v3.26.1
Segment and other information - Schedule of Reconciliation of Segment Net Income (Loss) to Consolidated Net Income (Loss) (Details) - USD ($)
$ in Millions
 3 Months Ended 6 Months Ended
Jun. 30, 2026
Jun. 30, 2025
Jun. 30, 2026
Jun. 30, 2025
Segment Reporting [Line Items]        
Total revenues $ 10,054 $ 9,179 $ 18,672 $ 17,328
Manufacturing cost of sales 2,811 3,011 5,555 5,979
Interest income (125) (86) (226) (212)
Interest expense, net 673 694 1,330 1,417
Provision for income taxes 393 136 658 379
Net income 2,375 1,432 4,194 3,162
Amortization expense of intangible assets 890 1,100 1,800 2,300
Depreciation and right-of-use asset amortization expense 222 220 442 429
Reportable Segment        
Segment Reporting [Line Items]        
Net income 2,375 1,432 4,194 3,162
Fair Value Adjustment to Inventory        
Segment Reporting [Line Items]        
Amortization of step-up to fair value of inventory acquired 60 339 307 702
Operating Segments | Reportable Segment        
Segment Reporting [Line Items]        
Total revenues 10,054 9,179 18,672 17,328
Manufacturing cost of sales 2,139 2,484 4,319 5,012
Profit share and royalties in cost of sales 672 527 1,236 967
Research and development 1,868 1,744 3,587 3,230
Sales and marketing 1,155 1,137 2,289 2,203
General and administrative 590 554 1,058 1,175
Other segment items 314 557 227 (5)
Interest income (125) (86) (226) (212)
Interest expense, net 673 694 1,330 1,417
Provision for income taxes 393 136 658 379
Net income 2,375 1,432 4,194 3,162
Adjustments and reconciling items | Reportable Segment        
Segment Reporting [Line Items]        
Net income 0 0 0 0
Product sales        
Segment Reporting [Line Items]        
Total revenues 9,537 8,771 17,755 16,644
Product sales | Reportable Segment        
Segment Reporting [Line Items]        
Total revenues 9,537 8,771 17,755 16,644
Other revenues        
Segment Reporting [Line Items]        
Total revenues 517 408 917 684
Other revenues | Reportable Segment        
Segment Reporting [Line Items]        
Total revenues $ 517 $ 408 $ 917 $ 684