Stockholders' equity - Schedule of Reclassifications Out of AOCI (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Product sales	$ 33,424	$ 28,190	$ 26,323
Other income (expense), net	506	2,833	(814)
Income before income taxes	4,609	7,855	7,346
Provision for income taxes	(519)	(1,138)	(794)
Net income	4,090	6,717	6,552
Reclassification out of AOCI | Cash flow hedges
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Income before income taxes	117	222	(2)
Provision for income taxes	(25)	(50)	0
Net income	92	172	(2)
Cross-currency swap contract (losses) gains | Reclassification out of AOCI | Cash flow hedges
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Other income (expense), net	(75)	42	(233)
Cross-currency swap contract (losses) gains | Cash flow hedge | Reclassification out of AOCI | Cash flow hedges
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Other income (expense), net	(75)	42	(233)
Product sales
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Product sales	32,026	26,910	24,801
Product sales | Foreign currency contract gains | Reclassification out of AOCI | Cash flow hedges
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Product sales	192	180	231
Product sales | Foreign currency contract gains | Cash flow hedge | Reclassification out of AOCI | Cash flow hedges
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Product sales	$ 192	$ 180	$ 231