v3.25.0.1
Income Taxes (Tables)
 12 Months Ended
Dec. 31, 2024
Income Tax Disclosure [Abstract]  
Schedule of earnings before income tax expense
Earnings Before Income Tax Expense
years ended December 31 (in millions)202420232022
Domestic$(7,743)$(3,475)$(4,608)
Foreign11,459 9,725 18,085 
Total earnings before income tax expense$3,716 $6,250 $13,477 
Schedule of income tax expense
Income Tax Expense
years ended December 31 (in millions)202420232022
Current
Domestic$(331)$3,272 $2,647 
Foreign1,210 994 916 
Total current taxes$879 $4,266 $3,563 
Deferred
Domestic$(1,303)$(2,324)$(1,512)
Foreign(146)(565)(419)
Total deferred taxes$(1,449)$(2,889)$(1,931)
Total income tax expense (benefit)$(570)$1,377 $1,632 
Summary of effective tax rate reconciliation
Effective Tax Rate Reconciliation
years ended December 31
202420232022
Statutory tax rate21.0 %21.0 %21.0 %
Effect of foreign operations7.6 8.0 (4.4)
U.S. tax credits(5.4)(3.1)(2.8)
Stock-based compensation (1.2)(1.0)(0.6)
Non-deductible expenses1.1 0.7 0.4 
Tax law changes and related structuring(0.3)(3.8)(2.4)
Tax audits, settlements and reserves(51.4)(1.1)0.9 
Acquisition costs13.4 0.2 — 
All other, net(0.1)1.1 — 
Effective tax rate(15.3)%22.0 %12.1 %
Schedule of deferred tax assets and liabilities
Deferred Tax Assets and Liabilities
as of December 31 (in millions)20242023
Deferred tax assets
Compensation and employee benefits$215 $519 
Accruals and reserves1,253 1,113 
Chargebacks and rebates1,354 1,431 
Advance payments66 298 
Net operating losses and other carryforwards15,815 14,316 
Other2,156 2,259 
Total deferred tax assets20,859 19,936 
Valuation allowances(14,823)(13,478)
Total net deferred tax assets6,036 6,458 
Deferred tax liabilities
Excess of book basis over tax basis of intangible assets(1,969)(1,535)
Excess of book basis over tax basis in investments(302)(374)
Other(718)(746)
Total deferred tax liabilities(2,989)(2,655)
Net deferred tax assets
$3,047 $3,803 
Schedule of Unrecognized Tax Benefits Roll Forward
Unrecognized Tax Benefits
years ended December 31 (in millions)202420232022
Beginning balance$5,762 $5,670 $5,489 
Increase due to current year tax positions173 129 88 
Increase due to prior year tax positions454 109 243 
Decrease due to prior year tax positions(1,741)(21)(33)
Settlements(284)(86)(7)
Increase due to acquisitions82 — — 
Lapse of statutes of limitations(45)(39)(110)
Ending balance$4,401 $5,762 $5,670