Goodwill and other intangible assets - Narrative (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Finite-Lived Intangible Assets [Line Items]
Impairment, Intangible Asset, Indefinite-Lived (Excluding Goodwill), Statement of Income or Comprehensive Income [Extensible Enumeration]		Other General Expense
Amortization charges associated with finite-lived intangible assets	$ 4,800	$ 3,200	$ 2,600
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
In-process research and development
Finite-Lived Intangible Assets [Line Items]
IPR&D impairment charge		783
Indefinite-lived intangible assets (excluding goodwill)	1,060	$ 1,218
Developed-product-technology rights
Finite-Lived Intangible Assets [Line Items]
Indefinite-lived intangible assets (excluding goodwill)	$ 5,200