INCOME TAXES (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Summary of Income Before Income Taxes

Income before income taxes consists of the following:

	Year Ended December 31,
(in millions)	2023		2022		2021
Domestic	$	5,467	$	4,439	$	8,587
Foreign	1,392		1,375		(309)
Income before income taxes	$	6,859	$	5,814	$	8,278

Summary of Income Tax Expense

Income tax expense consists of the following:

	Year Ended December 31,
(in millions)	2023		2022		2021
Federal:
Current	$	(1,781)	$	(2,539)	$	(1,776)
Deferred	1,126		1,502		250
	(655)		(1,037)		(1,526)
State:
Current	(80)		(32)		(228)
Deferred	(170)		154		(185)
	(250)		122		(413)
Foreign:
Current	(381)		(232)		(185)
Deferred	39		(101)		47
	(342)		(333)		(138)
Income tax expense	$	(1,247)	$	(1,248)	$	(2,077)

Summary of Difference Between Provision for Income Taxes and Federal Statutory Income Tax Rate to Income Before Provision for Income Taxes

The reconciliation between the federal statutory tax rate applied to Income before income taxes and our effective tax rate is summarized as follows:

	Year Ended December 31,
	2023		2022		2021
Federal statutory rate	21.0	%	21.0	%	21.0	%
State taxes, net of federal benefit	2.3	%	(2.0)	%	2.5	%
Foreign earnings at different rates	(0.2)	%	(0.6)	%	(0.3)	%
Research and other credits	(4.3)	%	(2.7)	%	(1.6)	%
US tax on foreign earnings	1.0	%	2.7	%	1.1	%
Foreign-derived intangible income deduction	(2.1)	%	(3.8)	%	(1.6)	%
Tax examinations	(4.7)	%	(0.2)	%	(0.7)	%
Acquired IPR&D & related charges	1.3	%	1.4	%	—	%
Changes in valuation allowance	0.9	%	1.2	%	1.5	%
Non-taxable unrealized loss on investment	0.2	%	0.7	%	1.8	%
Other	2.8	%	3.8	%	1.4	%
Effective tax rate	18.2	%	21.5	%	25.1	%

Summary of Deferred Tax Assets and Liabilities

Significant components of our deferred tax assets and liabilities are as follows:

	December 31,
(in millions)	2023		2022
Deferred tax assets:
Net operating loss carryforwards	$	417	$	430
Stock-based compensation	94		95
Reserves and accruals not currently deductible	644		645
Excess of tax basis over book basis of intangible assets	1,041		1,067
Upfront and milestone payments	1,271		1,298
Research and other credit carryforwards	283		233
Equity investments	221		196
Liability related to future royalties	296		278
Capitalized R&D expenditures	1,623		784
Other, net	320		263
Total deferred tax assets before valuation allowance	6,210		5,289
Valuation allowance	(663)		(599)
Total deferred tax assets	5,547		4,690
Deferred tax liabilities:
Property, plant and equipment	(274)		(234)
Excess of book basis over tax basis of intangible assets	(5,481)		(5,728)
Other	(184)		(160)
Total deferred tax liabilities	(5,939)		(6,122)
Net deferred tax assets (liabilities)	$	(392)	$	(1,432)

Summary of Unrecognized Tax Benefits Roll Forward

The following is a rollforward of our total gross unrecognized tax benefits:

	Year Ended December 31,
(in millions)	2023		2022		2021
Beginning balance	$	1,959	$	1,713	$	1,614
Tax positions related to current year:
Additions	265		129		147
Reductions	—		—		—
Tax positions related to prior years:
Additions	109		225		161
Reductions	(315)		(31)		(179)
Settlements	(42)		(10)		(28)
Lapse of statute of limitations	(13)		(68)		(2)
Ending balance	$	1,962	$	1,959	$	1,713

Summary of Transition Tax

The following table summarizes the anticipated timing of payments associated with this transition tax as of December 31, 2023:

(in millions)	Amount
2024	$	1,182
2025	1,252
Total	$	2,434