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Identifiable intangible assets - Additional Information (Detail) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2026 USD ($)	Sep. 30, 2025 USD ($)	Sep. 30, 2026 USD ($)	Sep. 30, 2025 USD ($)	Dec. 31, 2024
Intangible Asset, Finite-Lived [Line Items]
Amortization of intangible assets useful life					7 years
Amortization of intangible assets	$ 139	$ 144	$ 415	$ 436
Intangible Asset, Excluding Goodwill, Impairment Loss, Statement of Income or Comprehensive Income [Extensible Enumeration]	Intangible assets impairments	Intangible assets impairments	Intangible assets impairments	Intangible assets impairments
Impairment of intangible assets excluding goodwill	$ 24	$ 64	$ 54	$ 227
Minimum \| Measurement input, discount rate
Intangible Asset, Finite-Lived [Line Items]
Business combination, contingent consideration, liability, measurement input	0.075		0.075
Maximum \| Measurement input, discount rate
Intangible Asset, Finite-Lived [Line Items]
Business combination, contingent consideration, liability, measurement input	0.11		0.11
Development progress and changes in other key valuation assumptions \| Generic pipeline products
Intangible Asset, Finite-Lived [Line Items]
Impairment of intangible assets excluding goodwill				17
Identifiable product rights
Intangible Asset, Finite-Lived [Line Items]
Impairment of intangible assets excluding goodwill			$ 54	210
Identifiable product rights \| Updated market assumptions
Intangible Asset, Finite-Lived [Line Items]
Impairment of intangible assets excluding goodwill				123
Identifiable product rights \| Regulatory price and volume of products
Intangible Asset, Finite-Lived [Line Items]
Impairment of intangible assets excluding goodwill				$ 87
In process research and development \| Minimum
Intangible Asset, Finite-Lived [Line Items]
Business combination, contingent consideration, liability, measurement input	0.075		0.075
In process research and development \| Maximum
Intangible Asset, Finite-Lived [Line Items]
Business combination, contingent consideration, liability, measurement input	0.1125		0.1125
In process research and development \| Maximum \| Measurement input, discount rate
Intangible Asset, Finite-Lived [Line Items]
Business combination, contingent consideration, liability, measurement input	0.90		0.90