Income Taxes (Tables)

12 Months Ended

Dec. 31, 2019

Income Tax Disclosure [Abstract]

Schedule of earnings before income tax expense

Earnings Before Income Tax Expense

years ended December 31 (in millions)	2019			2018			2017
Domestic	$	(2,784	)	$	(4,274	)	$	(2,678	)
Foreign	11,210			9,471			10,405
Total earnings before income tax expense	$	8,426		$	5,197		$	7,727

Schedule of income tax expense

Income Tax Expense

years ended December 31 (in millions)	2019			2018			2017
Current
Domestic	$	102		$	593		$	6,204
Foreign	320			434			376
Total current taxes	$	422		$	1,027		$	6,580
Deferred
Domestic	$	(137	)	$	(1,497	)	$	(4,898	)
Foreign	259			(20		)	736
Total deferred taxes	$	122		$	(1,517	)	$	(4,162	)
Total income tax expense (benefit)	$	544		$	(490	)	$	2,418

Summary of effective tax rate reconciliation

Effective Tax Rate Reconciliation

years ended December 31	2019		2018		2017
Statutory tax rate	21.0	%	21.0	%	35.0	%
Effect of foreign operations	(8.4	)	(28.7	)	(12.2	)
U.S. tax credits	(3.3	)	(7.3	)	(4.0	)
Impacts related to U.S. tax reform	(1.6	)	8.2		12.0
Stock-based compensation excess tax benefit	(0.2	)	(1.5	)	(0.9	)
Tax audit settlements	(4.7	)	(2.5	)	(1.2	)
Deferred tax remeasurements due to change in tax rate	3.1		—		—
All other, net	0.6		1.4		2.6
Effective tax rate	6.5	%	(9.4	)%	31.3	%

Schedule of deferred tax assets and liabilities

Deferred Tax Assets and Liabilities

as of December 31 (in millions)	2019			2018
Deferred tax assets
Compensation and employee benefits	$	810		$	529
Accruals and reserves	371			371
Chargebacks and rebates	477			417
Advance payments	615			867
Net operating losses and other credit carryforwards	838			228
Other	406			353
Total deferred tax assets	3,517			2,765
Valuation allowances	(731		)	(103		)
Total net deferred tax assets	2,786			2,662
Deferred tax liabilities
Excess of book basis over tax basis of intangible assets	(2,712		)	(2,940		)
Excess of book basis over tax basis in investments	(249		)	(211		)
Other	(440		)	(250		)
Total deferred tax liabilities	(3,401		)	(3,401		)
Net deferred tax liabilities	$	(615	)	$	(739	)

Schedule of unrecognized tax benefits

Unrecognized Tax Benefits

years ended December 31 (in millions)	2019			2018			2017
Beginning balance	$	2,852		$	2,701		$	1,168
Increase due to current year tax positions	113			163			1,768
Increase due to prior year tax positions	499			110			16
Decrease due to prior year tax positions	(21		)	(36		)	(2		)
Settlements	(749		)	(79		)	(233		)
Lapse of statutes of limitations	(33		)	(7		)	(16		)
Ending balance	$	2,661		$	2,852		$	2,701