Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Cash flows from operating activities:
Net income	$ 3,529.1	$ 2,836.4
Adjustments to reconcile net income to net cash flows from operating activities:
Depreciation and amortization	686.9	872.0
Acquired in-process research and development	112.5	120.0
Share-based compensation	119.0	97.4
Contingent consideration	(91.6)	61.2
Deferred income taxes	44.8	39.7
Other	(68.2)	65.7
Changes in operating assets and liabilities, net:
Accounts receivable	(254.0)	(225.8)
Inventory	(31.9)	(170.3)
Accrued expenses and other current liabilities	100.7	(504.5)
Income tax assets and liabilities	315.6	170.5
Other changes in operating assets and liabilities, net	(81.0)	(250.2)
Net cash flows provided by operating activities	4,292.3	3,032.7
Cash flows from investing activities:
Proceeds from sales and maturities of marketable securities	7,994.7	4,472.6
Purchases of marketable securities	6,093.8	4,093.9
Contingent consideration paid related to Fumapharm AG acquisition	1,200.0	900.0
Purchases of property, plant and equipment	(544.7)	(636.8)
Acquired in-process research and development	(112.5)	(120.0)
Acquisitions of intangible assets	(3.0)	(910.4)
Purchase of Ionis Pharmaceuticals, Inc. stock	(462.9)	0.0
Other	(1.2)	5.1
Net cash flows used in investing activities	(421.0)	(2,193.6)
Cash flows from financing activities:
Purchases of treasury stock	(3,000.0)	(1,365.4)
Payments related to issuance of stock for share-based compensation arrangements, net	(6.7)	(10.7)
Repayment of borrowings	(3.2)	(3.2)
Net distribution to noncontrolling interest	(36.9)	0.0
Net cash contribution to Bioverativ Inc.	0.0	302.7
Other	11.8	10.1
Net cash flows used in financing activities	(3,035.0)	(1,671.9)
Net increase (decrease) in cash and cash equivalents	836.3	(832.8)
Effect of exchange rate changes on cash and cash equivalents	(23.4)	54.4
Cash and cash equivalents, beginning of the period	1,573.8	2,326.5
Cash and cash equivalents, end of the period	$ 2,386.7	$ 1,548.1