Stockholders' equity (Reclassifications out of AOCI) (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Total revenues	$ 6,238	$ 5,901
Other (expense) income, net	(530)	13
Income before income taxes	1,675	1,857
Provision for income taxes	(199)	(211)
Net income	1,476	1,646
Product sales [Member]
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Total revenues	5,731	5,592
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member]
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Income before income taxes	(51)	(133)
Provision for income taxes	11	28
Net income	(40)	(105)
Reclassification out of Accumulated Other Comprehensive Income [Member] | Foreign currency contract [Member] | Cash flow hedges [Member] | Product sales [Member]
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Total revenues	27	(1)
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cross-currency swap contract [Member] | Cash flow hedges [Member]
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Other (expense) income, net	(78)	(132)
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Foreign currency contract [Member] | Cash flow hedges [Member] | Product sales [Member]
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Total revenues	27	(1)
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Cross-currency swap contract [Member] | Cash flow hedges [Member]
Reclassification out of Accumulated Other Comprehensive Income [Line Items]
Other (expense) income, net	$ (78)	$ (132)