Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
Cash flows from operating activities:
Net income	$ 2,902.9	$ 2,086.2
Adjustments to reconcile net income to net cash flows from operating activities:
Depreciation, amortization and impairments	238.1	340.4
Acquired in-process research and development	0.0	85.0
Share-based compensation	98.0	81.7
Contingent consideration	8.5	3.7
Loss on assets and liabilities held for sale	113.2	0.0
Deferred income taxes	71.6	(57.4)
Unrealized (gain) loss on strategic investments	199.2	(1.0)
Other	91.1	45.1
Changes in operating assets and liabilities, net:
Accounts receivable	(2.9)	(187.2)
Inventory	(108.7)	40.1
Accrued expenses and other current liabilities	216.1	(13.3)
Income tax assets and liabilities	306.9	183.4
Other changes in operating assets and liabilities, net	(80.3)	8.7
Net cash flows provided by operating activities	3,423.5	2,556.4
Cash flows from investing activities:
Proceeds from sales and maturities of marketable securities	3,255.8	6,802.7
Purchases of marketable securities	(2,075.1)	(4,774.3)
Contingent consideration paid related to Fumapharm AG acquisition	(300.0)	(900.0)
Acquisition of Nightstar Therapeutics plc, net of cash acquired	(744.4)	0.0
Purchases of property, plant and equipment	(314.0)	(381.5)
Acquired in-process research and development	0.0	(85.0)
Acquisitions of intangible assets	0.0	(3.0)
Purchase of Ionis Pharmaceuticals, Inc. stock	0.0	(462.9)
Proceeds from sales of strategic investments	309.7	0.0
Other	4.0	(2.1)
Net cash flows provided by investing activities	128.0	198.1
Cash flows from financing activities:
Purchases of treasury stock	(3,057.3)	(3,000.0)
Payments related to issuance of stock for share-based compensation arrangements, net	(23.6)	(14.3)
Net distribution to noncontrolling interest	4.3	(38.9)
Other	21.6	(6.9)
Net cash flows used in financing activities	(3,055.0)	(3,060.1)
Net increase (decrease) in cash and cash equivalents	496.5	(305.6)
Effect of exchange rate changes on cash and cash equivalents	(2.3)	18.0
Cash and cash equivalents, beginning of the period	1,224.6	1,573.8
Cash and cash equivalents, end of the period	$ 1,723.4	$ 1,250.2