CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Operating Activities:
Net income:	$ 480	$ 5,613	$ 4,566
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation expense	381	354	323
Amortization expense	2,386	2,339	1,780
Stock-based compensation expense	835	766	637
Deferred income taxes	(1,844)	(962)	(1,552)
Net loss from equity securities	274	167	657
Acquired in-process research and development expenses	4,663	1,155	944
In-process research and development impairments	4,180	50	2,700
Other	353	826	780
Changes in operating assets and liabilities:
Accounts receivable, net	139	157	(406)
Inventories	(426)	(842)	(310)
Prepaid expenses and other	(259)	39	(134)
Accounts payable	290	(347)	226
Income tax assets and liabilities, net	(732)	(1,768)	(364)
Accrued and other liabilities	108	458	(775)
Net cash provided by operating activities	10,828	8,006	9,072
Investing Activities:
Purchases of marketable debt securities	(244)	(1,930)	(1,770)
Proceeds from sales of marketable debt securities	2,265	510	412
Proceeds from maturities of marketable debt securities	327	1,334	1,590
Acquisitions, including in-process research and development, net of cash acquired	(4,840)	(1,152)	(1,797)
Purchases of equity securities	(492)	(442)	(172)
Capital expenditures	(523)	(585)	(728)
Other	58	(1)	(1)
Net cash used in investing activities	(3,449)	(2,265)	(2,466)
Financing Activities:
Proceeds from debt financing, net of issuance costs	3,464	1,980	0
Proceeds from issuances of common stock	422	232	309
Repurchases of common stock under repurchase programs	(1,150)	(1,000)	(1,396)
Repayments of debt and other obligations	(1,970)	(2,250)	(1,500)
Payments of dividends	(3,918)	(3,809)	(3,709)
Other	(281)	(279)	(173)
Net cash used in financing activities	(3,433)	(5,125)	(6,469)
Effect of exchange rate changes on cash and cash equivalents	(40)	57	(63)
Net change in cash and cash equivalents	3,906	673	74
Cash and cash equivalents at beginning of period	6,085	5,412	5,338
Cash and cash equivalents at end of period	9,991	6,085	5,412
Supplemental disclosure of cash flow information:
Interest paid, net of amounts capitalized	951	891	907
Income taxes paid	$ 2,779	$ 3,990	$ 3,136