Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Cash flows from operating activities:
Net income	$ 4,448.8	$ 3,529.1
Adjustments to reconcile net income to net cash flows from operating activities:
Depreciation, amortization and impairments	567.6	686.9
Acquired in-process research and development	0.0	112.5
Share-based compensation	143.9	119.0
Contingent consideration	66.3	91.6
Loss on divestiture of Hillerød, Denmark manufacturing operations	95.5	0.0
Deferred income taxes	28.4	(44.8)
Unrealized (gain) loss on strategic investments	189.8	136.9
Loss on equity method investment	63.5	0.0
Other	87.4	68.7
Changes in operating assets and liabilities, net:
Accounts receivable	(2.4)	(254.0)
Inventory	(47.3)	31.9
Accrued expenses and other current liabilities	109.1	(100.7)
Income tax assets and liabilities	64.6	315.6
Other changes in operating assets and liabilities, net	(61.0)	(81.0)
Net cash flows provided by operating activities	5,118.4	4,292.3
Cash flows from investing activities:
Proceeds from sales and maturities of marketable securities	3,867.6	7,994.7
Purchases of marketable securities	(4,052.1)	(6,093.8)
Contingent consideration paid related to Fumapharm AG acquisition	(300.0)	(1,200.0)
Acquisition of Nightstar Therapeutics plc, net of cash acquired	(744.4)	0.0
Proceeds from Sale of Property, Plant, and Equipment	923.7	0.0
Purchases of property, plant and equipment	(404.1)	(544.7)
Acquired in-process research and development	0.0	(112.5)
Acquisitions of intangible assets	0.0	(3.0)
Purchase of Ionis Pharmaceuticals, Inc. stock	0.0	(462.9)
Proceeds from sales of strategic investments	476.0	0.0
Other	4.6	(1.2)
Net cash flows used in investing activities	(237.9)	(421.0)
Cash flows from financing activities:
Purchases of treasury stock	(3,775.2)	(3,000.0)
Payments related to issuance of stock for share-based compensation arrangements, net	(16.9)	(6.7)
Repayments of Long-term Debt	0.0	(3.2)
Net distribution to noncontrolling interest	4.3	(36.9)
Other	43.8	11.8
Net cash flows used in financing activities	(3,744.0)	(3,035.0)
Net increase (decrease) in cash and cash equivalents	1,136.5	836.3
Effect of exchange rate changes on cash and cash equivalents	17.2	23.4
Cash and cash equivalents, beginning of the period	1,224.6	1,573.8
Cash and cash equivalents, end of the period	$ 2,343.9	$ 2,386.7