% 2031 Notes) 1,250 1,250 2.00% notes due 2032 (2.00% 2032 Notes) 1,001 1,001 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 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) 1,768 1,803 5.75% notes due 2040 (5.75% 2040 Notes) 373 373 2.80% notes due 2041 (2.80% 2041 Notes) 828 949 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 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) 1,914 2,132 4.663% notes due 2051 (4.663% 2051 Notes) 3,541 3,541 3.00% notes due 2052 (3.00% 2052 Notes) 919 999 4.20% notes due 2052 (4.20% 2052 Notes) 895 950 4.875% notes due 2053 (4.875% 2053 Notes) 1,000 1,000 5.65% notes due 2053 (5.65% 2053 Notes) 4,250 4,250 2.77% notes due 2053 (2.77% 2053 Notes) 940 940 4.40% notes due 2062 (4.40% 2062 Notes) 1,165 1,200 March 31, 2024 December 31, 2023 5.75% notes due 2063 (5.75% 2063 Notes) 2,750 2,750 Other notes due 2097 100 100 Unamortized bond discounts, premiums and issuance costs, net (1,404) (1,420) Fair value adjustments (363) (314) Other 33 17 Total carrying value of debt 64,020 64,613 Less current portion (3,959) (1,443) Total long-term debt $ 60,061 $ 63,170 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. The Term loans have an interest rate of three-month SOFR plus 1.225%. Debt extinguishment During the three months ended March 31, 2024, we repurchased portions of the 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 $410 million, which resulted in the recognition of a $133 million gain on extinguishment of debt recorded in Other (expense) income, net, in the Condensed Consolidated Statements of (Loss) Income.

Stockholders' equity

Stockholders' equity	3 Months Ended
Stockholders' equity	Mar. 31, 2024
Equity [Abstract]
Stockholders' equity	Stockholders’ equity Stock repurchase program During the three months ended March 31, 2024 and 2023, we did not repurchase shares under our stock repurchase program. As of March 31, 2024, $7.0 billion of authorization remained available under our stock repurchase program. Dividends In March 2024, the Board of Directors declared a quarterly cash dividend of $2.25 per share, which will be paid in June 2024. In December 2023, the Board of Directors declared a quarterly cash dividend of $2.25 per share, which was paid in March 2024. Accumulated other comprehensive income (loss) The components of AOCI were as follows (in millions): Foreign Cash flow Other AOCI Balance as of December 31, 2023 $ (298) $ (22) $ 31 $ (289) Foreign currency translation adjustments (24) — — (24) Unrealized gains — 178 — 178 Reclassification adjustments to income — (20) — (20) Other — — (3) (3) Income taxes — (32) — (32) Balance as of March 31, 2024 $ (322) $ 104 $ 28 $ (190) 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 2024 2023 Condensed Consolidated Cash flow hedges: Foreign currency contract gains $ 51 $ 52 Product sales Cross-currency swap contract losses (31) (22) Other (expense) income, net 20 30 (Loss) income before income taxes (4) (6) Provision for income taxes $ 16 $ 24 Net (loss) income

Fair value measurement

Fair value measurement	3 Months Ended
Fair value measurement	Mar. 31, 2024
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, 2024, using: Total Assets: Available-for-sale securities: Money market mutual funds $ 9,099 $ — $ — $ 9,099 Other short-term interest-bearing securities — 138 — 138 Equity securities 3,985 — — 3,985 Derivatives: Foreign currency forward contracts — 225 — 225 Total assets $ 13,084 $ 363 $ — $ 13,447 Liabilities: Derivatives: Foreign currency forward contracts $ — $ 43 $ — $ 43 Cross-currency swap contracts — 429 — 429 Interest rate swap contracts — 600 — 600 Contingent consideration obligations — — 96 96 Total liabilities $ — $ 1,072 $ 96 $ 1,168 Quoted prices Significant Significant Fair value measurement as of December 31, 2023, using: Total Assets: Available-for-sale securities: Money market mutual funds $ 10,266 $ — $ — $ 10,266 Other short-term interest-bearing securities — 138 — 138 Equity securities 4,514 — — 4,514 Derivatives: Foreign currency forward contracts — 145 — 145 Total assets $ 14,780 $ 283 $ — $ 15,063 Liabilities: Derivatives: Foreign currency forward contracts $ — $ 116 $ — $ 116 Cross-currency swap contracts — 405 — 405 Interest rate swap contracts — 571 — 571 Contingent consideration obligations — — 96 96 Total liabilities $ — $ 1,092 $ 96 $ 1,188 Interest-bearing and equity securities The fair values of our money market mutual funds and equity investments in publicly traded securities, including our equity investments in BeiGene and Neumora, as of March 31, 2024 and December 31, 2023, are based on quoted market prices in active markets, with no valuation adjustment. 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, SOFR, swap rates, obligor credit default swap rates and cross-currency basis swap spreads. Certain inputs, when applicable, are at commonly quoted intervals. See Note 12, 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 (Loss) Income. Changes in the carrying amounts of contingent consideration obligations were as follows (in millions): Three months ended 2024 2023 Beginning balance $ 96 $ 270 Payments (2) (2) Net changes in valuations 2 5 Ending balance $ 96 $ 273 As of March 31, 2024 and December 31, 2023, 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 payments 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 are approximated at 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, 2024 and December 31, 2023, the aggregate fair values of our borrowings were $57.8 billion and $59.2 billion, respectively, and the carrying values were $64.0 billion and $64.6 billion, respectively. During the three months ended March 31, 2024 and 2023, 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, 2024
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 both March 31, 2024 and December 31, 2023, we had outstanding foreign currency forward contracts with aggregate notional amounts of $6.6 billion. 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 (Loss) 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 and pounds sterling 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 and pounds sterling. In addition, we will pay U.S. dollars to and receive euros and pounds sterling 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 and pounds sterling 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 (expense) income, net, in the Condensed Consolidated Statements of (Loss) 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, 2024, 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. Ga ins 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 (Loss) 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, 2024, 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 2024 2023 Foreign currency forward contracts $ 202 $ — Cross-currency swap contracts (24) (40) Forward interest rate contracts — (31) Total unrealized gains (losses) $ 178 $ (71) 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 coupons over the terms of the related hedge contracts. As of both March 31, 2024 and December 31, 2023, 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 (Loss) 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, 2024 December 31, 2023 March 31, 2024 December 31, 2023 Current portion of long-term debt $ 1,454 $ 1,441 $ 54 $ 41 Long-term debt $ 4,728 $ 4,788 $ (417) $ (355) ____________ (1) Current portion of long-term debt includes $64 million and $69 million of carrying value with discontinued hedging relationships as of March 31, 2024 and December 31, 2023, respectively. Long-term debt includes $273 million and $288 million of carrying value with discontinued hedging relationships as of March 31, 2024 and December 31, 2023, respectively. (2) Current portion of long-term debt includes $64 million and $69 million of hedging adjustments on discontinued hedging relationships as of March 31, 2024 and December 31, 2023, respectively. Long-term debt includes $173 million and $188 million of hedging adjustments on discontinued hedging relationships as of March 31, 2024 and December 31, 2023, 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, 2024 Product sales Other (expense) income, net Interest expense, net Total amounts recorded in income and (expense) line items presented in the Condensed Consolidated Statements of (Loss) Income $ 7,118 $ (235) $ (824) The effects of cash flow and fair value hedging: Gains (losses) on cash flow hedging relationships reclassified out of AOCI: Foreign currency forward contracts $ 51 $ — $ — Cross-currency swap contracts $ — $ (31) $ — Gains (losses) on fair value hedging relationships—interest rate swap agreements: Hedged items (1) $ — $ — $ 49 Derivatives designated as hedging instruments $ — $ — $ (28) Three months ended March 31, 2023 Product sales Other (expense) income, net Interest expense, net Total amounts recorded in income and (expense) line items presented in the Condensed Consolidated Statements of (Loss) 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 __________ (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, 2024, 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, 2024 and December 31, 2023, the total notional amounts of these foreign currency forward contracts were $300 million and $457 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, 2024 and 2023. 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, 2024 Condensed Consolidated Fair values Condensed Consolidated Fair values Derivatives designated as hedging instruments: Foreign currency forward contracts Other current assets/ Other noncurrent assets $ 225 Accrued liabilities/ Other noncurrent liabilities $ 43 Cross-currency swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 429 Interest rate swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 600 Forward interest rate contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities — Total derivatives designated as hedging instruments 225 1,072 Total derivatives $ 225 $ 1,072 Derivative assets Derivative liabilities December 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 $ 145 Accrued liabilities/ Other noncurrent liabilities $ 116 Cross-currency swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 405 Interest rate swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 571 Forward interest rate contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities — Total derivatives designated as hedging instruments 145 1,092 Total derivatives $ 145 $ 1,092 For additional information, see Note 11, Fair value measurement. Our derivative contracts that were in liability positions as of March 31, 2024, 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 (used in) provided by financing activities.

Contingencies and commitments

Contingencies and commitments	3 Months Ended
Contingencies and commitments	Mar. 31, 2024
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, 2023, 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 20, Contingencies and commitments, to the consolidated financial statements in our Annual Report on Form 10-K for the year ended December 31, 2023. 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 20, Contingencies and commitments, to the consolidated financial statements in our Annual Report on Form 10-K for the year ended December 31, 2023, 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 20, Contingencies and commitments, to the consolidated financial statements in our Annual Report on Form 10-K for the year ended December 31, 2023, 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. Repatha Patent Litigation Patent Disputes in the International Region Germany On February 29, 2024, in Amgen’s Nullity Action before the German Federal Patent Court seeking invalidation of Regeneron Pharmaceuticals, Inc.’s (Regeneron) European Patent No. 2,756,004 (the EP’004 Patent), the Federal Patent Court issued a preliminary opinion that the EP’004 Patent is likely to be invalid and scheduled the main hearing for November 25, 2025. European Patent Office On November 16, 2023 and February 29, 2024, Sanofi-Aventis and Regeneron each filed a notice of opposition against Amgen’s European Patent No. 3,666,797 before the European Patent Office’s Opposition Division. On February 29, 2024, Amgen filed a Notice of Opposition and Grounds of Opposition before the European Patent Office against Regeneron’s European Patent No. 3,536,712. Prolia/XGEVA Biologics Price Competition and Innovation Act (BPCIA) Litigation Amgen Inc. et al. v. Sandoz Inc., et al. On April 29, 2024, the U.S. District Court for the District of New Jersey (the New Jersey District Court) entered judgment in the lawsuit pending against Sandoz Inc. based on Sandoz’s submission to the FDA of a Biologics License Application seeking approval to market and sell a biosimilar version of Amgen’s Prolia and XGEVA products (“Sandoz’s biosimilar denosumab products”). The complaint asserted infringement of patents listed in the FDA’s Purple Book for Amgen’s Prolia and XGEVA products. A preliminary injunction hearing, held between October 30 and December 21, 2023, focused on a composition of matter patent U.S. Patent No. 7,364,736 (the ‘736 Patent) and two manufacturing patents. The judgment entered by the New Jersey District Court found the asserted claims of Amgen’s ‘736 Patent valid, enforceable and infringed by Sandoz’s biosimilar denosumab products and included an injunction prohibiting Sandoz and third parties acting on behalf of or in active concert with Sandoz from making, using, selling, or offering to sell in the United States or importing into the United States Sandoz’s biosimilar denosumab products before the expiry of the ’736 Patent on February 19, 2025, except as specifically authorized by a confidential settlement agreement. As a result of the settlement, the parties’ remaining claims and counterclaims related to the other asserted patents were dismissed with prejudice and Sandoz is permitted to launch the Sandoz biosimilar denosumab products in the United States on May 31, 2025, unless accelerated pursuant to the terms of a confidential settlement agreement, and subject to confidential financial terms stated therein. ABP 938 (aflibercept) Patent Litigation On April 11, 2024, the Judicial Panel on Multidistrict Litigation granted Regeneron’s motion to transfer Regeneron’s patent infringement lawsuit pending against Amgen in the U.S. District Court for the Central District of California to the U.S. District Court for the Northern District of West Virginia for coordinated and consolidated pretrial proceedings. Antitrust Class Action Sensipar Antitrust Class Actions On February 17, 2024, Amgen and the indirect purchasers filed a stipulation in the U.S. District Court for the District of Delaware (the Delaware District Court) to dismiss the indirect purchasers’ claims. On February 22, 2024, Amgen and the indirect purchasers filed a stipulation in the U.S. Court of Appeals for the Third Circuit (the Third Circuit Court) dismissing the portion of the Third Circuit Court’s appeal relating to the claims of the indirect purchasers. Amgen and the direct purchasers filed a stipulation on April 12, 2024 in the Delaware District Court, dismissing with prejudice the direct purchasers’ claims that were at issue in the appeal and seeking entry of final judgment in Amgen’s favor. On April 15, 2024, the Delaware District Court entered an order pursuant to the stipulation and closed the case. The direct purchasers retain a right to appeal the claims that were dismissed by the Delaware District Court on March 11, 2022. U.S. Tax Litigation and Related Matters Amgen Inc. & Subsidiaries v. Commissioner of Internal Revenue See Note 4, Income taxes, for discussion of the IRS tax dispute and the Company’s petitions in the U.S. Tax Court. ChemoCentryx, Inc. Securities Matters On March 6, 2024, the U.S. District Court for the Northern District of California certified a class of all persons who purchased or otherwise acquired the common stock of ChemoCentryx between November 26, 2019 and May 6, 2021. Trial is scheduled to begin on September 22, 2025. On March 20, 2024, ChemoCentryx filed a petition with the U.S. Court of Appeals for the Ninth Circuit, seeking permission to have the district court’s order on class certification heard on appeal. The lead plaintiff’s response to ChemoCentryx’s petition was submitted on April 2, 2024.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Millions	3 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Millions	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net (loss) income for basic and diluted (loss) earnings per share	$ (113)	$ 2,841

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Mar. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Summary of significant accoun_2

Summary of significant accounting policies (Policies)	3 Months Ended
Summary of significant accounting policies (Policies)	Mar. 31, 2024
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, 2024 and 2023, 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, 2023.
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. Certain reclassifications have been made to prior periods in the condensed consolidated financial statements and accompanying notes to conform with the current presentation.
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 $9.9 billion and $9.8 billion as of March 31, 2024 and December 31, 2023, respectively.
Recent accounting pronouncements	Recent accounting pronouncements In November 2023, the Financial Accounting Standards Board (FASB) issued a new accounting standard that improves reportable segment disclosure requirements. The new standard requires enhanced disclosures about a public company’s significant segment expenses and more timely and detailed segment information reporting throughout the fiscal period, including for companies with a single reportable segment. The standard is effective for public business entities for annual periods beginning after December 15, 2023 and interim periods beginning after December 15, 2024, and early adoption is permitted. We are currently evaluating the impact of this new standard on our related disclosures. In December 2023, the FASB issued a new accounting standard that improves income tax disclosure requirements. The new standard requires more detailed information on several income tax disclosures, such as income taxes paid and the income tax rate reconciliation table. The standard is effective for public business entities for annual periods beginning after December 15, 2024, and early adoption is permitted. We are currently evaluating the impact of this new standard on our related disclosures.

Acquisitions (Tables)

Acquisitions (Tables)	3 Months Ended
Acquisitions (Tables)	Mar. 31, 2024
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 $ 681 Inventories 5,025 Property, plant and equipment, net 318 Finite-lived intangible assets – developed-product-technology rights 19,590 IPR&D 1,060 Goodwill 3,062 Deferred tax asset 834 Deferred tax liability (2,492) Other assets and liabilities, net (245) Total assets acquired, net $ 27,833
Business Acquisition, Pro Forma Information	The following table presents the unaudited supplemental pro forma results of a hypothetical combined Amgen and Horizon entity for the three months ended March 31, 2023, as if the acquisition of Horizon had occurred on January 1, 2022 (in millions): Three months ended Total revenue $ 6,941 Net income $ 2,182

Revenues (Tables)

Revenues (Tables)	3 Months Ended
Revenues (Tables)	Mar. 31, 2024
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, 2024 2023 U.S. ROW Total U.S. ROW Total Prolia $ 657 $ 342 $ 999 $ 623 $ 304 $ 927 ENBREL 561 6 567 564 15 579 XGEVA 366 195 561 384 152 536 Repatha 273 244 517 197 191 388 TEPEZZA (1) 419 5 424 — — — Otezla 293 101 394 294 98 392 KYPROLIS 234 142 376 234 124 358 Aranesp 100 249 349 115 240 355 EVENITY 236 106 342 164 90 254 Nplate 190 127 317 246 116 362 Vectibix 120 127 247 111 122 233 BLINCYTO 153 91 244 126 68 194 KRYSTEXXA (1) 235 — 235 — — — TEZSPIRE (2) 173 — 173 96 — 96 Other products (3) 963 410 1,373 821 351 1,172 Total product sales (4) $ 4,973 $ 2,145 7,118 $ 3,975 $ 1,871 5,846 Other revenues 329 259 Total revenues $ 7,447 $ 6,105 ____________ (1) TEPEZZA and KRYSTEXXA were acquired from the acquisition of Horizon on October 6, 2023, and include product sales in the periods after the acquisition date. (2) TEZSPIRE is marketed by our collaborator AstraZeneca outside the United States. (3) Consists of product sales of our non-principal products. (4) Hedging gains and losses, which are included in product sales, were not material for the three months ended March 31, 2024 and 2023.

Earnings per share (Tables)

Earnings per share (Tables)	3 Months Ended
Earnings per share (Tables)	Mar. 31, 2024
Earnings Per Share [Abstract]
Computation for Basic and Diluted Earnings per Share	The computations for basic and diluted (loss) earnings per share were as follows (in millions, except per-share data): Three months ended 2024 2023 Income (Numerator): Net (loss) income for basic and diluted (loss) earnings per share $ (113) $ 2,841 Shares (Denominator): Weighted-average shares for basic (loss) earnings per share 536 534 Effect of dilutive securities — 4 Weighted-average shares for diluted (loss) earnings per share 536 538 Basic (loss) earnings per share $ (0.21) $ 5.32 Diluted (loss) earnings per share $ (0.21) $ 5.28

Investments (Tables)

Investments (Tables)	3 Months Ended
Investments (Tables)	Mar. 31, 2024
Investments, Debt and Equity Securities [Abstract]
Schedule of 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, 2024 Amortized Gross Gross Fair Money market mutual funds $ 9,099 $ — $ — $ 9,099 Other short-term interest-bearing securities 138 — — 138 Total interest-bearing securities $ 9,237 $ — $ — $ 9,237 Types of securities as of December 31, 2023 Amortized Gross Gross Fair Money market mutual funds $ 10,266 $ — $ — $ 10,266 Other short-term interest-bearing securities 138 — — 138 Total interest-bearing securities $ 10,404 $ — $ — $ 10,404
Schedule of Fair Values by Classification	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, 2024 December 31, 2023 Cash and cash equivalents $ 9,237 $ 10,404 Total interest-bearing securities $ 9,237 $ 10,404

Inventories (Tables)

Inventories (Tables)	3 Months Ended
Inventories (Tables)	Mar. 31, 2024
Inventory Disclosure [Abstract]
Inventories	Inventories consisted of the following (in millions): March 31, 2024 December 31, 2023 Raw materials $ 928 $ 993 Work in process 5,270 5,747 Finished goods 2,526 2,778 Total inventories $ 8,724 $ 9,518

Goodwill and other intangible_2

Goodwill and other intangible assets (Tables)	3 Months Ended
Goodwill and other intangible assets (Tables)	Mar. 31, 2024
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 $ 18,629 Adjustments to goodwill resulting from acquisitions (1) (49) Currency translation adjustment (10) Ending balance $ 18,570 ____________ (1) For the three months ended March 31, 2024, adjustments to goodwill consisted of a measurement period adjustment related to our Horizon acquisition. See Note 2, Acquisitions.
Schedule of Identifiable Intangible Assets	Other intangible assets consisted of the following (in millions): March 31, 2024 December 31, 2023 Gross Accumulated Other intangible Gross Accumulated Other intangible Finite-lived intangible assets: Developed-product-technology rights $ 48,625 $ (19,184) $ 29,441 $ 48,631 $ (18,049) $ 30,582 Licensing rights 3,864 (3,297) 567 3,865 (3,265) 600 Marketing-related rights 1,203 (1,148) 55 1,339 (1,264) 75 Research and development technology rights 1,388 (1,229) 159 1,394 (1,228) 166 Total finite-lived intangible assets 55,080 (24,858) 30,222 55,229 (23,806) 31,423 Indefinite-lived intangible assets: In-process research and development 1,150 — 1,150 1,218 — 1,218 Total other intangible assets $ 56,230 $ (24,858) $ 31,372 $ 56,447 $ (23,806) $ 32,641

Financing arrangements (Tables)

Financing arrangements (Tables)	3 Months Ended
Financing arrangements (Tables)	Mar. 31, 2024
Debt Disclosure [Abstract]
Schedule of Borrowings	Our borrowings consisted of the following (in millions): March 31, 2024 December 31, 2023 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 2,000 Term loan due April 2025 2,000 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) 809 828 5.507% notes due 2026 (5.507% 2026 Notes) 1,500 1,500 2.60% notes due 2026 (2.60% 2026 Notes) 1,250 1,250 Term loan due October 2026 2,000 2,000 5.50% £475 million notes due 2026 (5.50% 2026 pound sterling Notes) 600 605 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 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) 884 892 2.45% notes due 2030 (2.45% 2030 Notes) 1,250 1,250 5.25% notes due 2030 (5.25% 2030 Notes) 2,750 2,750 2.30% notes due 2031 (2.30% 2031 Notes) 1,250 1,250 2.00% notes due 2032 (2.00% 2032 Notes) 1,001 1,001 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 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) 1,768 1,803 5.75% notes due 2040 (5.75% 2040 Notes) 373 373 2.80% notes due 2041 (2.80% 2041 Notes) 828 949 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 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) 1,914 2,132 4.663% notes due 2051 (4.663% 2051 Notes) 3,541 3,541 3.00% notes due 2052 (3.00% 2052 Notes) 919 999 4.20% notes due 2052 (4.20% 2052 Notes) 895 950 4.875% notes due 2053 (4.875% 2053 Notes) 1,000 1,000 5.65% notes due 2053 (5.65% 2053 Notes) 4,250 4,250 2.77% notes due 2053 (2.77% 2053 Notes) 940 940 4.40% notes due 2062 (4.40% 2062 Notes) 1,165 1,200 March 31, 2024 December 31, 2023 5.75% notes due 2063 (5.75% 2063 Notes) 2,750 2,750 Other notes due 2097 100 100 Unamortized bond discounts, premiums and issuance costs, net (1,404) (1,420) Fair value adjustments (363) (314) Other 33 17 Total carrying value of debt 64,020 64,613 Less current portion (3,959) (1,443) Total long-term debt $ 60,061 $ 63,170

Stockholders' equity (Tables)

Stockholders' equity (Tables)	3 Months Ended
Stockholders' equity (Tables)	Mar. 31, 2024
Equity [Abstract]
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, 2023 $ (298) $ (22) $ 31 $ (289) Foreign currency translation adjustments (24) — — (24) Unrealized gains — 178 — 178 Reclassification adjustments to income — (20) — (20) Other — — (3) (3) Income taxes — (32) — (32) Balance as of March 31, 2024 $ (322) $ 104 $ 28 $ (190)
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 2024 2023 Condensed Consolidated Cash flow hedges: Foreign currency contract gains $ 51 $ 52 Product sales Cross-currency swap contract losses (31) (22) Other (expense) income, net 20 30 (Loss) income before income taxes (4) (6) Provision for income taxes $ 16 $ 24 Net (loss) income

Fair value measurement (Tables)

Fair value measurement (Tables)	3 Months Ended
Fair value measurement (Tables)	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value of Financial Assets and Liabilities on 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, 2024, using: Total Assets: Available-for-sale securities: Money market mutual funds $ 9,099 $ — $ — $ 9,099 Other short-term interest-bearing securities — 138 — 138 Equity securities 3,985 — — 3,985 Derivatives: Foreign currency forward contracts — 225 — 225 Total assets $ 13,084 $ 363 $ — $ 13,447 Liabilities: Derivatives: Foreign currency forward contracts $ — $ 43 $ — $ 43 Cross-currency swap contracts — 429 — 429 Interest rate swap contracts — 600 — 600 Contingent consideration obligations — — 96 96 Total liabilities $ — $ 1,072 $ 96 $ 1,168 Quoted prices Significant Significant Fair value measurement as of December 31, 2023, using: Total Assets: Available-for-sale securities: Money market mutual funds $ 10,266 $ — $ — $ 10,266 Other short-term interest-bearing securities — 138 — 138 Equity securities 4,514 — — 4,514 Derivatives: Foreign currency forward contracts — 145 — 145 Total assets $ 14,780 $ 283 $ — $ 15,063 Liabilities: Derivatives: Foreign currency forward contracts $ — $ 116 $ — $ 116 Cross-currency swap contracts — 405 — 405 Interest rate swap contracts — 571 — 571 Contingent consideration obligations — — 96 96 Total liabilities $ — $ 1,092 $ 96 $ 1,188
Contingent Consideration Obligations	Changes in the carrying amounts of contingent consideration obligations were as follows (in millions): Three months ended 2024 2023 Beginning balance $ 96 $ 270 Payments (2) (2) Net changes in valuations 2 5 Ending balance $ 96 $ 273

Derivative instruments (Tables)

Derivative instruments (Tables)	3 Months Ended
Derivative instruments (Tables)	Mar. 31, 2024
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Cross-Currency Swaps	The notional amounts and interest rates of our cross-currency swaps as of March 31, 2024, 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 %
Summary of Unrealized Gains and Losses Recognized in AOCI	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 2024 2023 Foreign currency forward contracts $ 202 $ — Cross-currency swap contracts (24) (40) Forward interest rate contracts — (31) Total unrealized gains (losses) $ 178 $ (71)
Hedged Liabilities and Cumulative Amount	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, 2024 December 31, 2023 March 31, 2024 December 31, 2023 Current portion of long-term debt $ 1,454 $ 1,441 $ 54 $ 41 Long-term debt $ 4,728 $ 4,788 $ (417) $ (355) ____________ (1) Current portion of long-term debt includes $64 million and $69 million of carrying value with discontinued hedging relationships as of March 31, 2024 and December 31, 2023, respectively. Long-term debt includes $273 million and $288 million of carrying value with discontinued hedging relationships as of March 31, 2024 and December 31, 2023, respectively. (2) Current portion of long-term debt includes $64 million and $69 million of hedging adjustments on discontinued hedging relationships as of March 31, 2024 and December 31, 2023, respectively. Long-term debt includes $173 million and $188 million of hedging adjustments on discontinued hedging relationships as of March 31, 2024 and December 31, 2023, respectively.
Summary 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, 2024 Product sales Other (expense) income, net Interest expense, net Total amounts recorded in income and (expense) line items presented in the Condensed Consolidated Statements of (Loss) Income $ 7,118 $ (235) $ (824) The effects of cash flow and fair value hedging: Gains (losses) on cash flow hedging relationships reclassified out of AOCI: Foreign currency forward contracts $ 51 $ — $ — Cross-currency swap contracts $ — $ (31) $ — Gains (losses) on fair value hedging relationships—interest rate swap agreements: Hedged items (1) $ — $ — $ 49 Derivatives designated as hedging instruments $ — $ — $ (28) Three months ended March 31, 2023 Product sales Other (expense) income, net Interest expense, net Total amounts recorded in income and (expense) line items presented in the Condensed Consolidated Statements of (Loss) 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 __________ (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 Value 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, 2024 Condensed Consolidated Fair values Condensed Consolidated Fair values Derivatives designated as hedging instruments: Foreign currency forward contracts Other current assets/ Other noncurrent assets $ 225 Accrued liabilities/ Other noncurrent liabilities $ 43 Cross-currency swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 429 Interest rate swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 600 Forward interest rate contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities — Total derivatives designated as hedging instruments 225 1,072 Total derivatives $ 225 $ 1,072 Derivative assets Derivative liabilities December 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 $ 145 Accrued liabilities/ Other noncurrent liabilities $ 116 Cross-currency swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 405 Interest rate swap contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities 571 Forward interest rate contracts Other current assets/ Other noncurrent assets — Accrued liabilities/ Other noncurrent liabilities — Total derivatives designated as hedging instruments 145 1,092 Total derivatives $ 145 $ 1,092

Summary of significant accoun_3

Summary of significant accounting policies (Details) $ in Billions	3 Months Ended
	Mar. 31, 2024 USD ($) segment	Mar. 31, 2024 USD ($) Segment	Dec. 31, 2023 USD ($)
Accounting Policies [Abstract]
Number of operating segments	1	1
Accumulated depreciation and amortization on property, plant and equipment	$ 9.9	$ 9.9	$ 9.8

Acquisitions - Acquisition of H

Acquisitions - Acquisition of Horizon Therapeutics plc (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions		3 Months Ended
	Oct. 06, 2023	Mar. 31, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Goodwill		$ 18,570	$ 18,629
Horizon Therapeutics
Business Acquisition [Line Items]
Acquisition price per share (in dollars per share)	$ 116.50
Consideration transferred	$ 27,800
Cash purchase price	26,700
Consideration transferred for vested and outstanding awards	523
Consideration transferred for replacement awards	180
Liabilities incurred	$ 382
Replacement equity awards issued (in shares)	1.7
Inventories	$ 5,025	$ 5,000
Business combination, turnover period of inventory acquired		27 months
Deferred tax liability	2,492
Deferred tax asset	834
Goodwill	3,062
Goodwill increase (decrease)		$ (49)
Horizon Therapeutics \| Developed-product-technology rights
Business Acquisition [Line Items]
Estimated fair value	$ 20,700
Weighted average period of amortization	10 years

Acquisitions - Summary of Total

Acquisitions - Summary of Total Consideration for Horizon Therapeutics plc (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023	Oct. 06, 2023
Business Acquisition [Line Items]
Goodwill	$ 18,570	$ 18,629
Horizon Therapeutics
Business Acquisition [Line Items]
Cash and cash equivalents			$ 681
Inventories	$ 5,000		5,025
Property, plant and equipment, net			318
IPR&D			1,060
Goodwill			3,062
Deferred tax asset			834
Deferred tax liability			(2,492)
Other assets and liabilities, net			(245)
Total assets acquired, net			27,833
Horizon Therapeutics \| Developed-product-technology rights
Business Acquisition [Line Items]
Finite-lived intangible assets – developed-product-technology rights			$ 19,590

Acquisitions - Supplemental Pro

Acquisitions - Supplemental Pro Forma Financial Information (Details) - Horizon Therapeutics $ in Millions	3 Months Ended
	Mar. 31, 2023 USD ($)
Business Acquisition [Line Items]
Total revenue	$ 6,941
Net income	$ 2,182

Revenues - Narrative (Details)

Revenues - Narrative (Details) - 3 months ended Mar. 31, 2024	segment	Segment
Revenue from Contract with Customer [Abstract]
Number of operating segments	1	1

Revenues - Disaggregation of Re

Revenues - Disaggregation of Revenue by Product and by Geographic Area (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenue from External Customer [Line Items]
Total revenues	$ 7,447	$ 6,105
Product sales
Revenue from External Customer [Line Items]
Total revenues	7,118	5,846
Product sales \| U.S.
Revenue from External Customer [Line Items]
Total revenues	4,973	3,975
Product sales \| ROW
Revenue from External Customer [Line Items]
Total revenues	2,145	1,871
Prolia
Revenue from External Customer [Line Items]
Total revenues	999	927
Prolia \| U.S.
Revenue from External Customer [Line Items]
Total revenues	657	623
Prolia \| ROW
Revenue from External Customer [Line Items]
Total revenues	342	304
ENBREL
Revenue from External Customer [Line Items]
Total revenues	567	579
ENBREL \| U.S.
Revenue from External Customer [Line Items]
Total revenues	561	564
ENBREL \| ROW
Revenue from External Customer [Line Items]
Total revenues	6	15
XGEVA
Revenue from External Customer [Line Items]
Total revenues	561	536
XGEVA \| U.S.
Revenue from External Customer [Line Items]
Total revenues	366	384
XGEVA \| ROW
Revenue from External Customer [Line Items]
Total revenues	195	152
Repatha
Revenue from External Customer [Line Items]
Total revenues	517	388
Repatha \| U.S.
Revenue from External Customer [Line Items]
Total revenues	273	197
Repatha \| ROW
Revenue from External Customer [Line Items]
Total revenues	244	191
TEPEZZA
Revenue from External Customer [Line Items]
Total revenues	424	0
TEPEZZA \| U.S.
Revenue from External Customer [Line Items]
Total revenues	419	0
TEPEZZA \| ROW
Revenue from External Customer [Line Items]
Total revenues	5	0
Otezla
Revenue from External Customer [Line Items]
Total revenues	394	392
Otezla \| U.S.
Revenue from External Customer [Line Items]
Total revenues	293	294
Otezla \| ROW
Revenue from External Customer [Line Items]
Total revenues	101	98
KYPROLIS
Revenue from External Customer [Line Items]
Total revenues	376	358
KYPROLIS \| U.S.
Revenue from External Customer [Line Items]
Total revenues	234	234
KYPROLIS \| ROW
Revenue from External Customer [Line Items]
Total revenues	142	124
Aranesp
Revenue from External Customer [Line Items]
Total revenues	349	355
Aranesp \| U.S.
Revenue from External Customer [Line Items]
Total revenues	100	115
Aranesp \| ROW
Revenue from External Customer [Line Items]
Total revenues	249	240
EVENITY
Revenue from External Customer [Line Items]
Total revenues	342	254
EVENITY \| U.S.
Revenue from External Customer [Line Items]
Total revenues	236	164
EVENITY \| ROW
Revenue from External Customer [Line Items]
Total revenues	106	90
Nplate
Revenue from External Customer [Line Items]
Total revenues	317	362
Nplate \| U.S.
Revenue from External Customer [Line Items]
Total revenues	190	246
Nplate \| ROW
Revenue from External Customer [Line Items]
Total revenues	127	116
Vectibix
Revenue from External Customer [Line Items]
Total revenues	247	233
Vectibix \| U.S.
Revenue from External Customer [Line Items]
Total revenues	120	111
Vectibix \| ROW
Revenue from External Customer [Line Items]
Total revenues	127	122
BLINCYTO
Revenue from External Customer [Line Items]
Total revenues	244	194
BLINCYTO \| U.S.
Revenue from External Customer [Line Items]
Total revenues	153	126
BLINCYTO \| ROW
Revenue from External Customer [Line Items]
Total revenues	91	68
KRYSTEXXA
Revenue from External Customer [Line Items]
Total revenues	235	0
KRYSTEXXA \| U.S.
Revenue from External Customer [Line Items]
Total revenues	235	0
KRYSTEXXA \| ROW
Revenue from External Customer [Line Items]
Total revenues	0	0
TEZSPIRE
Revenue from External Customer [Line Items]
Total revenues	173	96
TEZSPIRE \| U.S.
Revenue from External Customer [Line Items]
Total revenues	173	96
TEZSPIRE \| ROW
Revenue from External Customer [Line Items]
Total revenues	0	0
Other products
Revenue from External Customer [Line Items]
Total revenues	1,373	1,172
Other products \| U.S.
Revenue from External Customer [Line Items]
Total revenues	963	821
Other products \| ROW
Revenue from External Customer [Line Items]
Total revenues	410	351
Other revenues
Revenue from External Customer [Line Items]
Total revenues	$ 329	$ 259

Income taxes (Details)

Income taxes (Details) $ in Millions	3 Months Ended
Income taxes (Details) $ in Millions	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)	Dec. 19, 2022 case	Apr. 28, 2022 USD ($)	May 31, 2021 USD ($) notice
Income Tax Examination [Line Items]
Income tax expense (benefit)	$ 45	$ 601
(Loss) income before income taxes	$ (68)	$ 3,442
Effective income tax rate	(66.20%)	17.50%
Increase in unrecognized tax benefits resulting from tax positions taken during the current period	$ 40
Domestic Tax Authority
Income Tax Examination [Line Items]
Number of notices on proposed additional tax \| notice					2
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 - Narrative

Earnings per share - Narrative (Details) - Employee Stock Option shares in Millions	3 Months Ended
	Mar. 31, 2024 shares
Earnings Per Share [Abstract]
Antidilutive shares excluded from the computation of earnings per share (in shares)	5
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive shares excluded from the computation of earnings per share (in shares)	5

Earnings per share - Computatio

Earnings per share - Computation for Basic and Diluted Earnings per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income (Numerator):
Net (loss) income for basic and diluted (loss) earnings per share	$ (113)	$ 2,841
Shares (Denominator):
Weighted-average shares for basic (loss) earnings per share (in shares)	536	534
Effect of dilutive securities (in shares)	0	4
Weighted-average shares for diluted (loss) earnings per share (in shares)	536	538
Basic (loss) earnings per share (in usd per share)	$ (0.21)	$ 5.32
Diluted (loss) earnings per share (in usd per share)	$ (0.21)	$ 5.28

Investments - Schedule of Avail

Investments - Schedule of Available-For-Sale Investments (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Marketable Securities [Line Items]
Amortized cost	$ 9,237	$ 10,404
Gross unrealized gains	0	0
Gross unrealized losses	0	0
Fair values	9,237	10,404
Money market mutual funds
Marketable Securities [Line Items]
Amortized cost	9,099	10,266
Gross unrealized gains	0	0
Gross unrealized losses	0	0
Fair values	9,099	10,266
Other short-term interest-bearing securities
Marketable Securities [Line Items]
Amortized cost	138	138
Gross unrealized gains	0	0
Gross unrealized losses	0	0
Fair values	$ 138	$ 138

Investments - Schedule of Fair

Investments - Schedule of Fair Values by Classification (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Marketable Securities [Line Items]
Total interest-bearing securities	$ 9,237	$ 10,404
Available-for-sale investments
Marketable Securities [Line Items]
Cash and cash equivalents	9,237	10,404
Total interest-bearing securities	$ 9,237	$ 10,404

Investments - Available-For-Sal

Investments - Available-For-Sale (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Investments, Debt and Equity Securities [Abstract]
Cash	$ 471	$ 540

Investments - BeiGene (Details)

Investments - BeiGene (Details) - USD ($) $ in Millions	3 Months Ended
Investments - BeiGene (Details) - USD ($) $ in Millions	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Debt Securities, Available-for-sale [Line Items]
Net unrealized gains	$ 50	$ 5
Equity securities	3,985		$ 4,514
Other Noncurrent Assets
Debt Securities, Available-for-sale [Line Items]
Equity securities	536		494
Equity securities without readily determinable fair value	333		309
BeiGene
Debt Securities, Available-for-sale [Line Items]
Net unrealized gains	$ (454)	$ 1,900
BeiGene \| Maximum
Debt Securities, Available-for-sale [Line Items]
Ownership percentage	5%	5%
BeiGene \| Other Noncurrent Assets
Debt Securities, Available-for-sale [Line Items]
Equity securities	$ 3,000		$ 3,400

Investments - Other Equity Secu

Investments - Other Equity Securities (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Equity securities	$ 3,985		$ 4,514
Unrealized gain (loss) on equity securities	50	$ 5
Other Noncurrent Assets
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Equity securities	536		494
Equity securities without readily determinable fair value	$ 333		$ 309

Investments - Neumora Therapeut

Investments - Neumora Therapeutics, Inc. (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Schedule of Equity Method Investments [Line Items]
Equity securities	$ 3,985		$ 4,514
Unrealized gain (loss) on equity securities	$ 50	$ 5
Neumora Therapeutics, Inc.
Schedule of Equity Method Investments [Line Items]
Ownership percentage	22.30%		23.20%
Equity securities	$ 486		$ 603
Unrealized gain (loss) on equity securities	$ (117)	$ (47)
Neumora Therapeutics, Inc. \| Maximum
Schedule of Equity Method Investments [Line Items]
Ownership percentage		5%
Neumora Therapeutics, Inc. \| Minimum
Schedule of Equity Method Investments [Line Items]
Ownership percentage		10%

Investments - Limited Partnersh

Investments - Limited Partnership Investments (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Net Investment Income [Line Items]
Investment, Type [Extensible Enumeration]	Partnership Interest [Member]		Partnership Interest [Member]
Fair Value Measured at Net Asset Value Per Share
Net Investment Income [Line Items]
Alternative investments	$ 278		$ 251
Unfunded additional commitments	164
Net gains from limited partnership investments	$ 27	$ 20

Inventories (Details)

Inventories (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Raw materials	$ 928	$ 993
Work in process	5,270	5,747
Finished goods	2,526	2,778
Total inventories	$ 8,724	$ 9,518

Goodwill and other intangible_3

Goodwill and other intangible assets - Schedule of Goodwill (Details) $ in Millions	3 Months Ended
	Mar. 31, 2024 USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 18,629
Adjustments to goodwill resulting from acquisition	(49)
Currency translation adjustment	(10)
Ending balance	$ 18,570

Goodwill and other intangible_4

Goodwill and other intangible assets - Schedule of Identifiable Intangible Assets (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Finite-lived intangible assets:
Gross carrying amounts	$ 55,080	$ 55,229
Accumulated amortization	(24,858)	(23,806)
Other intangible assets, net	30,222	31,423
Indefinite-lived intangible assets:
Identifiable intangible assets	56,230	56,447
Accumulated amortization	(24,858)	(23,806)
Intangible assets, net	31,372	32,641
In-process research and development
Indefinite-lived intangible assets:
Indefinite-lived intangible assets	1,150	1,218
Developed-product-technology rights
Finite-lived intangible assets:
Gross carrying amounts	48,625	48,631
Accumulated amortization	(19,184)	(18,049)
Other intangible assets, net	29,441	30,582
Licensing rights
Finite-lived intangible assets:
Gross carrying amounts	3,864	3,865
Accumulated amortization	(3,297)	(3,265)
Other intangible assets, net	567	600
Marketing-related rights
Finite-lived intangible assets:
Gross carrying amounts	1,203	1,339
Accumulated amortization	(1,148)	(1,264)
Other intangible assets, net	55	75
Research and development technology rights
Finite-lived intangible assets:
Gross carrying amounts	1,388	1,394
Accumulated amortization	(1,229)	(1,228)
Other intangible assets, net	$ 159	$ 166

Goodwill and other intangible_5

Goodwill and other intangible assets - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization charges associated with finite-lived intangible assets	$ 1,200	$ 693
Total estimated amortization of finite-lived intangible assets for the remainder of the year	3,600
Total estimated amortization of finite-lived intangible assets for 2025	4,500
Total estimated amortization of finite-lived intangible assets for 2026	3,900
Total estimated amortization of finite-lived intangible assets for 2027	3,900
Total estimated amortization of finite-lived intangible assets for 2028	2,900
Total estimated amortization of finite-lived intangible assets for 2029	$ 2,200

Financing arrangements - Schedu

Financing arrangements - Schedule of Borrowings (Details) $ in Millions	Mar. 31, 2024 USD ($)	Mar. 31, 2024 EUR (€)	Mar. 31, 2024 GBP (£)	Dec. 31, 2023 USD ($)
Debt Instrument [Line Items]
Unamortized bond discounts, premiums and issuance costs, net	$ (1,404)			$ (1,420)
Fair value adjustments	(363)			(314)
Other	33			17
Total carrying value of debt	64,020			64,613
Less current portion	(3,959)			(1,443)
Total long-term debt	$ 60,061			63,170
Notes \| 3.625% notes due 2024 (3.625% 2024 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	3.625%	3.625%	3.625%
Long-term debt, gross	$ 1,400			1,400
Notes \| 1.90% notes due 2025 (1.90% 2025 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	1.90%	1.90%	1.90%
Long-term debt, gross	$ 500			500
Notes \| 5.25% notes due 2025 (5.25% 2025 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.25%	5.25%	5.25%
Long-term debt, gross	$ 2,000			2,000
Notes \| 3.125% notes due 2025 (3.125% 2025 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	3.125%	3.125%	3.125%
Long-term debt, gross	$ 1,000			1,000
Notes \| 2.00% €750 million notes due 2026 (2.00% 2026 euro Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	2%	2%	2%
Face amount \| €		€ 750,000,000
Long-term debt, gross	$ 809			828
Notes \| 5.507% notes due 2026 (5.507% 2026 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.507%	5.507%	5.507%
Long-term debt, gross	$ 1,500			1,500
Notes \| 2.60% notes due 2026 (2.60% 2026 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	2.60%	2.60%	2.60%
Long-term debt, gross	$ 1,250			1,250
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%
Face amount \| £			£ 475,000,000
Long-term debt, gross	$ 600			605
Notes \| 2.20% notes due 2027 (2.20% 2027 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	2.20%	2.20%	2.20%
Long-term debt, gross	$ 1,724			1,724
Notes \| 3.20% notes due 2027 (3.20% 2027 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	3.20%	3.20%	3.20%
Long-term debt, gross	$ 1,000			1,000
Notes \| 5.15% notes due 2028 (5.15% 2028 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.15%	5.15%	5.15%
Long-term debt, gross	$ 3,750			3,750
Notes \| 1.65% notes due 2028 (1.65% 2028 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	1.65%	1.65%	1.65%
Long-term debt, gross	$ 1,234			1,234
Notes \| 3.00% notes due 2029 (3.00% 2029 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	3%	3%	3%
Long-term debt, gross	$ 750			750
Notes \| 4.05% notes due 2029 (4.05% 2029 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	4.05%	4.05%	4.05%
Long-term debt, gross	$ 1,250			1,250
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%
Face amount \| £			£ 700,000,000
Long-term debt, gross	$ 884			892
Notes \| 2.45% notes due 2030 (2.45% 2030 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	2.45%	2.45%	2.45%
Long-term debt, gross	$ 1,250			1,250
Notes \| 5.25% notes due 2030 (5.25% 2030 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.25%	5.25%	5.25%
Long-term debt, gross	$ 2,750			2,750
Notes \| 2.30% notes due 2031 (2.30% 2031 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	2.30%	2.30%	2.30%
Long-term debt, gross	$ 1,250			1,250
Notes \| 2.00% notes due 2032 (2.00% 2032 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	2%	2%	2%
Long-term debt, gross	$ 1,001			1,001
Notes \| 3.35% notes due 2032 (3.35% 2032 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	3.35%	3.35%	3.35%
Long-term debt, gross	$ 1,000			1,000
Notes \| 4.20% notes due 2033 (4.20% 2033 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	4.20%	4.20%	4.20%
Long-term debt, gross	$ 750			750
Notes \| 5.25% notes due 2033 (5.25% 2033 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.25%	5.25%	5.25%
Long-term debt, gross	$ 4,250			4,250
Notes \| 6.375% notes due 2037 (6.375% 2037 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	6.375%	6.375%	6.375%
Long-term debt, gross	$ 478			478
Notes \| 6.90% notes due 2038 (6.90% 2038 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	6.90%	6.90%	6.90%
Long-term debt, gross	$ 254			254
Notes \| 6.40% notes due 2039 (6.40% 2039 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	6.40%	6.40%	6.40%
Long-term debt, gross	$ 333			333
Notes \| 3.15% notes due 2040 (3.15% 2040 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	3.15%	3.15%	3.15%
Long-term debt, gross	$ 1,768			1,803
Notes \| 5.75% notes due 2040 (5.75% 2040 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.75%	5.75%	5.75%
Long-term debt, gross	$ 373			373
Notes \| 2.80% notes due 2041 (2.80% 2041 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	2.80%	2.80%	2.80%
Long-term debt, gross	$ 828			949
Notes \| 4.95% notes due 2041 (4.95% 2041 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	4.95%	4.95%	4.95%
Long-term debt, gross	$ 600			600
Notes \| 5.15% notes due 2041 (5.15% 2041 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.15%	5.15%	5.15%
Long-term debt, gross	$ 729			729
Notes \| 5.65% notes due 2042 (5.65% 2042 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.65%	5.65%	5.65%
Long-term debt, gross	$ 415			415
Notes \| 5.60% notes due 2043 (5.60% 2043 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.60%	5.60%	5.60%
Long-term debt, gross	$ 2,750			2,750
Notes \| 5.375% notes due 2043 (5.375% 2043 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.375%	5.375%	5.375%
Long-term debt, gross	$ 185			185
Notes \| 4.40% notes due 2045 (4.40% 2045 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	4.40%	4.40%	4.40%
Long-term debt, gross	$ 2,250			2,250
Notes \| 4.563% notes due 2048 (4.563% 2048 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	4.563%	4.563%	4.563%
Long-term debt, gross	$ 1,415			1,415
Notes \| 3.375% notes due 2050 (3.375% 2050 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	3.375%	3.375%	3.375%
Long-term debt, gross	$ 1,914			2,132
Notes \| 4.663% notes due 2051 (4.663% 2051 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	4.663%	4.663%	4.663%
Long-term debt, gross	$ 3,541			3,541
Notes \| 3.00% notes due 2052 (3.00% 2052 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	3%	3%	3%
Long-term debt, gross	$ 919			999
Notes \| 4.20% notes due 2052 (4.20% 2052 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	4.20%	4.20%	4.20%
Long-term debt, gross	$ 895			950
Notes \| 4.875% notes due 2053 (4.875% 2053 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	4.875%	4.875%	4.875%
Long-term debt, gross	$ 1,000			1,000
Notes \| 5.65% notes due 2053 (5.65% 2053 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.65%	5.65%	5.65%
Long-term debt, gross	$ 4,250			4,250
Notes \| 2.77% notes due 2053 (2.77% 2053 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	2.77%	2.77%	2.77%
Long-term debt, gross	$ 940			940
Notes \| 4.40% notes due 2062 (4.40% 2062 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	4.40%	4.40%	4.40%
Long-term debt, gross	$ 1,165			1,200
Notes \| 5.75% notes due 2063 (5.75% 2063 Notes)
Debt Instrument [Line Items]
Interest rate, stated percentage	5.75%	5.75%	5.75%
Long-term debt, gross	$ 2,750			2,750
Notes \| Other notes due 2097
Debt Instrument [Line Items]
Long-term debt, gross	100			100
Secured Debt \| Term Loan Due April 2025
Debt Instrument [Line Items]
Long-term debt, gross	2,000			2,000
Secured Debt \| Term Loan Due October 2026
Debt Instrument [Line Items]
Long-term debt, gross	$ 2,000			$ 2,000

Financing arrangements - Narrat

Financing arrangements - Narrative (Details) $ in Millions	3 Months Ended
Financing arrangements - Narrative (Details) $ in Millions	Mar. 31, 2024 USD ($)
Debt Instrument [Line Items]
Extinguishment of debt	$ 410
Gain (loss) on extinguishment of debt	$ 133
Notes \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Basis spread on variable rate	1.225%
4.563% notes due 2048 (4.563% 2048 Notes) \| Notes
Debt Instrument [Line Items]
Interest rate, stated percentage	4.563%
Effective interest rate	6.30%
4.663% notes due 2051 (4.663% 2051 Notes) \| Notes
Debt Instrument [Line Items]
Interest rate, stated percentage	4.663%
Effective interest rate	5.60%
2.77% notes due 2053 (2.77% 2053 Notes) \| Notes
Debt Instrument [Line Items]
Interest rate, stated percentage	2.77%
Effective interest rate	5.20%
3.15% notes due 2040 (3.15% 2040 Notes) \| Notes
Debt Instrument [Line Items]
Interest rate, stated percentage	3.15%
2.80% notes due 2041 (2.80% 2041 Notes) \| Notes
Debt Instrument [Line Items]
Interest rate, stated percentage	2.80%
3.375% notes due 2050 (3.375% 2050 Notes) \| Notes
Debt Instrument [Line Items]
Interest rate, stated percentage	3.375%
3.00% notes due 2052 (3.00% 2052 Notes) \| Notes
Debt Instrument [Line Items]
Interest rate, stated percentage	3%
4.20% notes due 2052 (4.20% 2052 Notes) \| Notes
Debt Instrument [Line Items]
Interest rate, stated percentage	4.20%
4.40% notes due 2062 (4.40% 2062 Notes) \| Notes
Debt Instrument [Line Items]
Interest rate, stated percentage	4.40%

Stockholders' equity - Narrativ

Stockholders' equity - Narrative (Details) - USD ($) $ / shares in Units, $ in Billions	1 Months Ended			3 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2024	Mar. 31, 2023
Class of Stock [Line Items]
Amount available for stock repurchases under a board approved stock repurchase plan		$ 7		$ 7
Dividends declared per share (in usd per share)		$ 2.25	$ 2.25	$ 2.25	$ 2.13
Dividends paid per share (in usd per share)		$ 2.25
Forecast
Class of Stock [Line Items]
Dividends paid per share (in usd per share)	$ 2.25

Stockholders' equity - Componen

Stockholders' equity - Components of Accumulated Other Comprehensive Income (Details) $ in Millions	3 Months Ended
	Mar. 31, 2024 USD ($)
Increase (Decrease) in AOCI [Roll Forward]
Beginning balance	$ 6,232
Ending balance	5,022
Foreign currency translation
Increase (Decrease) in AOCI [Roll Forward]
Beginning balance	(298)
Foreign currency translation adjustments	(24)
Unrealized gains	0
Reclassification adjustments to income	0
Other	0
Income taxes	0
Ending balance	(322)
Cash flow hedges
Increase (Decrease) in AOCI [Roll Forward]
Beginning balance	(22)
Foreign currency translation adjustments	0
Unrealized gains	178
Reclassification adjustments to income	(20)
Other	0
Income taxes	(32)
Ending balance	104
Other
Increase (Decrease) in AOCI [Roll Forward]
Beginning balance	31
Foreign currency translation adjustments	0
Unrealized gains	0
Reclassification adjustments to income	0
Other	(3)
Income taxes	0
Ending balance	28
AOCI
Increase (Decrease) in AOCI [Roll Forward]
Beginning balance	(289)
Foreign currency translation adjustments	(24)
Unrealized gains	178
Reclassification adjustments to income	(20)
Other	(3)
Income taxes	(32)
Ending balance	$ (190)

Stockholders' equity - Reclassi

Stockholders' equity - Reclassifications Out of Accumulated Other Comprehensive Income (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Product sales	$ 7,447	$ 6,105
Other (expense) income, net	(235)	2,064
(Loss) income before income taxes	(68)	3,442
Provision for income taxes	(45)	(601)
Net (loss) income	(113)	2,841
Product sales
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Product sales	7,118	5,846
Reclassification out of Accumulated Other Comprehensive Income \| Cash flow hedges
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
(Loss) income before income taxes	20	30
Provision for income taxes	(4)	(6)
Net (loss) income	16	24
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]
Product sales	51	52
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 (expense) income, net	(31)	(22)
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]
Product sales	51	52
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 (expense) income, net	$ (31)	$ (22)

Fair value measurement - Fair V

Fair value measurement - Fair Value of Financial Assets and Liabilities on Recurring Basis (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023	Dec. 31, 2022
Assets:
Available-for-sale securities:	$ 9,237	$ 10,404
Equity securities	3,985	4,514
Derivatives:
Total assets	13,447	15,063
Derivatives:
Contingent consideration obligations	96	96	$ 273	$ 270
Total liabilities	1,168	1,188
Foreign currency forward contracts
Derivatives:
Derivative assets	225	145
Derivatives:
Derivative liabilities	43	116
Cross-currency swap contracts
Derivatives:
Derivative liabilities	429	405
Interest rate swap contracts
Derivatives:
Interest rate swap contracts	600	571
Quoted prices in active markets for identical assets (Level 1)
Assets:
Equity securities	3,985	4,514
Derivatives:
Total assets	13,084	14,780
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:
Derivative assets	0	0
Derivatives:
Derivative liabilities	0	0
Quoted prices in active markets for identical assets (Level 1) \| Cross-currency swap contracts
Derivatives:
Derivative liabilities	0	0
Quoted prices in active markets for identical assets (Level 1) \| Interest rate swap contracts
Derivatives:
Interest rate swap contracts	0	0
Significant other observable inputs (Level 2)
Assets:
Equity securities	0	0
Derivatives:
Total assets	363	283
Derivatives:
Contingent consideration obligations	0	0
Total liabilities	1,072	1,092
Significant other observable inputs (Level 2) \| Foreign currency forward contracts
Derivatives:
Derivative assets	225	145
Derivatives:
Derivative liabilities	43	116
Significant other observable inputs (Level 2) \| Cross-currency swap contracts
Derivatives:
Derivative liabilities	429	405
Significant other observable inputs (Level 2) \| Interest rate swap contracts
Derivatives:
Interest rate swap contracts	600	571
Significant unobservable inputs (Level 3)
Assets:
Equity securities	0	0
Derivatives:
Total assets	0	0
Derivatives:
Contingent consideration obligations	96	96
Total liabilities	96	96
Significant unobservable inputs (Level 3) \| Foreign currency forward contracts
Derivatives:
Derivative assets	0	0
Derivatives:
Derivative liabilities	0	0
Significant unobservable inputs (Level 3) \| Cross-currency swap contracts
Derivatives:
Derivative liabilities	0	0
Significant unobservable inputs (Level 3) \| Interest rate swap contracts
Derivatives:
Interest rate swap contracts	0	0
Money market mutual funds
Assets:
Available-for-sale securities:	9,099	10,266
Money market mutual funds \| Quoted prices in active markets for identical assets (Level 1)
Assets:
Available-for-sale securities:	9,099	10,266
Money market mutual funds \| Significant other observable inputs (Level 2)
Assets:
Available-for-sale securities:	0	0
Money market mutual funds \| Significant unobservable inputs (Level 3)
Assets:
Available-for-sale securities:	0	0
Other short-term interest-bearing securities
Assets:
Available-for-sale securities:	138	138
Other short-term interest-bearing securities \| Quoted prices in active markets for identical assets (Level 1)
Assets:
Available-for-sale securities:	0	0
Other short-term interest-bearing securities \| Significant other observable inputs (Level 2)
Assets:
Available-for-sale securities:	138	138
Other short-term interest-bearing securities \| Significant unobservable inputs (Level 3)
Assets:
Available-for-sale securities:	$ 0	$ 0

Fair value measurement - Contin

Fair value measurement - Contingent Consideration Obligations (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Business Combination, Contingent Consideration [Roll Forward]
Beginning balance	$ 96	$ 270
Payments	(2)	(2)
Net changes in valuations	2	5
Ending balance	$ 96	$ 273

Fair value measurement - Narrat

Fair value measurement - Narrative (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Aggregate fair value of long-term debt, including current portion	$ 57,800	$ 59,200
Carrying value of long-term debt, including current portion	$ 64,020	$ 64,613

Derivative instruments - Narrat

Derivative instruments - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Derivative [Line Items]
Length of time hedged in foreign currency contracts (or less)	3 years
Amounts expected to be reclassified from AOCI into earnings over the next 12 months, foreign currency and cross-currency swaps	$ 97
Foreign currency forward contracts \| Designated as Hedging Instrument
Derivative [Line Items]
Notional amounts	6,600	$ 6,600
Foreign currency forward contracts \| Derivatives not designated as hedging instrument
Derivative [Line Items]
Notional amounts	300	457
Interest Rate Swap \| Designated as Hedging Instrument
Derivative [Line Items]
Notional amounts	$ 6,700	$ 6,700

Derivative instruments - Schedu

Derivative instruments - Schedule of Cross-Currency Swaps (Details) € in Millions, £ in Millions, $ in Millions	Mar. 31, 2024 USD ($)	Mar. 31, 2024 EUR (€)	Mar. 31, 2024 GBP (£)
2.00% 2026 euro Notes \| Notes
Derivative [Line Items]
Interest rate, stated percentage	2%	2%	2%
5.50% 2026 pound sterling Notes \| Notes
Derivative [Line Items]
Interest rate, stated percentage	5.50%	5.50%	5.50%
4.00% 2029 pound sterling Notes \| Notes
Derivative [Line Items]
Interest rate, stated percentage	4%	4%	4%
Cash flow hedge \| Cross-currency swap contracts \| 2.00% 2026 euro Notes
Derivative [Line Items]
Notional amounts	$ 833	€ 750
Cash flow hedge \| Cross-currency swap contracts \| 5.50% 2026 pound sterling Notes
Derivative [Line Items]
Notional amounts	747		£ 475
Cash flow hedge \| Cross-currency swap contracts \| 4.00% 2029 pound sterling Notes
Derivative [Line Items]
Notional amounts	$ 1,111		£ 700
Cash flow hedge \| Cross-currency swap contracts \| Euro Member Countries, Euro \| 2.00% 2026 euro Notes
Derivative [Line Items]
Interest rates	2%	2%	2%
Cash flow hedge \| Cross-currency swap contracts \| United Kingdom, Pounds \| 5.50% 2026 pound sterling Notes
Derivative [Line Items]
Interest rates	5.50%	5.50%	5.50%
Cash flow hedge \| Cross-currency swap contracts \| United Kingdom, Pounds \| 4.00% 2029 pound sterling Notes
Derivative [Line Items]
Interest rates	4%	4%	4%
Cash flow hedge \| Cross-currency swap contracts \| United States of America, Dollars \| 2.00% 2026 euro Notes
Derivative [Line Items]
Interest rates	3.90%	3.90%	3.90%
Cash flow hedge \| Cross-currency swap contracts \| United States of America, Dollars \| 5.50% 2026 pound sterling Notes
Derivative [Line Items]
Interest rates	6%	6%	6%
Cash flow hedge \| Cross-currency swap contracts \| United States of America, Dollars \| 4.00% 2029 pound sterling Notes
Derivative [Line Items]
Interest rates	4.60%	4.60%	4.60%

Derivative instruments - Summar

Derivative instruments - Summary of Unrealized Gains and Losses Recognized in AOCI (Details) - Cash flow hedge - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Derivative Instruments, Gain (Loss) [Line Items]
Total unrealized gains (losses)	$ 178	$ (71)
Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Total unrealized gains (losses)	202	0
Cross-currency swap contracts
Derivative Instruments, Gain (Loss) [Line Items]
Total unrealized gains (losses)	(24)	(40)
Forward interest rate contracts
Derivative Instruments, Gain (Loss) [Line Items]
Total unrealized gains (losses)	$ 0	$ (31)

Derivative instruments - Hedged

Derivative instruments - Hedged Liabilities and Cumulative Amount (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Derivative [Line Items]
Cumulative amounts of fair value hedging adjustments related to the carrying amounts of the hedged liabilities	$ (363)	$ (314)
Current portion of long-term debt
Derivative [Line Items]
Carrying amounts of hedged liabilities	1,454	1,441
Cumulative amounts of fair value hedging adjustments related to the carrying amounts of the hedged liabilities	54	41
Carrying value with discontinued hedging relationships	64	69
Hedging adjustments on discontinued hedging relationships	64	69
Long-term debt
Derivative [Line Items]
Carrying amounts of hedged liabilities	4,728	4,788
Cumulative amounts of fair value hedging adjustments related to the carrying amounts of the hedged liabilities	(417)	(355)
Carrying value with discontinued hedging relationships	273	288
Hedging adjustments on discontinued hedging relationships	$ 173	$ 188

Derivative instruments - Summ_2

Derivative instruments - Summary of Income and Expense Line Items (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Derivative Instruments, Gain (Loss) [Line Items]
Product sales	$ 7,447	$ 6,105
Other (expense) income, net	(235)	2,064
Interest expense, net	(824)	(543)
Interest rate swap agreements
Derivative Instruments, Gain (Loss) [Line Items]
Gains (losses) on fair value hedging relationships, Hedged items	49	(88)
Gains (losses) on fair value hedging relationships, Derivatives designated as hedging instruments	(28)	114
Reclassification out of Accumulated Other Comprehensive Income \| Cash flow hedges \| Cross-currency swap contracts
Derivative Instruments, Gain (Loss) [Line Items]
Other (expense) income, net	(31)	(22)
Product sales
Derivative Instruments, Gain (Loss) [Line Items]
Product sales	7,118	5,846
Product sales \| Reclassification out of Accumulated Other Comprehensive Income \| Cash flow hedges \| Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Product sales	$ 51	$ 52

Derivative instruments - Fair V

Derivative instruments - Fair Value of Derivatives (Details) - USD ($) $ in Millions	Mar. 31, 2024	Dec. 31, 2023
Derivatives Fair Value [Line Items]
Derivative assets	$ 225	$ 145
Derivative liabilities	1,072	1,092
Derivatives designated as hedging instrument
Derivatives Fair Value [Line Items]
Derivative assets	225	145
Derivative liabilities	1,072	1,092
Derivatives designated as hedging instrument \| Foreign currency forward contracts \| Other Current Noncurrent Assets
Derivatives Fair Value [Line Items]
Derivative assets	225	145
Derivatives designated as hedging instrument \| Foreign currency forward contracts \| Accrued Liabilities Other Non Current Liabilities
Derivatives Fair Value [Line Items]
Derivative liabilities	43	116
Derivatives designated as hedging instrument \| Cross-currency swap contracts \| Other Current Noncurrent Assets
Derivatives Fair Value [Line Items]
Derivative assets	0	0
Derivatives designated as hedging instrument \| Cross-currency swap contracts \| Accrued Liabilities Other Non Current Liabilities
Derivatives Fair Value [Line Items]
Derivative liabilities	429	405
Derivatives designated as hedging instrument \| Interest rate swap contracts \| Other Current Noncurrent Assets
Derivatives Fair Value [Line Items]
Derivative assets	0	0
Derivatives designated as hedging instrument \| Interest rate swap contracts \| Accrued Liabilities Other Non Current Liabilities
Derivatives Fair Value [Line Items]
Derivative liabilities	600	571
Derivatives designated as hedging instrument \| Forward interest rate contracts \| Other Current Noncurrent Assets
Derivatives Fair Value [Line Items]
Derivative assets	0	0
Derivatives designated as hedging instrument \| Forward interest rate contracts \| Accrued Liabilities Other Non Current Liabilities
Derivatives Fair Value [Line Items]
Derivative liabilities	$ 0	$ 0