Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Cash flow from operating activities:
Net income	$ 2,412.1	$ 1,748.1
Adjustments to reconcile net income to net cash flow from operating activities:
Depreciation and amortization	398.6	353.0
Impairment of intangible assets	0.0	629.3
Excess and obsolescence charges related to inventory	321.6	36.5
Acquired in-process research and development	0.0	18.0
Share-based compensation	186.9	179.8
Contingent consideration	(13.7)	(49.1)
Deferred income taxes	(139.8)	(750.1)
(Gain) loss on strategic investments	160.3	710.5
(Gain) loss on equity method investments	(2.6)	(17.2)
Gain on sale of equity interest in Samsung Bioepis	(1,505.4)	0.0
Gain on sale of building	(503.7)	0.0
Other	147.8	164.5
Changes in operating assets and liabilities, net:
Accounts receivable	(109.5)	157.8
Due from anti-CD20 therapeutic programs	(3.0)	13.5
Inventory	(338.3)	(322.6)
Accrued expense and other current liabilities	632.3	(243.3)
Income tax assets and liabilities	(100.2)	260.5
Other changes in operating assets and liabilities, net	15.9	(87.6)
Net cash flow provided by (used in) operating activities	1,559.3	2,801.6
Cash flows from investing activities:
Purchases of property, plant and equipment	(153.9)	(206.5)
Proceeds from sales and maturities of marketable securities	3,104.7	2,028.1
Purchases of marketable securities	(2,805.9)	(2,372.6)
Proceeds from sale of equity interest in Samsung Bioepis	(990.3)	0.0
Proceeds from sale of building	582.6	0.0
Proceeds from divestiture of Hillerød, Denmark manufacturing operations	0.0	28.1
Acquired in-process research and development	0.0	(18.0)
Acquisitions of intangible assets	(1.9)	(1.9)
Proceeds from sales of strategic investments	0.0	91.2
Other	1.8	0.6
Net cash flow provided by (used in) investing activities	1,717.7	(451.0)
Cash flows from financing activities:
Purchases of treasury stock	(750.0)	(1,800.0)
Payments related to issuance of stock for share-based compensation arrangements, net	(5.8)	(8.3)
Repayment of borrowings and premiums paid	(1,002.2)	(170.0)
Net (distribution) contribution to noncontrolling interest	12.2	(94.8)
Other	5.9	(22.9)
Net cash flow provided by (used in) financing activities	(1,739.9)	(2,096.0)
Net increase (decrease) in cash and cash equivalents	1,537.1	254.6
Effect of exchange rate changes on cash and cash equivalents	(122.9)	(44.0)
Cash and cash equivalents, beginning of the period	2,261.4	1,331.2
Cash and cash equivalents, end of the period	$ 3,675.6	$ 1,541.8