v3.24.0.1
Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Cash flows from operating activities      
Net earnings $ 4,873 $ 11,845 $ 11,549
Adjustments to reconcile net earnings to net cash from operating activities:      
Depreciation 752 778 803
Amortization of intangible assets 7,946 7,689 7,718
Deferred income taxes (2,889) (1,931) (898)
Change in fair value of contingent consideration liabilities 5,128 2,761 2,679
Payments of contingent consideration liabilities (870) (164) (91)
Stock-based compensation 747 671 692
Acquired IPR&D and milestones 778 697 1,124
Other charges related to collaborations 0 0 500
Gain on divestitures 0 (172) (68)
Non-cash litigation reserve adjustments, net of cash payments (443) 2,243 163
Impairment of intangible assets 4,229 770 50
Other, net (225) (150) (213)
Changes in operating assets and liabilities, net of acquisitions:      
Accounts receivable 66 (1,455) (1,321)
Inventories (417) (686) (142)
Prepaid expenses and other assets (188) (264) (197)
Accounts payable and other liabilities 3,840 1,769 1,719
Income tax assets and liabilities, net (488) 542 (1,290)
Cash flows from operating activities 22,839 24,943 22,777
Cash flows from investing activities      
Acquisition of businesses, net of cash acquired 0 (255) (525)
Other acquisitions and investments (1,223) (539) (1,377)
Acquisitions of property and equipment (777) (695) (787)
Purchases of investment securities (77) (1,438) (119)
Sales and maturities of investment securities 55 1,530 98
Other, net 13 774 366
Cash flows from investing activities (2,009) (623) (2,344)
Cash flows from financing activities      
Proceeds from issuance of long-term debt   2,000 1,000
Repayments of long-term debt and finance lease obligations (4,149) (14,433) (9,414)
Debt issuance costs (38) 0 0
Dividends paid (10,539) (10,043) (9,261)
Purchases of treasury stock (1,972) (1,487) (934)
Proceeds from the exercise of stock options 180 262 244
Payments of contingent consideration liabilities (752) (1,132) (698)
Other, net 48 30 24
Cash flows from financing activities (17,222) (24,803) (19,039)
Effect of exchange rate changes on cash and equivalents 5 (62) (97)
Net change in cash and equivalents 3,613 (545) 1,297
Cash and equivalents, beginning of year 9,201 9,746 8,449
Cash and equivalents, end of year 12,814 9,201 9,746
Other supplemental information      
Interest paid, net of portion capitalized 2,469 2,546 2,712
Income taxes paid $ 4,702 $ 2,988 $ 3,648