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Indebtedness (Details Textual)
SFr in Millions
1 Months Ended 3 Months Ended 12 Months Ended
Dec. 31, 2008
USD ($)
Dec. 31, 2017
USD ($)
Dec. 31, 2018
USD ($)
Dec. 31, 2015
USD ($)
Mar. 04, 2008
USD ($)
Dec. 31, 2006
CHF (SFr)
Debt Instrument            
Costs associated with the Senior Notes offerings       $ 47,500,000    
Redemptions percentage of 2015 notes     100.00%      
Redemption percentage for change in control provision on the 2015 Senior Notes     101.00%      
Senior unsecured revolving credit facility maximum borrowing capacity       $ 1,000,000,000    
Term of credit facility       5 years    
Amount outstanding under the credit facility     $ 0      
Notes Payable To Fumedica            
Debt Instrument            
Notes Payable | SFr           SFr 61.4
6.875% Senior Notes due 2018            
Debt Instrument            
Senior Notes aggregate principal amount         $ 550,000,000  
Interest rate on senior notes         6.875%  
Redemption percentage par value of senior notes         99.184%  
Increased Carrying Amount Of Senior Notes $ 62,800,000          
Net charge upon extinguishment of debt   $ 5,200,000        
Payment for Debt Extinguishment or Debt Prepayment Cost   7,700,000        
2.90% Senior Notes due 2020            
Debt Instrument            
Senior Notes aggregate principal amount       $ 1,500,000,000    
Interest rate on senior notes     2.90% 2.90%    
Redemption percentage par value of senior notes       99.792%    
3.625% Senior Notes due 2022            
Debt Instrument            
Senior Notes aggregate principal amount       $ 1,000,000,000    
Interest rate on senior notes     3.625% 3.625%    
Redemption percentage par value of senior notes       99.92%    
4.05% Senior Notes due 2025            
Debt Instrument            
Senior Notes aggregate principal amount       $ 1,750,000,000    
Interest rate on senior notes     4.05% 4.05%    
Redemption percentage par value of senior notes       99.764%    
5.20% Senior Notes due 2045            
Debt Instrument            
Senior Notes aggregate principal amount       $ 1,750,000,000    
Interest rate on senior notes     5.20% 5.20%    
Redemption percentage par value of senior notes       99.294%    
Interest rate swap            
Debt Instrument            
Net charge upon extinguishment of debt   2,900,000        
Interest rate swap | 2.90% Senior Notes due 2020            
Debt Instrument            
Fair value of the interest rate swaps   $ 10,100,000 $ 14,500,000