0000059478-24-000065 | 10-K | XBRL Viewer

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Goodwill and Other Intangibles (Schedule of Estimated Amortization Expense) (Details) $ in Millions	Dec. 31, 2023 USD ($)
Estimated amortization expense
2024	$ 542.5
2025	530.3
2026	519.7
2027	517.7
2028	$ 511.6

Income Taxes (Schedule of Unrecognized Tax Benefits) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Beginning balance	$ 2,987.0	$ 2,798.3	$ 2,551.9
Additions based on tax positions related to the current year	364.3	274.2	310.3
Additions for tax positions of prior years	78.2	34.6	98.6
Reductions for tax positions of prior years	(39.0)	(10.9)	(8.1)
Settlements	(4.7)	(44.8)	(38.5)
Lapses of statutes of limitation	(21.5)	(11.8)	(49.7)
Changes related to the impact of foreign currency translation	30.7
Changes related to the impact of foreign currency translation		(52.6)	(66.2)
Ending balance	$ 3,395.0	$ 2,987.0	$ 2,798.3

Acquisitions (Narrative) (Details) $ / shares in Units, $ in Millions			1 Months Ended		12 Months Ended
	Dec. 27, 2023 USD ($)	Jan. 22, 2021 USD ($)	Dec. 31, 2022 USD ($) right $ / shares	Jan. 31, 2021 USD ($) right $ / shares	Dec. 31, 2023 USD ($) $ / shares	Dec. 31, 2022 USD ($) $ / shares	Dec. 31, 2021 USD ($)
Business Acquisition [Line Items]
Acquired in-process research and development (Note 3)					$ 3,799.8	$ 908.5	$ 970.1
Acquired IPR&D Expense						$ 333.8
Biopharma Global Inc
Business Acquisition [Line Items]
Business acquisition, share price (in dollars per share) \| $ / shares					$ 12.50
Cash paid, net of cash acquired	$ 1,035.8
Akouos Acquisition
Business Acquisition [Line Items]
Business acquisition, share price (in dollars per share) \| $ / shares			$ 12.50			$ 12.50
Cash paid, net of cash acquired			$ 327.2
Consideration transferred, number of contingent value rights \| right			1
Contingent value right, additional price per share (in dollars per share) \| $ / shares			$ 3.00			$ 3.00
Contingent value right, additional price per share, aggregate amount			$ 122.0			$ 122.0
Prevail Therapeutics Inc.
Business Acquisition [Line Items]
Business acquisition, share price (in dollars per share) \| $ / shares				$ 22.50
Cash paid, net of cash acquired		$ 747.4		$ 747.4
Consideration transferred, number of contingent value rights \| right				1
Contingent value right, additional price per share (in dollars per share) \| $ / shares				$ 4.00
Contingent value right, additional price per share, aggregate amount				$ 160.0
Contingent value right, monthly reduction \| $ / shares				$ 0.083

Revenue

12 Months Ended

Dec. 31, 2023

Revenue from Contract with Customer [Abstract]

Revenue

The following table summarizes our revenue recognized in our consolidated statements of operations:


	2023		2022		2021
Net product revenue	$	28,813.9	$	25,462.8	$	25,957.9
Collaboration and other revenue(1)	5,310.2		3,078.6		2,360.5
Revenue	$	34,124.1	$	28,541.4	$	28,318.4

(1) Collaboration and other revenue associated with prior period transfers of intellectual property was $191.6 million, $163.4 million, and $175.0 million during the years ended December 31, 2023, 2022, and 2021, respectively.

We recognize revenue primarily from two different types of contracts, product sales to customers (net product revenue) and collaborations and other arrangements. Revenue recognized from collaborations and other arrangements includes our share of profits from the collaborations, as well as royalties, upfront and milestone payments we receive under these types of contracts. See Note 4 for additional information related to our collaborations and other arrangements. Collaboration and other revenue disclosed above includes the revenue from the Jardiance® and Trajenta® families of products resulting from our collaboration with Boehringer Ingelheim, as well as from the sales of rights for the olanzapine portfolio, including Zyprexa®, and for Baqsimi®, all of which are discussed in Note 4. Substantially all of the remainder of collaboration and other revenue is related to contracts accounted for as contracts with customers.

Net Product Revenue

Revenue from sales of products is recognized at the point where the customer obtains control of the goods and we satisfy our performance obligation, which generally is at the time we ship the product to the customer. Payment terms differ by jurisdiction and customer, but payment terms in most of our major jurisdictions typically range from 30 to 70 days from date of shipment. Revenue for our product sales has not been adjusted for the effects of a financing component as we expect, at contract inception, that the period between when we transfer control of the product and when we receive payment will be one year or less. Any exceptions are either not material or we collect interest for payments made after the due date. Provisions for rebates, discounts, and returns are established in the same period the related product sales are recognized. We generally ship product shortly after orders are received; therefore, we generally only have a few days of orders received but not yet shipped at the end of any reporting period. Shipping and handling activities are considered to be fulfillment activities and are not considered to be a separate performance obligation. We exclude from the measurement of the transaction price all taxes assessed by a governmental authority that are imposed on our sales of product and collected from a customer.

Most of our products are sold to wholesalers that serve pharmacies, physicians and other healthcare professionals, and hospitals. For the years ended December 31, 2023, 2022, and 2021, our three largest wholesalers each accounted for between 16 percent and 21 percent of consolidated revenue. Further, they each accounted for between 18 percent and 29 percent of accounts receivable as of December 31, 2023 and 2022.

Significant judgments must be made in determining the transaction price for our sales of products related to anticipated rebates, discounts, and returns. The following describe the most significant of these judgments:

Sales Rebates and Discounts - Background and Uncertainties

•We initially invoice our customers at contractual list prices. Contracts with direct and indirect customers may provide for various rebates and discounts that may differ in each contract. As a consequence, to determine the appropriate transaction price for our product sales at the time we recognize a sale to a direct customer, we estimate any rebates or discounts that ultimately will be due to the direct customer and other customers in the distribution chain under the terms of our contracts. Significant judgments are required in making these estimates.

•The rebate and discount amounts are recorded as a deduction to arrive at our net product revenue. Sales rebates and discounts that require the use of judgment in the establishment of the accrual include managed care, Medicare, Medicaid, chargebacks, long-term care, hospital, patient assistance programs, and various other programs. We estimate these accruals using an expected value approach.

•The largest of our sales rebate and discount amounts include rebates associated with sales covered by managed care, Medicare, Medicaid, and chargeback programs, as well as reductions in revenue related to our patient assistance programs, in the U.S. In determining the appropriate accrual amount, we consider our historical rebate payments for these programs, as well as patient assistance program costs, by product as a percentage of our historical sales as well as any significant changes in sales trends (e.g., patent expiries and product launches), an evaluation of the current contracts for these programs, the percentage of our products that are sold via these programs, and our product pricing. Although we accrue a liability for revenue reductions related to these programs at the time we record the sale, the reduction related to that sale is typically paid up to six months later. Because of this time lag, in any particular period our net product revenue may incorporate revisions of accruals for several periods.

•Most of our rebates outside the U.S. are contractual or legislatively mandated and are estimated and recognized in the same period as the related sales. In some large European countries, government rebates are based on the anticipated budget for pharmaceutical payments in the country. An estimate of these rebates, updated as governmental authorities revise budgeted deficits, is recognized in the same period as the related sale.

Sales Returns - Background and Uncertainties

•When product sales occur, to determine the appropriate transaction price for our sales, we estimate a reserve for future product returns related to those sales using an expected value approach. This estimate is based on several factors, including: historical return rates, expiration date by product (on average, approximately 24 months after the initial sale of a product to our customer), and estimated levels of inventory in the wholesale and retail channels, as well as any other specifically identified anticipated returns due to known factors such as the loss of patent exclusivity, product recalls and discontinuations, or a changing competitive environment. We maintain a returns policy that allows most U.S. customers to return most of our products for dating issues within a specified period prior to and subsequent to the product's expiration date. Following the loss of exclusivity for a patent-dependent product, we expect to experience an elevated level of product returns as product inventory remaining in the wholesale and retail channels expires. Adjustments to the returns reserve have been and may in the future be required based on revised estimates to our assumptions. We record the return amounts as a deduction to arrive at our net product revenue. Once the product is returned, it is destroyed; we do not record a right of return asset. Our returns policies outside the U.S. are generally more restrictive than in the U.S. as returns are not allowed for reasons other than failure to meet product specifications in many countries. Our reserve for future product returns for product sales outside the U.S. is not material.

•As a part of our process to estimate a reserve for product returns, we regularly review the supply levels of our significant products at the major wholesalers in the U.S. and in major markets outside the U.S., primarily by reviewing periodic inventory reports supplied by our major wholesalers and available prescription volume information for our products, or alternative approaches. We attempt to maintain U.S. wholesaler inventory levels at an average of approximately one month or less. Causes of unusual wholesaler buying patterns include actual or anticipated product-supply issues, weather patterns, anticipated changes in the transportation network, redundant holiday stocking, and changes in wholesaler business operations. In the U.S., the current structure of our arrangements provides us with data on inventory levels at our wholesalers; however, our data on inventory levels in the retail channel is more limited. Wholesaler stocking and destocking activity historically has not caused any material changes in the rate of actual product returns.

•Actual U.S. product returns have been less than 2 percent of our U.S. revenue during each of the past three years and have not fluctuated significantly as a percentage of revenue, although fluctuations are more likely in periods following loss of patent exclusivity for major products in the U.S. market.

Adjustments to Revenue

Adjustments to revenue recognized as a result of changes in estimates for our most significant U.S. sales returns, rebates, and discounts liability balances for products shipped in previous periods were less than 1 percent of U.S. revenue during each of the years ended December 31, 2023, 2022, and 2021.

Collaboration and Other Arrangements

We recognize several types of revenue from our collaborations and other arrangements, which we discuss in general terms immediately below and more specifically in Note 4 for each of our material collaborations and other arrangements. Our collaborations and other arrangements are evaluated to determine if the arrangements in their entirety, or contain aspects that, are contracts with customers.

•Revenue related to products we sell pursuant to these arrangements is included in net product revenue at the earlier of when control of the asset transfers to the other party or when the product has no alternative use to us and we have right to payment.

•Profit-sharing due from our collaboration partners, which is based upon gross margins reported to us by our partners, is recognized as collaboration and other revenue as earned.

•Royalty revenue from licensees and certain of our collaboration partners, which is based on sales to third parties of licensed products and technology, is recorded when the third-party sale occurs and the performance obligation to which some or all of the royalty has been allocated has been satisfied (or partially satisfied). This royalty revenue is included in collaboration and other revenue.

•The net gain or loss related to the sale of rights of a product is included in collaboration and other revenue when control of the asset transfers to the other party.

•For arrangements that involve variable consideration where we have sold intellectual property, we recognize revenue based on estimates of the amount of consideration we believe we will be entitled to receive from the other party, but only to the extent a significant reversal in the amount of revenue recognized is not probable of occurring when the uncertainties associated with the variable consideration are subsequently resolved. These estimates are adjusted to reflect the actual amounts to be collected when those facts and circumstances become known. Significant judgments must be made in determining the transaction price for our sales of intellectual property. Because of the risk that products in development will not receive regulatory approval, we generally do not recognize any contingent payments that would be due to us upon or after regulatory approval.

•For arrangements involving multiple goods or services (e.g., research and development, marketing and selling, manufacturing, and distribution), each required good or service is evaluated to determine whether it is distinct. If a good or service does not qualify as distinct, it is combined with the other non-distinct goods or services within the arrangement and these combined goods or services are treated as a single performance obligation for accounting purposes. The arrangement's transaction price is then allocated to each performance obligation based on the relative standalone selling price of each performance obligation.

Contract Liabilities

Our contract liabilities result from arrangements where we have received payment in advance of performance under the contract and do not include sales returns, rebates, and discounts. Changes in contract liabilities are generally due to either receipt of additional advance payments or our performance under the contract.

The following table summarizes contract liability balances:


	2023		2022
Contract liabilities	$	193.6	$	219.2

The contract liabilities balances disclosed above as of December 31, 2023 and 2022 were primarily related to the remaining license period of symbolic intellectual property and obligations to supply product for a defined period of time.

During the years ended December 31, 2023, 2022, and 2021, revenue recognized from contract liabilities as of the beginning of the respective year was not material. Revenue expected to be recognized in the future from contract liabilities as the related performance obligations are satisfied is not expected to be material in any one year.

Disaggregation of Revenue

The following table summarizes revenue, including net product revenue and collaboration and other revenue, by product:


	U.S.						Outside U.S.
	2023		2022		2021		2023		2022		2021



Diabetes and obesity:
Trulicity®	$	5,433.3	$	5,688.8	$	4,914.4	$	1,699.2	$	1,750.9	$	1,557.6
Mounjaro®	4,834.2		366.6		—		328.9		115.9		—
Jardiance(1)	1,600.4		1,194.5		807.3		1,144.2		871.5		683.5
Humalog® (2)	863.2		1,191.9		1,320.7		800.2		868.7		1,132.3
Humulin®	610.1		730.2		832.9		242.0		289.2		389.6
Basaglar® (3)	443.1		470.7		588.3		285.2		289.7		304.2
Baqsimi	645.7		110.4		96.4		31.9		28.9		16.8
Zepbound®	175.8		—		—		—		—		—
Other diabetes and obesity	175.0		158.0		159.3		355.2		338.9		384.8
Total diabetes and obesity	14,780.8		9,911.1		8,719.3		4,886.8		4,553.7		4,468.8

Oncology:
Verzenio®	2,509.0		1,653.2		834.9		1,354.3		830.3		515.0
Cyramza®	402.3		351.4		358.1		572.4		620.0		674.8
Erbitux®	528.9		500.1		481.8		67.6		66.4		66.4
Tyvyt®	—		—		—		393.4		293.3		418.1
Alimta®	72.9		543.7		1,233.9		144.6		384.0		827.5
Other oncology	283.9		169.7		120.1		329.0		254.1		210.7
Total oncology	3,797.0		3,218.1		3,028.8		2,861.3		2,448.1		2,712.5

Immunology:
Taltz®	1,831.6		1,724.6		1,542.4		928.0		757.4		670.4
Olumiant® (4)	225.5		148.2		324.1		697.2		682.3		791.0
Other immunology	0.8		20.0		15.3		114.4		12.1		17.6
Total immunology	2,057.9		1,892.8		1,881.8		1,739.6		1,451.8		1,479.0

Neuroscience:
Zyprexa(5)	79.4		30.4		39.6		1,615.4		306.5		390.7
Emgality®	482.2		462.8		434.5		196.0		188.1		142.7
Other neuroscience	134.4		119.2		140.7		371.1		439.2		750.3
Total neuroscience	696.0		612.4		614.8		2,182.5		933.8		1,283.7

Other:
Forteo®	335.5		367.3		441.6		197.7		245.8		360.3
Cialis®	26.1		35.2		10.6		355.3		552.1		707.9
COVID-19 antibodies(6)	—		2,008.9		1,978.0		—		14.7		261.4
Other	97.7		144.2		136.1		109.9		151.3		233.9
Total other	459.3		2,555.7		2,566.4		662.9		964.0		1,563.5

Revenue	$	21,791.0	$	18,190.0	$	16,811.0	$	12,333.1	$	10,351.3	$	11,507.4

Numbers may not add due to rounding.

(1) Jardiance revenue includes Glyxambi®, Synjardy®, and Trijardy® XR.

(2) Humalog revenue includes insulin lispro.

(3) Basaglar revenue includes Rezvoglar®.

(4) Olumiant revenue includes sales for baricitinib that were made pursuant to Emergency Use Authorization (EUA) or similar regulatory authorizations.

(5) Zyprexa revenue includes sale of the rights for the olanzapine portfolio.

(6) COVID-19 antibodies include sales for bamlanivimab administered alone, for bamlanivimab and etesevimab administered together, and for bebtelovimab and were made pursuant to EUAs or similar regulatory authorizations.

The following table summarizes revenue by geographical area:


	2023		2022		2021

Revenue(1):
U.S.	$	21,791.0	$	18,190.0	$	16,811.0
Europe	6,174.7		4,299.2		4,776.8
Japan	1,672.6		1,747.3		2,367.0
China	1,539.7		1,452.8		1,661.4
Other foreign countries	2,946.2		2,852.0		2,702.2
Revenue	$	34,124.1	$	28,541.4	$	28,318.4

Numbers may not add due to rounding.

(1) Revenue is attributed to the countries based on the location of the customer or other party.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Section 50
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-URI https://asc.fasb.org//1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
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-Section 50
-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Name Accounting Standards Codification
-Section 50
-Paragraph 12
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Name Accounting Standards Codification
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-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org//606/tableOfContent

+ Details

Revenue (Narrative) (Details)	12 Months Ended
Revenue (Narrative) (Details)	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Change in Accounting Estimate [Line Items]
Revenue, performance obligation, payment terms, days from date of shipment, minimum	30 days
Revenue, performance obligation, payment terms, days from date of shipment, maximum	70 days
Revenue, performance obligation, payment terms, financing component, period between transfer of control and payment receipt (or less)	1 year
Revenue, performance obligation, sales rebate payment period (up to)	6 months
Revenue, performance obligation, sales returns, product expiration date	24 months
Revenue, performance obligation, sales returns, average inventory level (or less)	1 month
Revenue, performance obligation, sales returns, percentage of net revenue (less than)	0.02	0.02	0.02
U.S. \| Sales returns, rebates, and discounts
Change in Accounting Estimate [Line Items]
Revenue, information used to determine revenue recognized, change in accounting estimate, percent (or less)	1.00%	1.00%	1.00%
Three Largest Wholesales \| Revenue Benchmark \| Minimum \| Customer Concentration Risk
Change in Accounting Estimate [Line Items]
Concentration risk, percentage	16.00%	16.00%	16.00%
Three Largest Wholesales \| Revenue Benchmark \| Maximum \| Customer Concentration Risk
Change in Accounting Estimate [Line Items]
Concentration risk, percentage	21.00%	21.00%	21.00%
Three Largest Wholesales \| Accounts Receivable \| Minimum \| Customer Concentration Risk
Change in Accounting Estimate [Line Items]
Concentration risk, percentage	18.00%	18.00%
Three Largest Wholesales \| Accounts Receivable \| Maximum \| Customer Concentration Risk
Change in Accounting Estimate [Line Items]
Concentration risk, percentage	29.00%	29.00%

Retirement Benefits (Narrative) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Defined Benefit Plan Disclosure [Line Items]
Defined benefit obligation, period decrease	$ 1,090.0	$ 4,750.0
Expense under the plans	$ 222.6	170.6	$ 167.3
Percentage of global investments in plan assets	85.00%
Defined Benefit Pension Plans
Defined Benefit Plan Disclosure [Line Items]
Total accumulated benefit obligation for our defined benefit pension plans	$ 12,740.0	$ 12,010.0
Expected future employer contributions, next fiscal year	$ 40.0
Marketable equity securities
Defined Benefit Plan Disclosure [Line Items]
Plan assets, target allocation	75.00%
Developed markets
Defined Benefit Plan Disclosure [Line Items]
Plan assets, target allocation	25.00%

Shareholders' Equity (Details) - USD ($) $ in Millions	12 Months Ended
Shareholders' Equity (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	May 31, 2021
Schedule of Equity [Line Items]
Purchase for treasury	$ 750.0	$ 1,500.0	$ 1,250.0
Preferred stock, shares authorized (in shares)	5,000,000
Shares issued (in shares)	0	0
Shares held in employee trust (in shares)	50,000,000	50,000,000
Employee benefit trust	$ 3,013.2	$ 3,013.2
May 2021 Share Repurchase Program
Schedule of Equity [Line Items]
Remaining authorized repurchase amount	$ 2,500.0
Stock repurchase program, authorized amount				$ 5,000.0

Revenue (Disaggregation of Revenue by Product) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Revenue	$ 34,124.1	$ 28,541.4	$ 28,318.4
U.S.
Disaggregation of Revenue [Line Items]
Revenue	21,791.0	18,190.0	16,811.0
Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	12,333.1	10,351.3	11,507.4
Diabetes and Obesity \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	14,780.8	9,911.1	8,719.3
Diabetes and Obesity \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	4,886.8	4,553.7	4,468.8
Trulicity® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	5,433.3	5,688.8	4,914.4
Trulicity® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	1,699.2	1,750.9	1,557.6
Mounjaro® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	4,834.2	366.6	0.0
Mounjaro® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	328.9	115.9	0.0
Jardiance
Disaggregation of Revenue [Line Items]
Revenue	2,744.7	2,066.0	1,490.8
Jardiance \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	1,600.4	1,194.5	807.3
Jardiance \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	1,144.2	871.5	683.5
Humalog® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	863.2	1,191.9	1,320.7
Humalog® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	800.2	868.7	1,132.3
Humulin® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	610.1	730.2	832.9
Humulin® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	242.0	289.2	389.6
Basaglar
Disaggregation of Revenue [Line Items]
Revenue	728.3	760.4	892.5
Basaglar \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	443.1	470.7	588.3
Basaglar \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	285.2	289.7	304.2
Baqsimi \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	645.7	110.4	96.4
Baqsimi \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	31.9	28.9	16.8
Zepbound® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	175.8	0.0	0.0
Zepbound® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	0.0	0.0	0.0
Other diabetes and obesity \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	175.0	158.0	159.3
Other diabetes and obesity \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	355.2	338.9	384.8
Oncology \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	3,797.0	3,218.1	3,028.8
Oncology \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	2,861.3	2,448.1	2,712.5
Verzenio® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	2,509.0	1,653.2	834.9
Verzenio® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	1,354.3	830.3	515.0
Cyramza® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	402.3	351.4	358.1
Cyramza® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	572.4	620.0	674.8
Erbitux® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	528.9	500.1	481.8
Erbitux® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	67.6	66.4	66.4
Tyvyt®
Disaggregation of Revenue [Line Items]
Revenue	393.4	293.3	418.1
Tyvyt® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	0.0	0.0	0.0
Tyvyt® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	393.4	293.3	418.1
Alimta® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	72.9	543.7	1,233.9
Alimta® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	144.6	384.0	827.5
Other oncology \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	283.9	169.7	120.1
Other oncology \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	329.0	254.1	210.7
Immunology \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	2,057.9	1,892.8	1,881.8
Immunology \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	1,739.6	1,451.8	1,479.0
Taltz® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	1,831.6	1,724.6	1,542.4
Taltz® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	928.0	757.4	670.4
Olumiant
Disaggregation of Revenue [Line Items]
Revenue	922.6	830.5	1,115.1
Olumiant \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	225.5	148.2	324.1
Olumiant \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	697.2	682.3	791.0
Other immunology \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	0.8	20.0	15.3
Other immunology \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	114.4	12.1	17.6
Neuroscience \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	696.0	612.4	614.8
Neuroscience \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	2,182.5	933.8	1,283.7
Zyprexa® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	79.4	30.4	39.6
Zyprexa® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	1,615.4	306.5	390.7
Emgality® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	482.2	462.8	434.5
Emgality® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	196.0	188.1	142.7
Other neuroscience \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	134.4	119.2	140.7
Other neuroscience \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	371.1	439.2	750.3
Other \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	459.3	2,555.7	2,566.4
Other \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	662.9	964.0	1,563.5
Forteo® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	335.5	367.3	441.6
Forteo® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	197.7	245.8	360.3
Cialis® \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	26.1	35.2	10.6
Cialis® \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	355.3	552.1	707.9
COVID-19 antibodies
Disaggregation of Revenue [Line Items]
Revenue		2,020.0	2,240.0
COVID-19 antibodies \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	0.0	2,008.9	1,978.0
COVID-19 antibodies \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	0.0	14.7	261.4
Other \| U.S.
Disaggregation of Revenue [Line Items]
Revenue	97.7	144.2	136.1
Other \| Outside U.S.
Disaggregation of Revenue [Line Items]
Revenue	$ 109.9	$ 151.3	$ 233.9

Borrowings (Schedule of Debt Maturities) (Details) $ in Millions	Dec. 31, 2023 USD ($)
Maturities on long-term debt
2024	$ 717.5
2025	778.1
2026	1,580.7
2027	765.8
2028	$ 476.4

Income Taxes (Schedule of Cash Payments of Income Taxes) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Cash payments of income taxes	$ 5,558.8	$ 2,672.9	$ 1,598.8

Goodwill and Other Intangibles (Narrative) (Details) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Finite-lived intangible assets:
Goodwill, impairment loss	$ 0	$ 0	$ 0
Remaining amortization period (in years)	12 years
Minimum
Finite-lived intangible assets:
Finite-lived intangible asset, useful life (in years)	1 year
Maximum
Finite-lived intangible assets:
Finite-lived intangible asset, useful life (in years)	20 years
Lebrikizumab
Finite-lived intangible assets:
Acquired IPR&D	$ 1,030,000,000.00

Retirement Benefits

12 Months Ended

Dec. 31, 2023

Retirement Benefits [Abstract]

Retirement Benefits

We use a measurement date of December 31 to determine the change in benefit obligation, change in plan assets, funded status, and amounts recognized in the consolidated balance sheets at December 31 for our defined benefit pension and retiree health benefit plans, which were as follows:


	Defined Benefit Pension Plans				Retiree Health Benefit Plans
	2023		2022		2023		2022
Change in benefit obligation:
Benefit obligation at beginning of year	$	13,222.0	$	17,565.0	$	1,258.8	$	1,663.8
Service cost	290.4		351.7		31.8		46.6
Interest cost	648.2		398.1		61.3		37.8
Actuarial (gain) loss	590.5		(4,158.9)		34.5		(395.9)
Benefits paid	(610.5)		(608.9)		(80.6)		(86.8)


Foreign currency exchange rate changes and other adjustments	117.3		(325.0)		4.5		(6.7)
Benefit obligation at end of year	14,257.9		13,222.0		1,310.3		1,258.8
Change in plan assets:
Fair value of plan assets at beginning of year	13,195.8		16,416.0		2,492.5		3,361.4
Actual return on plan assets	881.9		(2,388.1)		166.8		(796.0)
Employer contribution	120.6		118.1		1.7		13.9
Benefits paid	(610.5)		(608.9)		(80.6)		(86.8)
Foreign currency exchange rate changes and other adjustments	120.9		(341.3)		(0.1)		—
Fair value of plan assets at end of year	13,708.7		13,195.8		2,580.3		2,492.5

Funded status	(549.2)		(26.2)		1,270.0		1,233.7
Unrecognized net actuarial (gain) loss	3,357.9		2,687.2		109.6		54.5
Unrecognized prior service (benefit) cost	6.4		8.4		(9.5)		(62.2)
Net amount recognized	$	2,815.1	$	2,669.4	$	1,370.1	$	1,226.0


Amounts recognized in the consolidated balance sheet consisted of:
Other noncurrent assets	$	810.6	$	1,208.0	$	1,427.7	$	1,383.4
Other current liabilities	(70.4)		(70.4)		(8.3)		(8.4)
Accrued retirement benefits	(1,289.4)		(1,163.8)		(149.4)		(141.3)
Accumulated other comprehensive (income) loss before income taxes	3,364.3		2,695.6		100.1		(7.7)
Net amount recognized	$	2,815.1	$	2,669.4	$	1,370.1	$	1,226.0

The unrecognized net actuarial (gain) loss and unrecognized prior service (benefit) cost have not yet been recognized in net periodic pension costs and were included in accumulated other comprehensive loss at December 31, 2023 and 2022.

The $1.09 billion increase in benefit obligation in 2023 is primarily driven by decreases in the discount rates. The $4.75 billion decline in benefit obligation in 2022 is primarily driven by increases in the discount rates.

The following represents our weighted-average assumptions:


	Defined Benefit Pension Plans						Retiree Health Benefit Plans
	2023		2022		2021		2023		2022		2021
Weighted-average assumptions used to determine net periodic benefit costs:
Discount rate	5.1	%	2.8	%	2.4	%	5.2	%	3.0	%	2.6	%
Rate of compensation increase	4.3		3.5		3.3
Expected return on plan assets	8.1		8.1		6.8		7.3		7.3		5.0
Weighted-average assumptions used to determine benefit obligation as of December 31:
Discount rate	4.8	%	5.1	%	2.8	%	5.0	%	5.2	%	3.0	%
Rate of compensation increase	4.3		4.3		3.5

We annually evaluate the expected return on plan assets in our defined benefit pension and retiree health benefit plans. In evaluating the expected rate of return, we consider many factors, with a primary analysis of current and projected market conditions; asset returns and asset allocations; and the views of leading financial advisers and economists. We may also review our historical assumptions compared with actual results, as well as the assumptions and trend rates utilized by similar plans, where applicable.

Given the design of our retiree health benefit plans, healthcare-cost trend rates do not have a material impact on our financial condition or results of operations.

Expected benefit payments, which reflect expected future service, are as follows:


	2024		2025		2026		2027		2028		2029-2033
Defined benefit pension plans	$	661.2	$	671.4	$	695.0	$	722.5	$	746.5	$	4,160.7
Retiree health benefit plans	93.8		94.5		94.7		95.2		95.6		475.9

Amounts relating to defined benefit pension plans with projected benefit obligations in excess of plan assets were as follows at December 31:


	2023		2022
Projected benefit obligation	$	2,395.3	$	2,211.2
Fair value of plan assets	1,035.4		977.1

Amounts relating to defined benefit pension plans and retiree health benefit plans with accumulated benefit obligations in excess of plan assets were as follows at December 31:


	Defined Benefit Pension Plans				Retiree Health Benefit Plans
	2023		2022		2023		2022
Accumulated benefit obligation	$	1,659.5	$	1,721.7	$	157.7	$	149.8
Fair value of plan assets	564.3		652.7		—		—

The total accumulated benefit obligation for our defined benefit pension plans was $12.74 billion and $12.01 billion at December 31, 2023 and 2022, respectively.

Net periodic (benefit) cost included the following components:


	Defined Benefit Pension Plans						Retiree Health Benefit Plans
	2023		2022		2021		2023		2022		2021
Components of net periodic (benefit) cost:
Service cost	$	290.4	$	351.7	$	369.2	$	31.8	$	46.6	$	49.2
Interest cost	648.2		398.1		337.8		61.3		37.8		32.5
Expected return on plan assets	(1,055.0)		(947.6)		(949.3)		(182.1)		(152.1)		(146.2)
Amortization of prior service (benefit) cost	2.4		2.4		4.2		(52.9)		(54.8)		(59.6)
Recognized actuarial (gain) loss	122.0		342.4		487.7		(5.8)		0.9		3.2


Net periodic (benefit) cost	$	8.0	$	147.0	$	249.6	$	(147.7)	$	(121.6)	$	(120.9)

The following represents the amounts recognized in other comprehensive income (loss) for the years ended December 31, 2023, 2022, and 2021:


	Defined Benefit Pension Plans						Retiree Health Benefit Plans
	2023		2022		2021		2023		2022		2021
Actuarial gain (loss) arising during period	$	(763.9)	$	823.6	$	2,072.4	$	(49.8)	$	(552.2)	$	142.5


Amortization of prior service (benefit) cost included in net income	2.4		2.4		4.2		(52.9)		(54.8)		(59.6)
Amortization of net actuarial (gain) loss included in net income	122.0		342.4		487.7		(5.8)		0.9		3.2
Foreign currency exchange rate changes and other	(29.2)		55.5		47.2		0.7		(0.9)		1.9
Total other comprehensive income (loss) during period	$	(668.7)	$	1,223.9	$	2,611.5	$	(107.8)	$	(607.0)	$	88.0

We have defined contribution savings plans that cover our eligible employees worldwide. The purpose of these plans is generally to provide additional financial security during retirement by providing employees with an incentive to save. Our contributions to the plans are based on employee contributions and the level of our match. Expenses under the plans totaled $222.6 million, $170.6 million, and $167.3 million for the years ended December 31, 2023, 2022, and 2021, respectively.

We provide certain other postemployment benefits primarily related to disability benefits and accrue for the related cost over the service lives of employees. Expenses associated with these benefit plans for the years ended December 31, 2023, 2022, and 2021 were not material.

Benefit Plan Investments

Our benefit plan investment policies are set with specific consideration of return and risk requirements in relationship to the respective liabilities. U.S. and Puerto Rico plans represent approximately 85 percent of our global investments. Given the long-term nature of our liabilities, these plans have the flexibility to manage an above-average degree of risk in the asset portfolios. At the investment-policy level, there are no specifically prohibited investments. However, within individual investment manager mandates, restrictions and limitations are contractually set to align with our investment objectives, ensure risk control, and limit concentrations.

We manage our portfolio to minimize concentration of risk by allocating funds within asset categories. In addition, within a category we use different managers with various management objectives to eliminate any significant concentration of risk.

Our global benefit plans may enter into contractual arrangements (derivatives) to implement the local investment policy or manage particular portfolio risks. Derivatives are principally used to increase or decrease exposure to a particular public equity, fixed income, commodity, or currency market more rapidly or less expensively than could be accomplished through the use of the cash markets. The plans utilize both exchange-traded and over-the-counter instruments. The maximum exposure to either a market or counterparty credit loss is limited to the carrying value of the receivable, and is managed within contractual limits. We expect all of our counterparties to meet their obligations. The gross values of these derivative receivables and payables are not material to the global asset portfolio, and their values are reflected within the tables below.

The defined benefit pension and retiree health benefit plan allocation for the U.S. and Puerto Rico currently comprises approximately 75 percent growth investments and 25 percent fixed-income investments. The growth investment allocation encompasses U.S. and international public equity securities, hedge funds, private equity-like investments, and real estate. These portfolio allocations are intended to reduce overall risk by providing diversification, while seeking moderate to high returns over the long term.

Public equity securities are well diversified and invested in U.S. and international small-to-large companies across various asset managers and styles. The remaining portion of the growth portfolio is invested in private alternative investments.

Fixed-income investments primarily consist of fixed-income securities in U.S. treasuries and agencies, emerging market debt obligations, corporate bonds, bank loans, mortgage-backed securities, commercial mortgage-backed obligations, and any related repurchase agreements.

Hedge funds are privately owned institutional investment funds that generally have moderate liquidity. Hedge funds seek specified levels of absolute return regardless of overall market conditions, and generally have low correlations to public equity and debt markets. Hedge funds often invest substantially in financial market instruments (stocks, bonds, commodities, currencies, derivatives, etc.) using a very broad range of trading activities to manage portfolio risks. Hedge fund strategies focus primarily on security selection and seek to be neutral with respect to market moves. Common groupings of hedge fund strategies include relative value, tactical, and event driven. Relative value strategies include arbitrage, when the same asset can simultaneously be bought and sold at different prices, achieving an immediate profit. Tactical strategies often take long and short positions to reduce or eliminate overall market risks while seeking a particular investment opportunity. Event strategy opportunities can evolve from specific company announcements such as mergers and acquisitions, and typically have little correlation to overall market directional movements. Our hedge fund investments are made through limited partnership interests in fund-of-funds structures and directly into hedge funds. Plan holdings in hedge funds are valued based on net asset values (NAVs) calculated by each fund or general partner, as applicable, and we have the ability to redeem these investments at NAV.

Private equity-like investment funds typically have low liquidity and are made through long-term partnerships or joint ventures that invest in pools of capital invested in primarily non-publicly traded entities. Underlying investments include venture capital (early stage investing), buyout, special situations, private debt, and private real estate investments. Private equity management firms typically acquire and then reorganize private companies to create increased long term value. Private equity-like funds usually have a limited life of approximately 10-15 years, and require a minimum investment commitment from their limited partners. Our private equity-like investments are made both directly into funds and through fund-of-funds structures to ensure broad diversification of management styles and assets across the portfolio. Plan holdings in private equity-like investments are valued using the value reported by the partnership, adjusted for known cash flows and significant events through our reporting date. Values provided by the partnerships are primarily based on analysis of and judgments about the underlying investments. Inputs to these valuations include underlying NAVs, discounted cash flow valuations, comparable market valuations, and may also include adjustments for currency, credit, liquidity and other risks as applicable. The vast majority of these private partnerships provide us with annual audited financial statements including their compliance with fair valuation procedures consistent with applicable accounting standards.

Real estate is composed of public holdings. Real estate investments in registered investment companies that trade on an exchange are classified as Level 1 on the fair value hierarchy. Real estate investments in funds measured at fair value on the basis of NAV provided by the fund manager are classified as such. These NAVs are developed with inputs including discounted cash flow, independent appraisal, and market comparable analyses.

Other assets include cash and cash equivalents and mark-to-market value of derivatives.

The cash value of the trust-owned insurance contract is primarily invested in investment-grade publicly traded equity and fixed-income securities.

Other than hedge funds, private equity-like investments, and a portion of the real estate holdings, which are discussed above, we determine fair values based on a market approach using quoted market values, significant other observable inputs for identical or comparable assets or liabilities, or discounted cash flow analyses.

The fair values of our defined benefit pension plan and retiree health plan assets as of December 31, 2023 by asset category were as follows:


			Fair Value Measurements Using
Asset Class	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Investments Valued at Net Asset Value(1)
Defined Benefit Pension Plans
Public equity securities:
U.S.	$	1,379.7	$	490.5	$	0.3	$	—	$	888.9
International	1,408.9		441.2		333.4		—		634.3
Fixed income:
Developed markets	2,783.9		21.2		2,597.3		0.1		165.3
Developed markets - repurchase agreements	(772.8)		13.2		(786.0)		—		—
Emerging markets	295.6		10.4		35.7		—		249.5
Private alternative investments:
Hedge funds	3,125.9		—		—		—		3,125.9
Equity-like funds	4,093.7		—		—		25.1		4,068.6
Real estate	369.7		261.9		—		—		107.8
Other	1,024.1		170.8		42.6		—		810.7
Total	$	13,708.7	$	1,409.2	$	2,223.3	$	25.2	$	10,051.0

Retiree Health Benefit Plans
Public equity securities:
U.S.	$	127.0	$	44.2	$	—	$	—	$	82.8
International	89.9		38.2		—		—		51.7
Fixed income:
Developed markets	74.9		—		74.9		—		—
Emerging markets	23.4		—		—		—		23.4
Private alternative investments:
Hedge funds	281.2		—		—		—		281.2
Equity-like funds	335.1		—		—		2.4		332.7
Cash value of trust owned insurance contract	1,526.5		—		1,526.5		—		—
Real estate	24.5		24.5		—		—		—
Other	97.8		23.2		2.1		—		72.5
Total	$	2,580.3	$	130.1	$	1,603.5	$	2.4	$	844.3

(1) Certain investments that are measured at fair value using the NAV per share (or its equivalent) as a practical expedient have not been classified in the fair value hierarchy.

No material transfers between Level 1, Level 2, or Level 3 occurred during the year ended December 31, 2023. The activity in the Level 3 investments during the year ended December 31, 2023 was not material.

The fair values of our defined benefit pension plan and retiree health plan assets as of December 31, 2022 by asset category were as follows:


			Fair Value Measurements Using
Asset Class	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Investments Valued at Net Asset Value(1)
Defined Benefit Pension Plans
Public equity securities:
U.S.	$	1,132.4	$	396.6	$	0.1	$	—	$	735.7
International	1,177.1		369.4		300.9		—		506.8
Fixed income:
Developed markets	2,445.5		19.8		2,058.2		0.1		367.4
Developed markets - repurchase agreements	(706.6)		6.4		(713.0)		—		—
Emerging markets	273.5		10.6		32.0		—		230.9
Private alternative investments:
Hedge funds	3,249.0		—		—		—		3,249.0
Equity-like funds	4,014.1		—		—		25.4		3,988.7
Real estate	349.1		234.9		—		—		114.2
Other	1,261.7		251.0		(131.8)		—		1,142.5
Total	$	13,195.8	$	1,288.7	$	1,546.4	$	25.5	$	10,335.2

Retiree Health Benefit Plans
Public equity securities:
U.S.	$	104.2	$	35.7	$	—	$	—	$	68.5
International	72.0		31.9		—		—		40.1
Fixed income:
Developed markets	63.1		—		63.1		—		—
Emerging markets	21.0		—		—		—		21.0
Private alternative investments:
Hedge funds	294.9		—		—		—		294.9
Equity-like funds	332.8		—		—		2.4		330.4
Cash value of trust owned insurance contract	1,470.8		—		1,470.8		—		—
Real estate	21.6		21.6		—		—		—
Other	112.1		24.2		(19.9)		—		107.8
Total	$	2,492.5	$	113.4	$	1,514.0	$	2.4	$	862.7

(1) Certain investments that are measured at fair value using the NAV per share (or its equivalent) as a practical expedient have not been classified in the fair value hierarchy.

No material transfers between Level 1, Level 2, or Level 3 occurred during the year ended December 31, 2022. The activity in the Level 3 investments during the year ended December 31, 2022 was not material.

In 2024, we expect to contribute approximately $40 million to our defined benefit pension plans to satisfy minimum funding requirements for the year. We do not currently expect to make material discretionary contributions in 2024.

- Definition

The entire disclosure for retirement benefits.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 70
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480794/715-70-50-1

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 17
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480482/715-20-55-17

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(iv)(03)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (q)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480506/715-20-50-1

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (l)
-Publisher FASB
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+ Details

Financial Instruments (Narrative) (Details) € in Millions, ¥ in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Dec. 31, 2023 EUR (€)	Dec. 31, 2023 CNY (¥)
Derivative [Line Items]
Net investment gains (loss) on equity securities	$ (20.2)	$ (410.7)	$ 176.9
Unfunded commitments to invest in venture capital funds	$ 930.0
Unfunded commitments to invest in venture capital funds, anticipated payment period	10 years
Percentage of nonperforming assets	99.00%
Accounts receivable derecognized	$ 431.9	422.1
Average remaining maturity of foreign currency derivatives	12 months
Maximum remaining maturity of foreign currency derivatives	180 days
Long-term debt	$ 19,104.6	14,815.3
Foreign currency-denominated notes, designated as hedge	$ 5,670.0	5,450.0
Variable rate	12.00%			12.00%	12.00%
Losses expected to be reclassified in the next 12 months	$ 13.0
Swap U.S Dollars To Euro
Derivative [Line Items]
Derivative liability, notional amount	728.6
Swap Swiss Francs to USD
Derivative [Line Items]
Derivative liability, notional amount	1,000.0
Sell Euro
Derivative [Line Items]
Derivative asset, notional amount \| €				€ 3,200
Sell Chinese Yuan
Derivative [Line Items]
Derivative asset, notional amount \| ¥					¥ 1,800
Forward-starting interest rate swaps \| Cash flow hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Derivative, notional amount	1,100.0
Foreign Currency Denominated Debt
Derivative [Line Items]
Long-term debt	$ 7,140.0	$ 6,830.0

Income Taxes (Narrative) (Details) - USD ($) $ in Millions	12 Months Ended
Income Taxes (Narrative) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating Loss Carryforwards [Line Items]
Prepaid taxes	$ 4,260.0	$ 2,370.0
Domestic and Puerto Rican companies contribution	14.00%	33.00%	28.00%
Long-term income taxes payable, estimated timing of future cash outflows not possible	$ 3,060.0
Unrecognized tax benefits that would impact effective tax rate	1,770.0	$ 1,700.0
Accruals for the payment of interest and penalties	414.9	$ 271.5
Carryforward
Operating Loss Carryforwards [Line Items]
Tax credit carryforward	1,000.0
Operating loss carryforwards	1,350.0
Expiration By 2026
Operating Loss Carryforwards [Line Items]
Tax credit carryforward	148.8
Expiration Between 2028 and 2042
Operating Loss Carryforwards [Line Items]
Tax credit carryforward	60.8
Operating loss carryforwards	35.0
Designated Unusable \| Internal Revenue Service (IRS)
Operating Loss Carryforwards [Line Items]
Tax credit carryforward	55.3
Designated Unusable \| Foreign Tax Authority
Operating Loss Carryforwards [Line Items]
Tax credit carryforward	109.9
Designated Unusable \| State and Local Jurisdiction
Operating Loss Carryforwards [Line Items]
Tax credit carryforward	629.3
Deferred tax assets related to state net operating losses	261.9
Expiration By 2027
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards	284.6
No Expiration
Operating Loss Carryforwards [Line Items]
Operating loss carryforwards	$ 1,030.0

Acquisitions (Asset Acquisitions) (Details) - USD ($) $ in Millions	1 Months Ended							12 Months Ended
	Dec. 31, 2023	Oct. 31, 2023	Aug. 31, 2023	Feb. 28, 2022	Dec. 31, 2021	Mar. 31, 2021	Jan. 31, 2021	Dec. 31, 2022
Business Acquisition [Line Items]
Acquired IPR&D Expense								$ 333.8
Mablink Biosciences SAS
Business Acquisition [Line Items]
Acquired IPR&D Expense	$ 256.6
Beam Therapeutics Inc.
Business Acquisition [Line Items]
Acquired IPR&D Expense		$ 216.3
DICE Therapeutics, Inc. (DICE)
Business Acquisition [Line Items]
Acquired IPR&D Expense			$ 1,915.5
Versanis Bio, Inc. (Versanis)
Business Acquisition [Line Items]
Acquired IPR&D Expense			604.1
Emergence Therapeutics AG
Business Acquisition [Line Items]
Acquired IPR&D Expense			$ 406.5
BioMarin Pharmaceutical Inc.
Business Acquisition [Line Items]
Acquired IPR&D Expense				$ 110.0
Foghorn Therapeutics Inc.
Business Acquisition [Line Items]
Acquired IPR&D Expense					$ 316.6
Rigel Pharmaceuticals, Inc.
Business Acquisition [Line Items]
Acquired IPR&D Expense						$ 125.0
Precision Biosciences, Inc.
Business Acquisition [Line Items]
Acquired IPR&D Expense							$ 107.8

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2023
Audit Information [Abstract]
Auditor Name	Ernst & Young LLP
Auditor Firm ID	42
Auditor Location	Indianapolis, Indiana

Financial Instruments (Unrealized Gains and Losses) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Unrealized gross gains	$ 3.4	$ 0.6
Unrealized gross losses	37.9	49.2
Fair value of securities in an unrealized gain position	159.2	46.8
Fair value of securities in an unrealized loss position	$ 452.0	$ 568.7

Borrowings (Tables)

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Schedule of Debt

Debt at December 31 consisted of the following:


	2023		2022
Short-term commercial paper borrowings	$	6,189.4	$	1,498.0
Long-term notes	19,104.6		14,815.3
Other long-term debt	6.5		6.9
Unamortized debt issuance costs	(90.5)		(77.2)
Fair value adjustment on hedged long-term notes	15.3		(4.4)
Total debt	25,225.3		16,238.6
Less current portion	(6,904.5)		(1,501.1)
Long-term debt	$	18,320.8	$	14,737.5

Summary of Long-term Notes

The following table summarizes long-term notes at December 31:


	2023		2022



0.15% Swiss franc denominated notes due 2024	$	714.6	$	649.5
7.125% notes due 2025	217.5		217.5
2.75% notes due 2025	560.6		560.6
5.0% notes due 2026	750.0		—
1.625% euro denominated notes due 2026	830.7		799.3
5.5% notes due 2027	364.3		364.3
3.1% notes due 2027	401.5		401.5
0.45% Swiss franc denominated notes due 2028	476.4		433.0
3.375% notes due 2029	930.6		930.6
0.42% Japanese yen denominated notes due 2029	162.5		172.1
2.125% euro denominated notes due 2030	830.7		799.3
0.625% euro denominated notes due 2031	664.6		639.4
4.7% notes due 2033	1,000.0		—
0.50% euro denominated notes due 2033	664.6		639.4
0.56% Japanese yen denominated notes due 2034	65.8		69.7
6.77% notes due 2036	158.6		158.6
5.55% notes due 2037	444.7		444.7
5.95% notes due 2037	266.8		266.8
3.875% notes due 2039	240.3		240.3
1.625% British pound denominated notes due 2043	318.5		301.2
4.65% notes due 2044	38.3		38.3
3.7% notes due 2045	386.8		386.8
3.95% notes due 2047	347.0		347.0
3.95% notes due 2049	958.2		958.2
1.70% euro denominated notes due 2049	1,107.6		1,065.7
0.97% Japanese yen denominated notes due 2049	54.2		57.4
2.25% notes due 2050	1,250.0		1,250.0

1.125% euro denominated notes due 2051	553.8		532.9
4.875% notes due 2053	1,250.0		—
4.15% notes due 2059	591.3		591.3
2.50% notes due 2060	850.0		850.0
1.375% euro denominated notes due 2061	775.3		746.0
4.95% notes due 2063	1,000.0		—
Unamortized note discounts	(121.2)		(96.1)
Total long-term notes	$	19,104.6	$	14,815.3

Schedule of Maturities of Long-term Debt

The aggregate amounts of maturities on long-term debt for the next five years are as follows:


	2024		2025		2026		2027		2028
Maturities on long-term debt	$	717.5	$	778.1	$	1,580.7	$	765.8	$	476.4

Schedule of Additional Borrowings Disclosures

The aggregate amount of cash payments for interest on borrowings, net of capitalized interest, are as follows:


	2023		2022		2021
Cash payments for interest on borrowings	$	404.2	$	323.7	$	338.0

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
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-Paragraph 69B
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-URI https://asc.fasb.org//1943274/2147481568/470-20-55-69B

Reference 2: http://www.xbrl.org/2003/role/exampleRef
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-URI https://asc.fasb.org//1943274/2147481568/470-20-55-69E

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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+ Details

Borrowings (Narrative) (Details) € in Millions, £ in Millions	1 Months Ended			12 Months Ended
	Feb. 29, 2024 USD ($)	Feb. 28, 2023 USD ($)	Sep. 30, 2021 USD ($)	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)	Feb. 27, 2024 USD ($)	Sep. 30, 2021 EUR (€)	Sep. 30, 2021 GBP (£)
Debt Instrument [Line Items]
Weighted average interest rate				539.00%	420.00%
Line of credit facility, remaining borrowing capacity				$ 7,420,000,000
Debt extinguishment loss (Note 11)				$ 0	$ 0	$ 405,200,000
Description of derivative activity volume percent				12.00%
Debt instrument, interest rate, effective percentage				3.37%	2.87%
Senior Notes \| 4.5% Notes Due 2027 \| Subsequent Event
Debt Instrument [Line Items]
Debt instrument, face amount	$ 1,000,000,000
Stated interest rate	4.50%
Senior Notes \| 4.5% Notes Due 2029 \| Subsequent Event
Debt Instrument [Line Items]
Debt instrument, face amount	$ 1,000,000,000
Stated interest rate	4.50%
Senior Notes \| 4.7% Notes Due 2034 \| Subsequent Event
Debt Instrument [Line Items]
Debt instrument, face amount	$ 1,500,000,000
Stated interest rate	4.70%
Senior Notes \| 5.0% Notes Due 2054 \| Subsequent Event
Debt Instrument [Line Items]
Debt instrument, face amount	$ 1,500,000,000
Stated interest rate	5.00%
Senior Notes \| 5.1% Notes Due 2064 \| Subsequent Event
Debt Instrument [Line Items]
Debt instrument, face amount	$ 1,500,000,000
Stated interest rate	5.10%
Senior Notes \| Senior Notes Due 2027, 2029, 2054 And 2064 \| Subsequent Event
Debt Instrument [Line Items]
Proceeds from issuance of debt	$ 6,450,000,000
Senior Notes \| 5.0% notes due 2026
Debt Instrument [Line Items]
Debt instrument, face amount		$ 750,000,000
Stated interest rate		5.00%		5.00%
Senior Notes \| 5.0% notes due 2026 \| Subsequent Event
Debt Instrument [Line Items]
Debt instrument, face amount							$ 750,000,000
Stated interest rate							5.00%
Senior Notes \| 4.7% notes due 2033
Debt Instrument [Line Items]
Debt instrument, face amount		$ 1,000,000,000
Stated interest rate		4.70%		4.70%
Senior Notes \| 4.875% notes due 2053
Debt Instrument [Line Items]
Debt instrument, face amount		$ 1,250,000,000
Stated interest rate		4.875%		4.875%
Senior Notes \| 4.95% notes due 2063
Debt Instrument [Line Items]
Debt instrument, face amount		$ 1,000,000,000
Stated interest rate		4.95%		4.95%
Senior Notes \| Senior Notes Due 2026, 2033, 2053 And 2063
Debt Instrument [Line Items]
Proceeds from issuance of debt		$ 3,960,000,000
Foreign Currency Denominated Debt
Debt Instrument [Line Items]
Debt instrument, face amount								€ 1,800	£ 250.0
Payment for debt extinguishment			$ 1,910,000,000
Extinguishment of debt, amount			1,500,000,000
Debt extinguishment loss (Note 11)			$ 405,200,000
Maturity Date 2024
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity				$ 4,000,000,000
Debt instrument, term				364 days
Maturity Date 2027
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity				$ 3,000,000,000

Collaborations and Other Arrangements (Narrative) (Details) - USD ($) $ in Millions	1 Months Ended		12 Months Ended
	Jul. 31, 2023	Jun. 30, 2023	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Revenue			$ 34,124.1	$ 28,541.4	$ 28,318.4
Proceeds from sale of product rights			1,604.3	95.8	216.0
Disposal Group, Disposed of by Sale, Not Discontinued Operations \| Olanzapine Portfolio
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Proceeds from sale of product rights	$ 1,050.0
Consideration received	$ 305.0
Milestone payment received			25.0
Revenue recognized			1,450.0
Disposal Group, Disposed of by Sale, Not Discontinued Operations \| Olanzapine Portfolio \| Maximum
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Milestone payment received			50.0
Disposal Group, Disposed of by Sale, Not Discontinued Operations \| Baqsimi
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Proceeds from sale of product rights		$ 500.0
Consideration received		$ 125.0
Milestone payment received			450.0
Revenue recognized			579.0
Olumiant
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Revenue			$ 922.6	830.5	1,115.1
Olumiant \| Royalty Payments Received
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Collaborative arrangement, rights and obligations percent (up to)			20.00%
Olumiant \| Milestone Payments, Development and Regulatory
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Potential achievements			$ 100.0
Ebglyss \| Milestone Payments, Development and Regulatory \| Roche
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Potential achievements			115.0
Ebglyss \| Milestone Payments, Sales-based
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Potential achievements			1,250.0
Ebglyss \| Milestone Payments, Sales-based \| Roche
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Potential achievements			1,030.0
Orforglipron \| Milestone Payments, Development and Regulatory \| Chugai
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Potential achievements			140.0
Orforglipron \| Milestone Payments, Sales-based \| Chugai
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Potential achievements			$ 250.0
COVID-19 Antibodies
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Revenue				$ 2,020.0	$ 2,240.0

Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2023

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Summary of the Contractual Maturities of Our Investments in Debt Securities Measured at Fair Value

The table below summarizes the contractual maturities of our investments in debt securities measured at fair value as of December 31, 2023:


	Maturities by Period
	Total		Less Than 1 Year		1-5 Years		6-10 Years		More Than 10 Years
Fair value of debt securities	$	657.2	$	84.1	$	227.9	$	98.4	$	246.8

Summary of the Fair Value of Available-for-Sale Securities in an Unrealized Gain or Loss Position

A summary of the amount of unrealized gains and losses in accumulated other comprehensive loss and the fair value of available-for-sale securities in an unrealized gain or loss position follows:


	2023		2022
Unrealized gross gains	$	3.4	$	0.6
Unrealized gross losses	37.9		49.2
Fair value of securities in an unrealized gain position	159.2		46.8
Fair value of securities in an unrealized loss position	452.0		568.7

Schedule of Activity Related to Our Available-for-Sale Securities

Activity related to our available-for-sale securities was as follows:


	2023		2022		2021
Proceeds from sales	$	145.6	$	132.9	$	174.7
Realized gross gains on sales	0.7		0.4		2.8
Realized gross losses on sales	4.0		9.7		1.7

Schedule of Fair Value Information, Assets

The following table summarizes certain fair value information at December 31, 2023 and 2022 for investment assets measured at fair value on a recurring basis, as well as the carrying amount and amortized cost of certain other investments:


					Fair Value Measurements Using
	Carrying Amount		Cost (1)		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value
December 31, 2023
Cash equivalents(2)	$	1,088.4	$	1,088.4	$	1,079.3	$	9.1	$	—	$	1,088.4
Short-term investments:
U.S. government and agency securities	$	32.1	$	32.3	$	32.1	$	—	$	—	$	32.1
Corporate debt securities	52.0		52.1		—		52.0		—		52.0


Other securities	25.0		25.0		—		13.6		11.4		25.0

Short-term investments	$	109.1
Noncurrent investments:
U.S. government and agency securities	$	148.1	$	161.0	$	148.1	$	—	$	—	$	148.1
Corporate debt securities	214.3		226.6		—		214.3		—		214.3
Mortgage-backed securities	157.3		167.1		—		157.3		—		157.3
Asset-backed securities	53.5		54.4		—		53.5		—		53.5
Other securities	197.4		100.2		—		23.5		173.9		197.4
Marketable equity securities	711.3		493.2		711.3		—		—		711.3
Equity investments without readily determinable fair values(3)	608.0
Equity method investments(3)	962.3
Noncurrent investments	$	3,052.2

December 31, 2022
Cash equivalents(2)	$	657.4	$	657.4	$	650.4	$	7.0	$	—	$	657.4
Short-term investments:
U.S. government and agency securities	$	30.8	$	31.1	$	30.8	$	—	$	—	$	30.8
Corporate debt securities	53.4		53.5		—		53.4		—		53.4

Asset-backed securities	2.0		2.0		—		2.0		—		2.0
Other securities	58.6		58.6		—		39.1		19.5		58.6

Short-term investments	$	144.8
Noncurrent investments:
U.S. government and agency securities	$	146.4	$	163.2	$	146.4	$	—	$	—	$	146.4
Corporate debt securities	213.9		235.8		—		213.9		—		213.9
Mortgage-backed securities	149.2		161.5		—		149.2		—		149.2
Asset-backed securities	50.6		52.5		—		50.6		—		50.6
Other securities	398.6		34.5		—		311.0		87.6		398.6
Marketable equity securities	683.6		484.7		683.6		—		—		683.6
Equity investments without readily determinable fair values(3)	478.4
Equity method investments(3)	781.1
Noncurrent investments	$	2,901.8

(1) For available-for-sale debt securities, amounts disclosed represent the securities' amortized cost.

(2) We consider all highly liquid investments with a maturity of three months or less from the date of purchase to be cash equivalents. The cost of these investments approximates fair value.

(3) Fair value disclosures are not applicable for equity method investments and investments accounted for under the measurement alternative for equity investments.

Summary of Fair Value Information, Liabilities

The following table summarizes certain fair value information at December 31, 2023 and 2022 for our short-term and long-term debt:


			Fair Value Measurements Using
	Carrying Amount		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value
Short-term commercial paper borrowings
December 31, 2023	$	(6,189.4)	$	—	$	(6,166.4)	$	—	$	(6,166.4)
December 31, 2022	(1,498.0)		—		(1,492.0)		—		(1,492.0)
Long-term debt, including current portion
December 31, 2023	$	(19,035.9)	$	—	$	(17,221.7)	$	—	$	(17,221.7)
December 31, 2022	(14,740.6)		—		(12,329.3)		—		(12,329.3)

Schedule of Derivative Instruments

At December 31, 2023, we had outstanding foreign currency forward commitments as follows, all of which have settlement dates within 180 days:

December 31, 2023

Purchase

Sell

Currency

Amount
(in millions)

Currency

Amount
(in millions)

U.S. dollars

4,779.4

Euro

4,352.2

Euro

3,940.4

U.S. dollars

4,250.9

British pounds

237.7

U.S. dollars

299.2

U.S. dollars

165.3

Chinese yuan

1,172.7

Schedule of Effects of Risk-Management Instruments Were Recognized in Other–Net, (Income) Expense

The following effects of risk-management instruments were recognized in other–net, (income) expense:


	2023		2022		2021
Fair value hedges:
Effect from hedged fixed-rate debt	$	31.5	$	(209.8)	$	(78.5)
Effect from interest rate contracts	(31.5)		209.8		78.5
Cash flow hedges:
Effective portion of losses on interest rate contracts reclassified from accumulated other comprehensive loss	13.5		16.5		16.6
Cross-currency interest rate swaps	(108.6)		8.6		41.8
Net losses on foreign currency exchange contracts not designated as hedging instruments	26.4		191.3		204.6
Total	$	(68.7)	$	216.4	$	263.0

Schedule of Effective Portion of Risk-Management Instruments that was Recognized in Other Comprehensive Income (Loss), Net Investment Hedges

The effective portion of risk-management instruments that was recognized in other comprehensive income (loss) is as follows:


	2023		2022		2021
Net investment hedges:
Foreign currency-denominated notes	$	(219.9)	$	324.9	$	435.0
Cross-currency interest rate swaps	(27.4)		52.0		213.7
Foreign currency forward contracts	(107.1)		(15.4)		—
Cash flow hedges:
Forward-starting interest rate swaps	85.6		391.5		97.6
Cross-currency interest rate swaps	15.2		29.8		42.3

Schedule of Effective Portion of Risk-Management Instruments that was Recognized in Other Comprehensive Income (Loss), Cash Flow Hedges

The effective portion of risk-management instruments that was recognized in other comprehensive income (loss) is as follows:


	2023		2022		2021
Net investment hedges:
Foreign currency-denominated notes	$	(219.9)	$	324.9	$	435.0
Cross-currency interest rate swaps	(27.4)		52.0		213.7
Foreign currency forward contracts	(107.1)		(15.4)		—
Cash flow hedges:
Forward-starting interest rate swaps	85.6		391.5		97.6
Cross-currency interest rate swaps	15.2		29.8		42.3

Schedule of Fair Value, by Balance Sheet Grouping

The following table summarizes certain fair value information at December 31, 2023 and 2022 for risk-management assets and liabilities measured at fair value on a recurring basis:


			Fair Value Measurements Using
	Carrying Amount		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value
December 31, 2023
Risk-management instruments
Interest rate contracts designated as fair value hedges:


Other current liabilities	$	(2.4)	$	—	$	(2.4)	$	—	$	(2.4)
Other noncurrent liabilities	(100.3)		—		(100.3)		—		(100.3)
Interest rate contracts designated as cash flow hedges:

Other noncurrent assets	291.2		—		291.2		—		291.2

Cross-currency interest rate contracts designated as net investment hedges:


Other current liabilities	(28.4)		—		(28.4)		—		(28.4)
Other noncurrent liabilities	(3.5)		—		(3.5)		—		(3.5)
Cross-currency interest rate contracts designated as cash flow hedges:
Other receivables	113.8		—		113.8		—		113.8

Other noncurrent assets	63.1		—		63.1		—		63.1

Foreign exchange contracts designated as hedging instruments:
Other current liabilities	(115.8)		—		(115.8)		—		(115.8)
Foreign exchange contracts not designated as hedging instruments:
Other receivables	129.6		—		129.6		—		129.6
Other current liabilities	(55.9)		—		(55.9)		—		(55.9)
Contingent consideration liabilities:
Other current liabilities	(39.5)		—		—		(39.5)		(39.5)
Other noncurrent liabilities	(64.4)		—		—		(64.4)		(64.4)


			Fair Value Measurements Using
	Carrying Amount		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value
December 31, 2022
Risk-management instruments
Interest rate contracts designated as fair value hedges:



Other noncurrent liabilities	$	(134.3)	$	—	$	(134.3)	$	—	$	(134.3)
Interest rate contracts designated as cash flow hedges:
Other receivables	162.9		—		162.9		—		162.9
Other noncurrent assets	246.0		—		246.0		—		246.0
Cross-currency interest rate contracts designated as net investment hedges:

Other receivables	67.6		—		67.6		—		67.6


Cross-currency interest rate contracts designated as cash flow hedges:
Other noncurrent assets	53.1		—		53.1		—		53.1

Foreign exchanges contracts designated as hedging instruments:
Other current liabilities	(38.3)		—		(38.3)		—		(38.3)
Foreign exchange contracts not designated as hedging instruments:
Other receivables	26.6		—		26.6		—		26.6
Other current liabilities	(21.5)		—		(21.5)		—		(21.5)
Contingent consideration liabilities:
Other current liabilities	(39.5)		—		—		(39.5)		(39.5)
Other noncurrent liabilities	(70.6)		—		—		(70.6)		(70.6)

Revenue (Schedule of Amounts Recorded for Contract Liabilities) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Contract liabilities	$ 193.6	$ 219.2

Consolidated Statements of Shareholders' Equity - USD ($) shares in Thousands, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Retained Earnings	Employee Benefit Trust	Accumulated Other Comprehensive Loss	Common Stock in Treasury	Noncontrolling Interest
Beginning balance (in shares) at Dec. 31, 2020		957,077
Beginning balance (in shares) at Dec. 31, 2020							487
Beginning balance at Dec. 31, 2020		$ 598.2	$ 6,778.5	$ 7,830.2	$ (3,013.2)	$ (6,496.4)	$ (55.7)	$ 183.6
Increase (Decrease) in Shareholders' Equity [Roll Forward]
Net income				5,581.7				3.4
Other comprehensive income (loss), net of tax	$ 2,153.3					2,153.3
Cash dividends declared				(3,201.7)
Retirement of treasury shares (in shares)		(5,412)					(5,412)
Retirement of treasury shares		$ (3.4)		(1,246.6)			$ 1,250.0
Purchase of treasury shares (in shares)							5,412
Purchase of treasury shares	(1,250.0)						$ (1,250.0)
Issuance of stock under employee stock plans, net (in shares)		2,451					(24)
Issuance of stock under employee stock plans, net		$ 1.5	(287.9)				$ 3.0
Stock-based compensation			342.8
Other				(5.1)				(11.4)
Ending balance (in shares) at Dec. 31, 2021		954,116
Ending balance (in shares) at Dec. 31, 2021							463
Ending balance at Dec. 31, 2021		$ 596.3	6,833.4	8,958.5	(3,013.2)	(4,343.1)	$ (52.7)	175.6
Increase (Decrease) in Shareholders' Equity [Roll Forward]
Net income				6,244.8				(20.9)
Other comprehensive income (loss), net of tax	498.5					498.5
Cash dividends declared				(3,667.5)
Retirement of treasury shares (in shares)		(5,607)					(5,607)
Retirement of treasury shares		$ (3.5)		(1,496.5)			$ 1,500.0
Purchase of treasury shares (in shares)							5,607
Purchase of treasury shares	$ (1,500.0)						$ (1,500.0)
Issuance of stock under employee stock plans, net (in shares)		2,123					(13)
Issuance of stock under employee stock plans, net		$ 1.3	(283.1)				$ 2.2
Stock-based compensation			371.1
Other				3.3				(29.1)
Ending balance (in shares) at Dec. 31, 2022	950,632	950,632
Ending balance (in shares) at Dec. 31, 2022							450
Ending balance at Dec. 31, 2022	$ 10,775.4	$ 594.1	6,921.4	10,042.6	(3,013.2)	(3,844.6)	$ (50.5)	125.6
Increase (Decrease) in Shareholders' Equity [Roll Forward]
Net income				5,240.4				11.0
Other comprehensive income (loss), net of tax	(482.4)					(482.4)
Cash dividends declared				(4,221.3)
Retirement of treasury shares (in shares)		(2,299)					(2,299)
Retirement of treasury shares		$ (1.4)		(748.6)			$ 750.0
Purchase of treasury shares (in shares)							2,299
Purchase of treasury shares	$ (750.0)						$ (750.0)
Issuance of stock under employee stock plans, net (in shares)		1,448					(48)
Issuance of stock under employee stock plans, net		$ 0.9	(299.5)				$ 8.8
Stock-based compensation			628.5
Other				(0.8)			$ (2.5)	(44.8)
Ending balance (in shares) at Dec. 31, 2023	949,781	949,781
Ending balance (in shares) at Dec. 31, 2023							402
Ending balance at Dec. 31, 2023	$ 10,863.7	$ 593.6	$ 7,250.4	$ 10,312.3	$ (3,013.2)	$ (4,327.0)	$ (44.2)	$ 91.8

Summary of Significant Accounting Policies and Implementation of New Financial Accounting Standards (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reclassification [Line Items]
Advertising expense	$ 1,120.0	$ 966.8	$ 1,240.0
Advertising expense, percentage of revenue	5.00%	5.00%	5.00%
Increase in net cash provided by operating activities	$ 4,240.1	$ 7,585.7	$ 7,365.9
Increase in net cash used in investing activities	$ (7,152.7)	(3,762.9)	(2,867.5)
Revision of Prior Period, Reclassification, Adjustment
Reclassification [Line Items]
Increase in net cash provided by operating activities		501.3	105.2
Increase in net cash used in investing activities		$ 501.3	$ 105.2

Other Comprehensive Income (Loss)

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Other Comprehensive Income (Loss)

The following table summarizes the activity related to each component of other comprehensive income (loss):



(Amounts presented net of taxes)	Foreign Currency Translation Gains (Losses)		Net Unrealized Gains (Losses) on Available-For-Sale Securities		Retirement Benefit Plans		Net Unrealized Gains (Losses) on Cash Flow Hedges		Accumulated Other Comprehensive Loss
Beginning balance at January 1, 2021	$	(1,427.5)	$	14.8	$	(4,751.0)	$	(332.7)	$	(6,496.4)

Other comprehensive income (loss) before reclassifications	(122.7)		(11.9)		1,823.4		106.6		1,795.4
Net amount reclassified from accumulated other comprehensive loss	—		0.8		344.0		13.1		357.9
Net other comprehensive income (loss)	(122.7)		(11.1)		2,167.4		119.7		2,153.3



Balance at December 31, 2021	(1,550.2)		3.7		(2,583.6)		(213.0)		(4,343.1)


Other comprehensive income (loss) before reclassifications	(324.4)		(52.2)		291.5		332.8		247.7
Net amount reclassified from accumulated other comprehensive loss	0.4		11.4		229.8		9.2		250.8
Net other comprehensive income (loss)	(324.0)		(40.8)		521.3		342.0		498.5

Balance at December 31, 2022	(1,874.2)		(37.1)		(2,062.3)		129.0		(3,844.6)

Other comprehensive income (loss) before reclassifications	78.9		10.1		(686.9)		79.7		(518.2)
Net amount reclassified from accumulated other comprehensive loss	(23.7)		0.8		51.9		6.8		35.8
Net other comprehensive income (loss)	55.2		10.9		(635.0)		86.5		(482.4)

Ending balance at December 31, 2023	$	(1,819.0)	$	(26.2)	$	(2,697.3)	$	215.5	$	(4,327.0)

The tax effects on the net activity related to each component of other comprehensive income (loss) for the years ended December 31, were as follows:


Tax benefit (expense)	2023		2022		2021
Foreign currency translation gains/losses	$	81.0	$	(75.9)	$	(136.2)
Net unrealized gains/losses on available-for-sale securities	(3.2)		12.4		4.7
Retirement benefit plans	141.5		(95.6)		(532.0)
Net unrealized gains/losses on cash flow hedges	(23.0)		(90.9)		(31.8)
Benefit (expense) for income taxes related to other comprehensive income (loss)	$	196.3	$	(250.0)	$	(695.3)

Except for the tax effects of foreign currency translation gains and losses related to our foreign currency-denominated notes, cross-currency interest rate swaps, and other foreign currency exchange contracts designated as net investment hedges (see Note 7), income taxes were not provided for foreign currency translation. Generally, the assets and liabilities of foreign operations are translated into U.S. dollars using the current exchange rate. For those operations, changes in exchange rates generally do not affect cash flows; therefore, resulting translation adjustments are made in shareholders' equity rather than in the consolidated statements of operations.

Reclassifications out of accumulated other comprehensive loss were as follows:


	Year Ended December 31,						Affected Line Item in the Consolidated Statements of Operations
	2023		2022		2021
Amortization of retirement benefit items:
Prior service benefits, net	$	(50.5)	$	(52.4)	$	(55.4)	Other—net, (income) expense
Actuarial losses	116.2		343.3		490.9		Other—net, (income) expense
Total before tax	65.7		290.9		435.5
Tax benefit	(13.8)		(61.1)		(91.5)		Income taxes
Net of tax	51.9		229.8		344.0

Other, net of tax	(16.1)		21.0		13.9		Other—net, (income) expense
Total reclassifications for the period, net of tax	$	35.8	$	250.8	$	357.9

Consolidated Statements of Shareholders' Equity (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Stockholders' Equity [Abstract]
Cash dividend declared per share (in usd per share)	$ 4.69	$ 4.07	$ 3.53

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 5,240.4	$ 6,244.8	$ 5,581.7
Other comprehensive income (loss):
Change in foreign currency translation gains (losses)	(25.8)	(248.1)	13.5
Change in net unrealized gains (losses) on available-for-sale securities	14.1	(53.2)	(15.9)
Change in retirement benefit plans (Note 15)	(776.5)	616.9	2,699.4
Change in net unrealized gains (losses) on cash flow hedges	109.5	432.9	151.6
Other comprehensive income (loss) before income taxes	(678.7)	748.5	2,848.6
Benefit (expense) for income taxes related to other comprehensive income (loss)	196.3	(250.0)	(695.3)
Other comprehensive income (loss), net of tax (Note 17)	(482.4)	498.5	2,153.3
Comprehensive income	$ 4,758.0	$ 6,743.3	$ 7,735.0

Borrowings (Schedule of Debt) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Debt Disclosure [Abstract]
Short-term commercial paper borrowings	$ 6,189.4	$ 1,498.0
Long-term notes	19,104.6	14,815.3
Other long-term debt	6.5	6.9
Unamortized debt issuance costs	(90.5)	(77.2)
Fair value adjustment on hedged long-term notes	15.3	(4.4)
Total debt	25,225.3	16,238.6
Less current portion	(6,904.5)	(1,501.1)
Long-term debt	$ 18,320.8	$ 14,737.5

Pay vs Performance Disclosure - USD ($) $ in Millions	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net income	$ 5,240.4	$ 6,244.8	$ 5,581.7

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

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-Topic 323
-SubTopic 10
-Name Accounting Standards Codification
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-URI https://asc.fasb.org//1943274/2147481687/323-10-50-3

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-Section 50
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
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-URI https://asc.fasb.org//1943274/2147482765/220-10-50-6

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-3

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
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-Section 50
-Paragraph 1
-Subparagraph (b)(2)
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-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 65
-Paragraph 1
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org//1943274/2147483443/250-10-50-9

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org//1943274/2147483443/250-10-50-11

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
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-Section 50
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-Subparagraph (b)
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
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-Name Accounting Standards Codification
-Section 50
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-URI https://asc.fasb.org//1943274/2147483443/250-10-50-4

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-Topic 946
-SubTopic 830
-Name Accounting Standards Codification
-Section 55
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480167/946-830-55-10

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section 45
-Paragraph 7
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-URI https://asc.fasb.org//1943274/2147483581/946-220-45-7

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
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-Name Accounting Standards Codification
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
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Reference 20: http://www.xbrl.org/2009/role/commonPracticeRef
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+ Details

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 income	$ 5,240.4	$ 6,244.8	$ 5,581.7
Adjustments to Reconcile Net Income to Cash Flows from Operating Activities:
Depreciation and amortization	1,527.3	1,522.5	1,547.6
Debt extinguishment loss (Note 11)	0.0	0.0	405.2
Change in deferred income taxes	(2,341.0)	(2,185.2)	(802.3)
Stock-based compensation expense	628.5	371.1	342.8
Net investment (gains) losses	23.5	420.0	(178.0)
Gains on sale of product rights	(1,878.9)	(156.5)	(216.0)
Acquired in-process research and development (Note 3)	3,799.8	908.5	970.1
Other operating activities, net	295.5	461.3	727.4
Other changes in operating assets and liabilities, net of acquisitions and divestitures:
Receivables—(increase) decrease	(2,451.0)	(299.6)	(1,278.3)
Inventories—(increase) decrease	(1,425.0)	(599.7)	(235.9)
Other assets—(increase) decrease	(3,453.4)	(793.5)	1,515.4
Accounts payable and other liabilities—increase (decrease)	4,274.4	1,692.0	(1,013.8)
Net Cash Provided by Operating Activities	4,240.1	7,585.7	7,365.9
Cash Flows from Investing Activities
Purchases of property and equipment	(3,447.6)	(1,854.3)	(1,309.8)
Proceeds from sales and maturities of short-term investments	192.2	121.4	47.4
Purchases of short-term investments	(98.2)	(107.4)	(83.5)
Proceeds from sales of and distributions from noncurrent investments	508.1	342.2	800.0
Purchases of noncurrent investments	(730.8)	(600.2)	(929.9)
Proceeds from sale of product rights	1,604.3	95.8	216.0
Purchases of in-process research and development	(3,944.5)	(1,131.0)	(668.6)
Cash paid for acquisitions, net of cash acquired (Note 3)	(1,044.3)	(327.2)	(747.4)
Other investing activities, net	(191.9)	(302.2)	(191.7)
Net Cash Used for Investing Activities	(7,152.7)	(3,762.9)	(2,867.5)
Cash Flows from Financing Activities
Dividends paid	(4,069.3)	(3,535.8)	(3,086.8)
Net change in short-term borrowings	4,691.4	1,498.0	(4.0)
Proceeds from issuance of long-term debt	3,958.5	0.0	2,410.8
Repayments of long-term debt	0.0	(1,560.0)	(1,905.4)
Purchases of common stock	(750.0)	(1,500.0)	(1,250.0)
Other financing activities, net	(335.0)	(308.9)	(295.9)
Net Cash Provided by (Used for) Financing Activities	3,495.6	(5,406.7)	(4,131.3)
Effect of exchange rate changes on cash and cash equivalents	168.6	(167.6)	(205.7)
Net increase (decrease) in cash and cash equivalents	751.6	(1,751.5)	161.4
Cash and cash equivalents at beginning of year	2,067.0	3,818.5	3,657.1
Cash and Cash Equivalents at End of Year	$ 2,818.6	$ 2,067.0	$ 3,818.5

Financial Instruments (Realized Gains and Losses) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Proceeds from sales	$ 145.6	$ 132.9	$ 174.7
Realized gross gains on sales	0.7	0.4	2.8
Realized gross losses on sales	$ 4.0	$ 9.7	$ 1.7

Inventories

12 Months Ended

Dec. 31, 2023

Inventory Disclosure [Abstract]

Inventories

We use the last-in, first-out (LIFO) method for the majority of our inventories located in the continental U.S. Other inventories are valued by the first-in, first-out (FIFO) method. FIFO cost approximates current replacement cost. Inventories measured using LIFO must be valued at the lower of cost or market. Inventories measured using FIFO must be valued at the lower of cost or net realizable value.

Inventories at December 31 consisted of the following:


	2023		2022
Finished products	$	791.7	$	901.2
Work in process	3,248.6		2,597.7
Raw materials and supplies	1,630.1		801.9
Total (approximates replacement cost)	5,670.4		4,300.8
Increase to LIFO cost	102.4		8.9
Inventories	$	5,772.8	$	4,309.7

Inventories valued under the LIFO method comprised $1.77 billion and $1.23 billion of total inventories at December 31, 2023 and 2022, respectively.

We recognized a net inventory impairment charge related to our COVID-19 antibodies of $339.7 million during the year ended December 31, 2021 in cost of sales in our consolidated statements of operations primarily due to the combination of changes to demand from U.S. and international governments, including changes to our agreement with the U.S. government, and near-term expiry dates of COVID-19 antibodies.

Income Taxes (Schedule of Reconciliation of Income Taxes) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Income tax at the U.S. federal statutory tax rate	$ 1,376.5	$ 1,429.3	$ 1,292.6
Add (deduct):
Non-deductible acquired IPR&D	677.2	68.3	10.5
General business credits	(258.0)	(155.0)	(100.5)
Foreign-derived intangible income deduction	(236.7)	(287.5)	(86.7)
International operations, including Puerto Rico	187.1	299.5	447.5
Stock-based compensation	(79.9)	(48.9)	(55.7)
Valuation allowance release	(4.2)	(116.4)	(19.0)
Other	26.4	(28.7)	(19.9)
Income taxes	$ 1,314.2	$ 561.6	$ 573.8

Insider Trading Arrangements	3 Months Ended	12 Months Ended
Insider Trading Arrangements	Dec. 31, 2023 shares	Dec. 31, 2023 shares
Trading Arrangements, by Individual
Material Terms of Trading Arrangement		On November 16, 2023, Donald Zakrowski, senior vice president, finance, and chief accounting officer, adopted a sales plan (Plan). The Plan was entered into during an open trading window and is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) of the Exchange Act of 1934 and our policies regarding trading in our securities. The Plan calls for the sale of up to 3,150 shares of company common stock between March 11, 2024 and November 14, 2024 subject to the terms and conditions of the Plan.
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Donald Zakrowski [Member]
Trading Arrangements, by Individual
Name	Donald Zakrowski
Title	senior vice president, finance, and chief accounting officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	November 16, 2023
Arrangement Duration	248 days
Aggregate Available	3,150	3,150

Property and Equipment (Schedule of Depreciation Expense) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 901.9	$ 816.6	$ 787.0

Inventories (Tables)

12 Months Ended

Dec. 31, 2023

Inventory Disclosure [Abstract]

Schedule of Inventory

Inventories at December 31 consisted of the following:


	2023		2022
Finished products	$	791.7	$	901.2
Work in process	3,248.6		2,597.7
Raw materials and supplies	1,630.1		801.9
Total (approximates replacement cost)	5,670.4		4,300.8
Increase to LIFO cost	102.4		8.9
Inventories	$	5,772.8	$	4,309.7

Leases (Impact of Leases to Consolidated Condensed Financial Statements) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Weighted-average remaining lease term	9 years	7 years
Weighted-average discount rate	4.40%	3.60%
Operating cash flows from operating leases	$ 171.0	$ 149.7	$ 156.7
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 590.0	$ 155.4	$ 163.5

Other Comprehensive Income (Loss) (Schedule of Component of Other Comprehensive Income (Loss)) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
AOCI Attributable to Parent [Abstract]
Beginning balance	$ 10,649.8
Other comprehensive income (loss) before reclassifications	(518.2)	$ 247.7	$ 1,795.4
Net amount reclassified from accumulated other comprehensive loss	(35.8)	(250.8)	(357.9)
Other comprehensive income (loss), net of tax (Note 17)	(482.4)	498.5	2,153.3
Ending balance	10,771.9	10,649.8
Accumulated Other Comprehensive Loss
AOCI Attributable to Parent [Abstract]
Beginning balance	(3,844.6)	(4,343.1)	(6,496.4)
Other comprehensive income (loss), net of tax (Note 17)	(482.4)	498.5	2,153.3
Ending balance	(4,327.0)	(3,844.6)	(4,343.1)
Foreign currency translation gains/losses
AOCI Attributable to Parent [Abstract]
Beginning balance	(1,874.2)	(1,550.2)	(1,427.5)
Other comprehensive income (loss) before reclassifications	78.9	(324.4)	(122.7)
Net amount reclassified from accumulated other comprehensive loss	23.7	(0.4)	0.0
Other comprehensive income (loss), net of tax (Note 17)	55.2	(324.0)	(122.7)
Ending balance	(1,819.0)	(1,874.2)	(1,550.2)
Net unrealized gains/losses on available-for-sale securities
AOCI Attributable to Parent [Abstract]
Beginning balance	(37.1)	3.7	14.8
Other comprehensive income (loss) before reclassifications	10.1	(52.2)	(11.9)
Net amount reclassified from accumulated other comprehensive loss	(0.8)	(11.4)	(0.8)
Other comprehensive income (loss), net of tax (Note 17)	10.9	(40.8)	(11.1)
Ending balance	(26.2)	(37.1)	3.7
Retirement benefit plans
AOCI Attributable to Parent [Abstract]
Beginning balance	(2,062.3)	(2,583.6)	(4,751.0)
Other comprehensive income (loss) before reclassifications	(686.9)	291.5	1,823.4
Net amount reclassified from accumulated other comprehensive loss	(51.9)	(229.8)	(344.0)
Other comprehensive income (loss), net of tax (Note 17)	(635.0)	521.3	2,167.4
Ending balance	(2,697.3)	(2,062.3)	(2,583.6)
Net unrealized gains/losses on cash flow hedges
AOCI Attributable to Parent [Abstract]
Beginning balance	129.0	(213.0)	(332.7)
Other comprehensive income (loss) before reclassifications	79.7	332.8	106.6
Net amount reclassified from accumulated other comprehensive loss	(6.8)	(9.2)	(13.1)
Other comprehensive income (loss), net of tax (Note 17)	86.5	342.0	119.7
Ending balance	$ 215.5	$ 129.0	$ (213.0)

Other - Net, (Income) Expense (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Nonoperating Income (Expense) [Abstract]
Interest expense	$ 485.9	$ 331.6	$ 339.8
Interest income	(173.6)	(62.8)	(25.4)
Net investment (gains) losses on equity securities (Note 7)	20.2	410.7	(176.9)
Debt extinguishment loss (Note 11)	0.0	0.0	405.2
Retirement benefit plans	(461.9)	(372.9)	(289.7)
Other (income) expense	32.7	14.3	(51.4)
Other–net, (income) expense	$ (96.7)	$ 320.9	$ 201.6

- Definition

Amount of the cost of borrowed funds accounted for as interest expense.

+ References + Details

Property and Equipment

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Property and Equipment

Property and equipment is stated on the basis of cost. Provisions for depreciation of buildings and equipment are computed generally by the straight-line method at rates based on their estimated useful lives (12 to 50 years for buildings and three to 25 years for equipment). We review the carrying value of long-lived assets for potential impairment on a periodic basis and whenever events or changes in circumstances indicate the carrying value of an asset may not be recoverable. Impairment is determined by comparing projected undiscounted cash flows to be generated by the asset to its carrying value. If an impairment is identified, a loss is recorded equal to the excess of the asset's net book value over its fair value, and the cost basis is adjusted.

At December 31, property and equipment consisted of the following:


	2023		2022
Land	$	319.8	$	256.6
Buildings	8,280.0		7,915.9
Equipment	10,329.0		9,406.3

Construction in progress	5,084.1		2,798.6
	24,012.9		20,377.4
Less accumulated depreciation	(11,099.3)		(10,233.4)
Property and equipment, net	$	12,913.6	$	10,144.0

Depreciation expense related to property and equipment was as follows:


	2023		2022		2021
Depreciation expense	$	901.9	$	816.6	$	787.0

Capitalized interest costs were not material for the years ended December 31, 2023, 2022, and 2021.

The following table summarizes long-lived assets by geographical area:


	2023		2022

Long-lived assets(1):
U.S. and Puerto Rico	$	9,993.2	$	7,709.7
Ireland	2,722.6		1,898.5
Other foreign countries	1,784.2		1,625.9
Long-lived assets	$	14,500.0	$	11,234.1

(1) Long-lived assets consist of property and equipment, net, operating lease assets, and unamortized computer software costs.

Other-Net, (Income) Expense

12 Months Ended

Dec. 31, 2023

Nonoperating Income (Expense) [Abstract]

Other-Net, (Income) Expense

Other–Net, (Income) Expense

Other–net, (income) expense consisted of the following:


	2023		2022		2021
Interest expense	$	485.9	$	331.6	$	339.8
Interest income	(173.6)		(62.8)		(25.4)
Net investment (gains) losses on equity securities (Note 7)	20.2		410.7		(176.9)
Debt extinguishment loss (Note 11)	—		—		405.2
Retirement benefit plans	(461.9)		(372.9)		(289.7)
Other (income) expense	32.7		14.3		(51.4)
Other–net, (income) expense	$	(96.7)	$	320.9	$	201.6

Borrowings (Schedule of Cash Payments for Interest on Borrowings) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Debt Disclosure [Abstract]
Cash payments for interest on borrowings	$ 404.2	$ 323.7	$ 338.0

Financial Instruments (Schedule of Foreign Currency Forward Commitments) (Details) - Dec. 31, 2023 € in Millions, ¥ in Millions, £ in Millions, $ in Millions	USD ($)	EUR (€)	GBP (£)	CNY (¥)
Buy USD Sell Euro
Offsetting Assets [Line Items]
Derivative liability, notional amount	$ 4,779.4
Derivative asset, notional amount \| €		€ 4,352.2
Buy Euro Sell USD
Offsetting Assets [Line Items]
Derivative liability, notional amount \| €		€ 3,940.4
Derivative asset, notional amount	4,250.9
Buy GBP Sell USD
Offsetting Assets [Line Items]
Derivative liability, notional amount \| £			£ 237.7
Derivative asset, notional amount	299.2
Buy US Dollar Sell Chinese Yuan
Offsetting Assets [Line Items]
Derivative liability, notional amount	$ 165.3
Derivative asset, notional amount \| ¥				¥ 1,172.7

- Definition

Nominal or face amount used to calculate payments on the derivative asset.

+ References + Details

- Definition

Nominal or face amount used to calculate payments on the derivative liability.

+ References + Details

Income Taxes

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

Deferred taxes are recognized for the future tax effects of temporary differences between financial and income tax reporting based on enacted tax laws and rates. Deferred taxes related to global intangible low-taxed income (GILTI) are also recognized for the future tax effects of temporary differences.

We recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position, based on its technical merits, will be sustained upon examination by the taxing authority. The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50 percent likelihood of being realized upon ultimate resolution.

Following is the composition of income tax expense:


	2023		2022		2021
Current:
Federal(1)	$	3,017.9	$	2,153.6	$	938.5
Foreign	613.0		547.7		466.0
State	24.3		45.5		(28.4)
Total current tax expense	3,655.2		2,746.8		1,376.1
Deferred:
Federal	(2,369.0)		(1,992.4)		(977.5)
Foreign	34.2		(78.2)		174.6
State	(6.2)		(114.6)		0.6
Total deferred tax benefit	(2,341.0)		(2,185.2)		(802.3)
Income taxes	$	1,314.2	$	561.6	$	573.8

(1) The 2023, 2022, and 2021 current tax expense includes $69.3 million, $189.5 million, and $64.7 million of tax benefit, respectively, from utilization of net operating loss and other tax carryforwards.

Significant components of our deferred tax assets and liabilities as of December 31 were as follows:


	2023		2022
Deferred tax assets:
Capitalized research and development	$	2,997.5	$	1,615.4
Purchases of intangible assets	1,981.9		2,071.3
Sales rebates and discounts	1,632.5		1,312.9
Correlative tax adjustments	1,031.3		752.5
Tax credit carryforwards	577.0		477.6
Tax loss and other tax carryforwards	527.2		626.0
Compensation and benefits	521.4		427.9
Foreign tax redeterminations	323.7		267.8
Operating lease liabilities	253.3		147.5
Other	463.4		361.0
Total gross deferred tax assets	10,309.2		8,059.9
Valuation allowances	(913.5)		(775.1)
Total deferred tax assets	9,395.7		7,284.8
Deferred tax liabilities:
Intangibles	(1,338.2)		(1,387.9)
Earnings of foreign subsidiaries	(796.6)		(1,226.0)
Inventories	(619.5)		(639.5)
Property and equipment	(495.2)		(433.5)
Prepaid employee benefits	(460.6)		(546.5)
Operating lease assets	(237.1)		(130.7)
Financial instruments	(75.1)		(215.0)
Total deferred tax liabilities	(4,022.3)		(4,579.1)
Deferred tax assets - net	$	5,373.4	$	2,705.7

The deferred tax asset and related valuation allowance amounts for U.S. federal, international, and state net operating losses and tax credits shown above have been reduced for differences between financial reporting and tax return filings.

At December 31, 2023, based on filed tax returns we have tax credit carryforwards and carrybacks of $1.00 billion available to reduce future income taxes; $148.8 million, if unused, will expire in 2026, and $60.8 million, if unused, will expire between 2029 and 2043. The remaining portion of the tax credit carryforwards is related to federal tax credits of $55.3 million, international tax credits of $109.9 million, and state tax credits of $629.3 million, all of which are fully reserved.

At December 31, 2023, based on filed tax returns we had net operating losses and other carryforwards for international and U.S. federal income tax purposes of $1.35 billion: $284.6 million will expire by 2028; $35.0 million will expire between 2029 and 2043; and $1.03 billion of the carryforwards will never expire. Net operating losses and other carryforwards for U.S. federal income tax purposes are partially reserved. Deferred tax assets related to state net operating losses and other carryforwards of $261.9 million are fully reserved as of December 31, 2023.

At December 31, 2023 and 2022, prepaid expenses included prepaid taxes of $4.26 billion and $2.37 billion, respectively.

Domestic and Puerto Rican companies contributed approximately 14 percent, 33 percent, and 28 percent for the years ended December 31, 2023, 2022, and 2021, respectively, to consolidated income before income taxes. We have a subsidiary operating in Puerto Rico under a tax incentive grant effective through the end of 2046. The tax incentive grant was amended in 2022 to apply the alternate tax regime established by Puerto Rico legislation starting in 2023.

Substantially all of the unremitted earnings of our foreign subsidiaries are considered not to be indefinitely reinvested for continued use in our foreign operations. At December 31, 2023 and 2022, we accrued an immaterial amount of foreign withholding taxes and state income taxes that would be owed upon future distributions of unremitted earnings of our foreign subsidiaries that are not indefinitely reinvested. For the amount considered to be indefinitely reinvested, it is not practicable to determine the amount of the related deferred income tax liability due to the complexities in the tax laws and assumptions we would have to make.

Cash payments of U.S. federal, state, and foreign income taxes, net of refunds, were as follows:


	2023		2022		2021
Cash payments of income taxes	$	5,558.8	$	2,672.9	$	1,598.8

In December 2017, the Tax Cuts and Job Act (2017 Tax Act) was signed into law. The 2017 Tax Act included significant changes to the U.S. corporate income tax system, including a one-time repatriation transition tax (also known as the 'Toll Tax') on unremitted foreign earnings. The 2017 Tax Act provided an election to taxpayers subject to the Toll Tax to make payments over an eight-year period beginning in 2018 through 2025. Having made this election, our future cash payments relating to the Toll Tax as of December 31, 2023 are as follows:


	Total		2024		2025
2017 Tax Act Toll Tax	$	1,427.0	$	634.2	$	792.8

As of December 31, 2023, we have additional noncurrent income tax payables of $3.06 billion unrelated to the Toll Tax; we cannot reasonably estimate the timing of future cash outflows associated with these liabilities.

Following is a reconciliation of the consolidated income tax expense applying the U.S. federal statutory rate to income before income taxes to reported consolidated income tax expense:


	2023		2022		2021
Income tax at the U.S. federal statutory tax rate	$	1,376.5	$	1,429.3	$	1,292.6
Add (deduct):
Non-deductible acquired IPR&D(1)	677.2		68.3		10.5
General business credits	(258.0)		(155.0)		(100.5)
Foreign-derived intangible income deduction	(236.7)		(287.5)		(86.7)
International operations, including Puerto Rico(2)	(187.1)		(299.5)		(447.5)
Stock-based compensation(3)	(79.9)		(48.9)		(55.7)

Valuation allowance release	(4.2)		(116.4)		(19.0)
Other	26.4		(28.7)		(19.9)
Income taxes	$	1,314.2	$	561.6	$	573.8

(1) Non-deductible acquired IPR&D was primarily related to the acquisitions of DICE, Versanis, and Emergence in 2023. See Note 3 for additional information related to acquisitions.

(2) Includes the impact of GILTI tax, Puerto Rico Excise Tax (for 2022 and 2021), and other U.S. taxation of foreign income.

(3) Includes excess tax benefits from stock-based compensation and non-deductible stock-based compensation.

A reconciliation of the beginning and ending amount of gross unrecognized tax benefits is as follows:


	2023		2022		2021
Beginning balance at January 1	$	2,987.0	$	2,798.3	$	2,551.9
Additions based on tax positions related to the current year	364.3		274.2		310.3
Additions for tax positions of prior years	78.2		34.6		98.6
Reductions for tax positions of prior years	(39.0)		(10.9)		(8.1)
Settlements	(4.7)		(44.8)		(38.5)
Lapses of statutes of limitation	(21.5)		(11.8)		(49.7)
Changes related to the impact of foreign currency translation	30.7		(52.6)		(66.2)
Ending balance at December 31	$	3,395.0	$	2,987.0	$	2,798.3

The total amount of unrecognized tax benefits that, if recognized, would affect our effective tax rate was $1.77 billion and $1.70 billion at December 31, 2023 and 2022, respectively.

We file U.S. federal, foreign, and various state and local income tax returns. We are no longer subject to U.S. federal income tax examination for years before 2016. In most major foreign and state jurisdictions, we are no longer subject to income tax examination for years before 2012.

The U.S. examination of tax years 2016-2018 began in 2019 and remains ongoing. The Internal Revenue Service commenced its examination of tax years 2019-2021 during the third quarter of 2023. The resolution of both audit periods will likely extend beyond the next 12 months.

Interest and penalties related to unrecognized tax benefits are recognized in income tax expense and were not material for the years ended December 31, 2023, 2022, and 2021. Our accrued interest and penalties related to unrecognized tax benefits were $414.9 million and $271.5 million at December 31, 2023 and 2022, respectively.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482526/740-270-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 17
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-17

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Property and Equipment (Schedule of Property and Equipment) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Abstract]
Land	$ 319.8	$ 256.6
Buildings	8,280.0	7,915.9
Equipment	10,329.0	9,406.3
Construction in progress	5,084.1	2,798.6
Property and equipment, gross	24,012.9	20,377.4
Less accumulated depreciation	(11,099.3)	(10,233.4)
Property and equipment, net	$ 12,913.6	$ 10,144.0

Financial Instruments

12 Months Ended

Dec. 31, 2023

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Financial Instruments

Investments in Equity and Debt Securities

Our equity investments are accounted for using three different methods depending on the type of equity investment:

•Investments in companies over which we have significant influence but not a controlling interest are accounted for using the equity method, with our share of earnings or losses reported in other-net, (income) expense.

•For equity investments that do not have readily determinable fair values, we measure these investments at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions for the identical or similar investment of the same issuer. Any change in recorded value is recorded in other-net, (income) expense.

•Our public equity investments are measured and carried at fair value. Any change in fair value is recognized in other-net, (income) expense.

We adjust our equity investments without readily determinable fair values based upon changes in the equity instruments' values resulting from observable price changes in orderly transactions for an identical or similar investment of the same issuer. Downward adjustments resulting from an impairment are recorded based upon impairment considerations, including the financial condition and near-term prospects of the issuer, general market conditions, and industry specific factors. Adjustments recorded for the years ended December 31, 2023, 2022, and 2021 were not material.

The net gains (losses) recognized in our consolidated statements of operations for equity securities were $(20.2) million, $(410.7) million, and $176.9 million for the years ended December 31, 2023, 2022, and 2021, respectively. The net gains (losses) recognized for the years ended December 31, 2023, 2022, and 2021 on equity securities sold during the respective periods were not material.

As of December 31, 2023, we had approximately $930 million of unfunded commitments to invest in venture capital funds, which we anticipate will be paid over a period of up to 10 years.

We record our available-for-sale debt securities at fair value, with changes in fair value reported as a component of accumulated other comprehensive income (loss). We periodically assess our investment in available-for-sale securities for impairment losses and credit losses. The amount of credit losses are determined by comparing the difference between the present value of future cash flows expected to be collected on these securities and the amortized cost. Factors considered in assessing credit losses include the position in the capital structure, vintage and amount of collateral, delinquency rates, current credit support, and geographic concentration. Impairment and credit losses related to available-for-sale securities were not material for the years ended December 31, 2023, 2022, and 2021.

The table below summarizes the contractual maturities of our investments in debt securities measured at fair value as of December 31, 2023:


	Maturities by Period
	Total		Less Than 1 Year		1-5 Years		6-10 Years		More Than 10 Years
Fair value of debt securities	$	657.2	$	84.1	$	227.9	$	98.4	$	246.8

A summary of the amount of unrealized gains and losses in accumulated other comprehensive loss and the fair value of available-for-sale securities in an unrealized gain or loss position follows:


	2023		2022
Unrealized gross gains	$	3.4	$	0.6
Unrealized gross losses	37.9		49.2
Fair value of securities in an unrealized gain position	159.2		46.8
Fair value of securities in an unrealized loss position	452.0		568.7

As of December 31, 2023, the available-for-sale securities in an unrealized loss position include primarily fixed-rate debt securities of varying maturities, which are sensitive to changes in the yield curve and other market conditions. Approximately 99 percent of the fixed-rate debt securities in a loss position are investment-grade debt securities. As of December 31, 2023, we do not intend to sell, and it is not more likely than not that we will be required to sell, the securities in a loss position before the market values recover or the underlying cash flows have been received, and there is no indication of a material default on interest or principal payments for our debt securities.

Activity related to our available-for-sale securities was as follows:


	2023		2022		2021
Proceeds from sales	$	145.6	$	132.9	$	174.7
Realized gross gains on sales	0.7		0.4		2.8
Realized gross losses on sales	4.0		9.7		1.7

Realized gains and losses on sales of available-for-sale investments are computed based upon specific identification of the initial cost adjusted for any other-than-temporary declines in fair value that were recorded in earnings.

Fair Value of Investments


					Fair Value Measurements Using
	Carrying Amount		Cost (1)		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value
December 31, 2023
Cash equivalents(2)	$	1,088.4	$	1,088.4	$	1,079.3	$	9.1	$	—	$	1,088.4
Short-term investments:
U.S. government and agency securities	$	32.1	$	32.3	$	32.1	$	—	$	—	$	32.1
Corporate debt securities	52.0		52.1		—		52.0		—		52.0


Other securities	25.0		25.0		—		13.6		11.4		25.0

Short-term investments	$	109.1
Noncurrent investments:
U.S. government and agency securities	$	148.1	$	161.0	$	148.1	$	—	$	—	$	148.1
Corporate debt securities	214.3		226.6		—		214.3		—		214.3
Mortgage-backed securities	157.3		167.1		—		157.3		—		157.3
Asset-backed securities	53.5		54.4		—		53.5		—		53.5
Other securities	197.4		100.2		—		23.5		173.9		197.4
Marketable equity securities	711.3		493.2		711.3		—		—		711.3
Equity investments without readily determinable fair values(3)	608.0
Equity method investments(3)	962.3
Noncurrent investments	$	3,052.2

December 31, 2022
Cash equivalents(2)	$	657.4	$	657.4	$	650.4	$	7.0	$	—	$	657.4
Short-term investments:
U.S. government and agency securities	$	30.8	$	31.1	$	30.8	$	—	$	—	$	30.8
Corporate debt securities	53.4		53.5		—		53.4		—		53.4

Asset-backed securities	2.0		2.0		—		2.0		—		2.0
Other securities	58.6		58.6		—		39.1		19.5		58.6

Short-term investments	$	144.8
Noncurrent investments:
U.S. government and agency securities	$	146.4	$	163.2	$	146.4	$	—	$	—	$	146.4
Corporate debt securities	213.9		235.8		—		213.9		—		213.9
Mortgage-backed securities	149.2		161.5		—		149.2		—		149.2
Asset-backed securities	50.6		52.5		—		50.6		—		50.6
Other securities	398.6		34.5		—		311.0		87.6		398.6
Marketable equity securities	683.6		484.7		683.6		—		—		683.6
Equity investments without readily determinable fair values(3)	478.4
Equity method investments(3)	781.1
Noncurrent investments	$	2,901.8

(1) For available-for-sale debt securities, amounts disclosed represent the securities' amortized cost.

(2) We consider all highly liquid investments with a maturity of three months or less from the date of purchase to be cash equivalents. The cost of these investments approximates fair value.

(3) Fair value disclosures are not applicable for equity method investments and investments accounted for under the measurement alternative for equity investments.

We determine our Level 1 and Level 2 fair value measurements based on a market approach using quoted market values, significant other observable inputs for identical or comparable assets or liabilities, or discounted cash flow analyses. Level 3 fair value measurements for other investment securities are determined using unobservable inputs, including the investments' cost adjusted for impairments and price changes from orderly transactions. Fair values are not readily available for certain equity investments measured under the measurement alternative.

Debt

Fair Value of Debt

The following table summarizes certain fair value information at December 31, 2023 and 2022 for our short-term and long-term debt:


			Fair Value Measurements Using
	Carrying Amount		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value
Short-term commercial paper borrowings
December 31, 2023	$	(6,189.4)	$	—	$	(6,166.4)	$	—	$	(6,166.4)
December 31, 2022	(1,498.0)		—		(1,492.0)		—		(1,492.0)
Long-term debt, including current portion
December 31, 2023	$	(19,035.9)	$	—	$	(17,221.7)	$	—	$	(17,221.7)
December 31, 2022	(14,740.6)		—		(12,329.3)		—		(12,329.3)

Risk Management and Related Financial Instruments

Financial instruments that potentially subject us to credit risk consist principally of trade receivables and interest-bearing investments. Wholesale distributors of life science products account for a substantial portion of our trade receivables; collateral is generally not required. We seek to mitigate the risk associated with this concentration through our ongoing credit-review procedures and insurance. The majority of our cash is held by a few major financial institutions that have been identified as Global Systemically Important Banks (G-SIBs) by the Financial Stability Board. G-SIBs are subject to rigorous regulatory testing and oversight and must meet certain capital requirements. We monitor our exposures with these institutions and do not expect any of these institutions to fail to meet their obligations. In accordance with documented corporate risk-management policies, we monitor the amount of credit exposure to any one financial institution or corporate issuer based on credit rating of our counterparty. We are exposed to credit-related losses in the event of nonperformance by counterparties to risk-management instruments but do not expect significant counterparties to fail to meet their obligations given their investment grade credit ratings.

We have entered into accounts receivable factoring agreements with financial institutions to sell certain of our non-U.S. accounts receivable. These transactions are accounted for as sales and result in a reduction in accounts receivable because the agreements transfer effective control over, and risk related to, the receivables to the buyers. Our factoring agreements do not allow for recourse in the event of uncollectibility, and we do not retain any interest in the underlying accounts receivable once sold. We derecognized $431.9 million and $422.1 million of accounts receivable as of December 31, 2023 and 2022, respectively, under these factoring arrangements. The costs of factoring such accounts receivable were not material for the years ended December 31, 2023, 2022, and 2021.

Our derivative activities are initiated within the guidelines of documented corporate risk-management policies and are intended to offset losses and gains on the assets, liabilities, and transactions being hedged. Management reviews the correlation and effectiveness of our derivatives on a quarterly basis.

For derivative instruments that are designated and qualify as fair value hedges, the derivative instrument is marked to market, with gains and losses recognized currently in income to offset the respective losses and gains recognized on the underlying exposure. For derivative instruments that are designated and qualify as cash flow hedges, gains and losses are reported as a component of accumulated other comprehensive income (loss) (see Note 17) and reclassified into earnings in the same period the hedged transaction affects earnings. For derivative and non-derivative instruments that are designated and qualify as net investment hedges, the foreign currency translation gains or losses due to spot rate fluctuations are reported as a component of accumulated other comprehensive income (loss) (see Note 17). Derivative contracts that are not designated as hedging instruments are recorded at fair value with the gain or loss recognized in earnings during the period of change.

We may enter into foreign currency forward or option contracts to reduce the effect of fluctuating currency exchange rates (primarily the euro, Chinese yuan, and Japanese yen). Foreign currency derivatives used for hedging are put in place using the same or like currencies and duration as the underlying exposures. Forward and option contracts are principally used to manage exposures arising from subsidiary trade and loan payables and receivables denominated in foreign currencies. These contracts are recorded at fair value with the gain or loss recognized in other–net, (income) expense. Forward contracts generally have maturities not exceeding 12 months. At December 31, 2023, we had outstanding foreign currency forward commitments as follows, all of which have settlement dates within 180 days:

December 31, 2023

Purchase

Sell

Currency

Amount
(in millions)

Currency

Amount
(in millions)

U.S. dollars

4,779.4

Euro

4,352.2

Euro

3,940.4

U.S. dollars

4,250.9

British pounds

237.7

U.S. dollars

299.2

U.S. dollars

165.3

Chinese yuan

1,172.7

Foreign currency exchange risk is also managed through the use of foreign currency debt, cross-currency interest rate swaps, and foreign currency forward contracts. Our foreign currency-denominated notes had carrying amounts of $7.14 billion and $6.83 billion as of December 31, 2023 and 2022, respectively, of which $5.67 billion and $5.45 billion have been designated as, and are effective as, economic hedges of net investments in certain of our foreign operations as of December 31, 2023 and 2022, respectively. At December 31, 2023, we had outstanding cross currency swaps with notional amounts of $728.6 million swapping U.S. dollars to euro and $1.00 billion swapping Swiss francs to U.S. dollars which have settlement dates ranging through 2028. Our cross-currency interest rate swaps, for which a majority convert a portion of our U.S. dollar-denominated fixed-rate debt to foreign-denominated fixed rate debt, have also been designated as, and are effective as, economic hedges of net investments. At December 31, 2023, we had outstanding foreign currency forward contracts to sell 3.20 billion euro and to sell 1.80 billion Chinese yuan, with settlement dates ranging through 2024, which have been designated as, and are effective as, economic hedges of net investments.

In the normal course of business, our operations are exposed to fluctuations in interest rates which can vary the costs of financing, investing, and operating. We seek to address a portion of these risks through a controlled program of risk management that includes the use of derivative financial instruments. The objective of controlling these risks is to limit the impact of fluctuations in interest rates on earnings. Our primary interest-rate risk exposure results from changes in short-term U.S. dollar interest rates. In an effort to manage interest-rate exposures, we strive to achieve an acceptable balance between fixed- and floating-rate debt and investment positions and may enter into interest rate swaps or collars to help maintain that balance.

Interest rate swaps or collars that convert our fixed-rate debt to a floating rate are designated as fair value hedges of the underlying instruments. Interest rate swaps or collars that convert floating-rate debt to a fixed rate are designated as cash flow hedges. Interest expense on the debt is adjusted to include the payments made or received under the swap agreements. Cash proceeds from or payments to counterparties resulting from the termination of interest rate swaps are classified as operating activities in our consolidated statements of cash flows. At December 31, 2023, all of our total long-term debt is at a fixed rate. We have converted approximately 12 percent of our long-term fixed-rate notes to floating rates through the use of interest rate swaps.

We also may enter into forward-starting interest rate swaps and treasury locks, which we designate as cash flow hedges, as part of any anticipated future debt issuances in order to reduce the risk of cash flow volatility from future changes in interest rates. The change in fair value of these instruments is recorded as part of other comprehensive income (loss) (see Note 17) and, upon completion of a debt issuance and termination of the instrument, is amortized to interest expense over the life of the underlying debt. As of December 31, 2023, the total notional amounts of forward-starting interest rate and treasury lock contracts in designated cash flow hedging instruments were $1.10 billion, which have settlement dates ranging through 2025.

The Effect of Risk Management Instruments on the Consolidated Statements of Operations

The following effects of risk-management instruments were recognized in other–net, (income) expense:


	2023		2022		2021
Fair value hedges:
Effect from hedged fixed-rate debt	$	31.5	$	(209.8)	$	(78.5)
Effect from interest rate contracts	(31.5)		209.8		78.5
Cash flow hedges:
Effective portion of losses on interest rate contracts reclassified from accumulated other comprehensive loss	13.5		16.5		16.6
Cross-currency interest rate swaps	(108.6)		8.6		41.8
Net losses on foreign currency exchange contracts not designated as hedging instruments	26.4		191.3		204.6
Total	$	(68.7)	$	216.4	$	263.0

During the years ended December 31, 2023, 2022, and 2021, the amortization of losses related to the portion of our risk management hedging instruments, fair value hedges, and cash flow hedges that was excluded from the assessment of effectiveness was not material.

The Effect of Risk-Management Instruments on Other Comprehensive Income (Loss)

The effective portion of risk-management instruments that was recognized in other comprehensive income (loss) is as follows:


	2023		2022		2021
Net investment hedges:
Foreign currency-denominated notes	$	(219.9)	$	324.9	$	435.0
Cross-currency interest rate swaps	(27.4)		52.0		213.7
Foreign currency forward contracts	(107.1)		(15.4)		—
Cash flow hedges:
Forward-starting interest rate swaps	85.6		391.5		97.6
Cross-currency interest rate swaps	15.2		29.8		42.3

During the next 12 months, we expect to reclassify $13.0 million of pretax net losses on cash flow hedges from accumulated other comprehensive loss to other–net, (income) expense. During the years ended December 31, 2023, 2022, and 2021, the amounts excluded from the assessment of hedge effectiveness recognized in other comprehensive income (loss) were not material.

Fair Value of Risk-Management Instruments

The following table summarizes certain fair value information at December 31, 2023 and 2022 for risk-management assets and liabilities measured at fair value on a recurring basis:


			Fair Value Measurements Using
	Carrying Amount		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value
December 31, 2023
Risk-management instruments
Interest rate contracts designated as fair value hedges:


Other current liabilities	$	(2.4)	$	—	$	(2.4)	$	—	$	(2.4)
Other noncurrent liabilities	(100.3)		—		(100.3)		—		(100.3)
Interest rate contracts designated as cash flow hedges:

Other noncurrent assets	291.2		—		291.2		—		291.2

Cross-currency interest rate contracts designated as net investment hedges:


Other current liabilities	(28.4)		—		(28.4)		—		(28.4)
Other noncurrent liabilities	(3.5)		—		(3.5)		—		(3.5)
Cross-currency interest rate contracts designated as cash flow hedges:
Other receivables	113.8		—		113.8		—		113.8

Other noncurrent assets	63.1		—		63.1		—		63.1

Foreign exchange contracts designated as hedging instruments:
Other current liabilities	(115.8)		—		(115.8)		—		(115.8)
Foreign exchange contracts not designated as hedging instruments:
Other receivables	129.6		—		129.6		—		129.6
Other current liabilities	(55.9)		—		(55.9)		—		(55.9)
Contingent consideration liabilities:
Other current liabilities	(39.5)		—		—		(39.5)		(39.5)
Other noncurrent liabilities	(64.4)		—		—		(64.4)		(64.4)


			Fair Value Measurements Using
	Carrying Amount		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Fair Value
December 31, 2022
Risk-management instruments
Interest rate contracts designated as fair value hedges:



Other noncurrent liabilities	$	(134.3)	$	—	$	(134.3)	$	—	$	(134.3)
Interest rate contracts designated as cash flow hedges:
Other receivables	162.9		—		162.9		—		162.9
Other noncurrent assets	246.0		—		246.0		—		246.0
Cross-currency interest rate contracts designated as net investment hedges:

Other receivables	67.6		—		67.6		—		67.6


Cross-currency interest rate contracts designated as cash flow hedges:
Other noncurrent assets	53.1		—		53.1		—		53.1

Foreign exchanges contracts designated as hedging instruments:
Other current liabilities	(38.3)		—		(38.3)		—		(38.3)
Foreign exchange contracts not designated as hedging instruments:
Other receivables	26.6		—		26.6		—		26.6
Other current liabilities	(21.5)		—		(21.5)		—		(21.5)
Contingent consideration liabilities:
Other current liabilities	(39.5)		—		—		(39.5)		(39.5)
Other noncurrent liabilities	(70.6)		—		—		(70.6)		(70.6)

Risk-management instruments above are disclosed on a gross basis. There are various rights of setoff associated with certain of the risk-management instruments above that are subject to enforceable master netting arrangements or similar agreements. Although various rights of setoff and master netting arrangements or similar agreements may exist with the individual counterparties to the risk-management instruments above, individually, these financial rights are not material.

Contingent consideration liabilities relate to our liabilities arising in connection with the CVRs issued as a result of acquisitions of businesses. The fair values of the CVR liabilities were estimated using a discounted cash flow analysis and Level 3 inputs, including projections representative of a market participant's view of the expected cash payments associated with the agreed upon regulatory milestones based on probabilities of technical success, timing of the potential milestone events for the compounds, and estimated discount rates.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Income Taxes (Schedule of Composition of Income Tax Expense) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Current:
Federal	$ 3,017.9	$ 2,153.6	$ 938.5
Foreign	613.0	547.7	466.0
State	24.3	45.5	(28.4)
Total current tax expense	3,655.2	2,746.8	1,376.1
Deferred:
Federal	(2,369.0)	(1,992.4)	(977.5)
Foreign	34.2	(78.2)	174.6
State	(6.2)	(114.6)	0.6
Total deferred tax benefit	(2,341.0)	(2,185.2)	(802.3)
Income taxes	1,314.2	561.6	573.8
Current federal tax expense, utilization of net operating loss carryforward	$ 69.3	$ 189.5	$ 64.7

Stock-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Schedule of Additional Stock-Based Compensation Disclosures

Stock-based compensation expense and the related tax benefits were as follows:


	2023		2022		2021
Stock-based compensation expense	$	628.5	$	371.1	$	342.8
Tax benefit	132.0		77.9		72.0

Share-based Compensation Awards, Fair Value Assumptions Used

The weighted-average fair values of the SVA units granted during the years ended December 31, 2023, 2022, and 2021 were $349.63, $203.88, and $230.19, respectively, determined using the following assumptions:


	2023		2022		2021
Expected dividend yield	1.07	%	1.60	%	2.50	%
Risk-free interest rate	4.08		1.57		0.19
Volatility	29.87		32.99		31.42

The weighted-average fair value of the RVA units granted during the years ended December 31, 2023, 2022 and 2021 were $397.95, $230.00, and $286.71, respectively, determined using the following assumptions:


	2023		2022		2021
Expected dividend yield	1.07	%	1.60	%	2.50	%
Risk-free interest rate	4.08		1.57		0.19
Volatility	31.25		32.86		30.95

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Accounts receivable, allowances	$ 14.8	$ 16.0
Common stock, shares authorized (in shares)	3,200,000,000	3,200,000,000
Common stock, shares, issued (in shares)	949,781,000	950,632,000

Consolidated Balance Sheets - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Current Assets
Cash and cash equivalents (Note 7)	$ 2,818.6	$ 2,067.0
Short-term investments (Note 7)	109.1	144.8
Accounts receivable, net of allowances of $14.8 (2023) and $16.0 (2022)	9,090.5	6,896.0
Other receivables	2,245.7	1,662.9
Inventories (Note 6)	5,772.8	4,309.7
Prepaid expenses	5,540.8	2,946.8
Other current assets	149.5	7.3
Total current assets	25,727.0	18,034.5
Investments (Note 7)	3,052.2	2,901.8
Goodwill (Note 8)	4,939.7	4,073.0
Other intangibles, net (Note 8)	6,906.6	7,206.6
Deferred tax assets (Note 14)	5,477.3	2,792.9
Property and equipment, net (Note 9)	12,913.6	10,144.0
Other noncurrent assets	4,989.9	4,337.0
Total assets	64,006.3	49,489.8
Current Liabilities
Short-term borrowings and current maturities of long-term debt (Note 11)	6,904.5	1,501.1
Accounts payable	2,598.8	1,930.6
Employee compensation	1,650.4	1,059.8
Sales rebates and discounts	11,689.0	8,784.1
Dividends payable	1,169.2	1,017.2
Other current liabilities	3,281.3	2,845.4
Total current liabilities	27,293.2	17,138.2
Noncurrent Liabilities
Long-term debt (Note 11)	18,320.8	14,737.5
Accrued retirement benefits (Note 15)	1,438.8	1,305.1
Long-term income taxes payable (Note 14)	3,849.2	3,709.6
Other noncurrent liabilities	2,240.6	1,824.0
Total noncurrent liabilities	25,849.4	21,576.2
Commitments and Contingencies (Note 16)
Eli Lilly and Company Shareholders' Equity (Notes 12 and 13)
Common stock—no par value Authorized shares: 3,200,000 Issued shares: 949,781 (2023) and 950,632 (2022)	593.6	594.1
Additional paid-in capital	7,250.4	6,921.4
Retained earnings	10,312.3	10,042.6
Employee benefit trust	(3,013.2)	(3,013.2)
Accumulated other comprehensive loss (Note 17)	(4,327.0)	(3,844.6)
Cost of common stock in treasury	(44.2)	(50.5)
Total Eli Lilly and Company shareholders' equity	10,771.9	10,649.8
Noncontrolling interests	91.8	125.6
Total equity	10,863.7	10,775.4
Total liabilities and equity	$ 64,006.3	$ 49,489.8

Acquisitions (Assets Acquired and Liabilities Assumed) (Details) - USD ($) $ in Millions				1 Months Ended
	Dec. 27, 2023	Dec. 01, 2022	Jan. 22, 2021	Dec. 31, 2022	Jan. 31, 2021	Dec. 31, 2023
Business Acquisition [Line Items]
Goodwill				$ 4,073.0		$ 4,939.7
Biopharma Global Inc
Business Acquisition [Line Items]
Cash	$ 302.7
Acquired IPR&D	196.0
Goodwill	859.1
Other assets and liabilities, net	(19.3)
Acquisition date fair value of consideration transferred	1,338.5
Cash acquired	(302.7)
Cash paid, net of cash acquired	$ 1,035.8
Akouos Acquisition
Business Acquisition [Line Items]
Cash		$ 153.2
Acquired IPR&D		184.0
Goodwill		185.6
Other assets and liabilities, net		24.5
Acquisition date fair value of consideration transferred		547.3
Cash acquired		(153.2)
Fair value of CVR liability		$ (66.9)
Cash paid, net of cash acquired				$ 327.2
Prevail Therapeutics Inc.
Business Acquisition [Line Items]
Cash			$ 90.5
Acquired IPR&D			824.0
Goodwill			126.8
Deferred tax liabilities			(106.0)
Other assets and liabilities, net			(31.5)
Acquisition date fair value of consideration transferred			903.8
Cash acquired			(90.5)
Fair value of CVR liability			(65.9)
Cash paid, net of cash acquired			$ 747.4		$ 747.4

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Revenue (Note 2)	$ 34,124.1	$ 28,541.4	$ 28,318.4
Costs, expenses, and other:
Cost of sales	7,082.2	6,629.8	7,312.8
Research and development	9,313.4	7,190.8	6,930.7
Marketing, selling, and administrative	7,403.1	6,440.4	6,431.6
Acquired in-process research and development (Note 3)	3,799.8	908.5	970.1
Asset impairment, restructuring, and other special charges (Note 5)	67.7	244.6	316.1
Other—net, (income) expense (Note 18)	(96.7)	320.9	201.6
Costs, expenses, and other	27,569.5	21,735.0	22,162.9
Income before income taxes	6,554.6	6,806.4	6,155.5
Income taxes (Note 14)	1,314.2	561.6	573.8
Net income	$ 5,240.4	$ 6,244.8	$ 5,581.7
Earnings per share:
Basic (in dollars per share)	$ 5.82	$ 6.93	$ 6.15
Diluted (in dollars per share)	$ 5.80	$ 6.90	$ 6.12
Shares used in calculation of earnings per share:
Basic (in shares)	900,181	901,736	906,963
Diluted (in shares)	903,284	904,619	911,681

Collaborations and Other Arrangements

12 Months Ended

Dec. 31, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Collaborations and Other Arrangements

We often enter into collaborative and other arrangements to develop and commercialize drug candidates or to sell the rights of a product. See Note 2 for a discussion of our recognition of revenue from our collaborations and other arrangements.

Collaborative activities may include research and development, marketing and selling, manufacturing, and distribution for which we may receive from or pay to the collaboration partner expense reimbursements. Operating expenses for costs incurred pursuant to these arrangements are reported in their respective expense line item, net of any payments due to or reimbursements due from our collaboration partners, with such reimbursements being recognized at the time the party becomes obligated to pay. Each arrangement is unique in nature, and our more significant arrangements are discussed below.

Boehringer Ingelheim Diabetes Collaboration

We and Boehringer Ingelheim have a global agreement to jointly develop and commercialize a portfolio of diabetes compounds. Currently included in the collaboration are Boehringer Ingelheim's oral diabetes products: Jardiance, Glyxambi, Synjardy, Trijardy XR, Trajenta, and Jentadueto® as well as our basal insulins, Basaglar and Rezvoglar. Glyxambi, Synjardy, and Trijardy XR are included in the Jardiance product family. Jentadueto is included in the Trajenta product family. Rezvoglar is included in the Basaglar product family.

In connection with the regulatory approvals of Jardiance, Trajenta, and Basaglar in the U.S., Europe, and Japan, milestone payments made for Jardiance and Trajenta were capitalized as intangible assets and are being amortized to cost of sales, and milestone payments received for Basaglar were recorded as contract liabilities and are being amortized to collaboration and other revenue. Net milestones capitalized with respect to Jardiance and Trajenta and net milestones deferred with respect to Basaglar are not material.

For the Jardiance product family, we and Boehringer Ingelheim generally share equally the ongoing development and commercialization costs in the most significant markets, and we record our portion of the development and commercialization costs as research and development expense and marketing, selling, and administrative expense, respectively. We receive a royalty on net sales of Boehringer Ingelheim's products in the most significant markets and recognize the royalty as collaboration and other revenue. Boehringer Ingelheim is entitled to potential performance payments depending on the net sales of the Jardiance product family; therefore, our reported revenue for Jardiance may be reduced by any potential performance payments we make related to this product family. The royalty received by us related to the Jardiance product family may also be increased or decreased depending on whether net sales for this product family exceed or fall below certain thresholds. We pay to Boehringer Ingelheim a royalty on net sales for the Basaglar product family in the U.S. We record our sales of the Basaglar product family to third parties as net product revenue with the royalty payments made to Boehringer Ingelheim recorded as cost of sales. The following table summarizes our revenue recognized:


	2023		2022		2021
Jardiance	$	2,744.7	$	2,066.0	$	1,490.8
Basaglar	728.3		760.4		892.5
Trajenta	386.9		383.7		372.5

Olumiant

We have a worldwide license and collaboration agreement with Incyte Corporation (Incyte), which provides us the development and commercialization rights to baricitinib, which is branded and trademarked as Olumiant, and certain follow-on compounds, for the treatment of inflammatory and autoimmune diseases and COVID-19. Incyte has the right to receive tiered, double digit royalty payments on worldwide net sales with rates ranging up to 20 percent. Incyte has the right to receive an additional royalty ranging up to the low teens on worldwide net sales for the treatment of COVID-19 that exceed a specified aggregate worldwide net sales threshold. The agreement calls for payments by us to Incyte associated with certain development, success-based regulatory, and sales-based milestones.

In connection with the regulatory approvals of Olumiant in the U.S., Europe, and Japan, as well as achievement of a sales-based milestone, milestone payments were capitalized as intangible assets and are being amortized to cost of sales through the term of the collaboration. Net milestones capitalized are not material. As of December 31, 2023, Incyte is eligible to receive up to $100.0 million of additional payments from us in potential sales-based milestones.

We record our sales of Olumiant, including sales of baricitinib that were made pursuant to EUA or similar regulatory authorizations, to third parties as net product revenue with the royalty payments made to Incyte recorded as cost of sales. The following table summarizes our net product revenue recognized:


	2023		2022		2021
Olumiant	$	922.6	$	830.5	$	1,115.1

Tyvyt

We have a collaboration agreement with Innovent Biologics, Inc. (Innovent) to jointly develop and commercialize sintilimab injection in China, where it is branded and trademarked as Tyvyt. We record our sales of Tyvyt to third parties as net product revenue, with payments made to Innovent for its portion of the gross margin reported as cost of sales. We report as collaboration and other revenue our portion of the gross margin for Tyvyt sales made by Innovent to third parties. The following table summarizes our revenue recognized:


	2023		2022		2021
Tyvyt	$	393.4	$	293.3	$	418.1

Ebglyss®

We have a license agreement with F. Hoffmann-La Roche Ltd and Genentech, Inc. (collectively, Roche), which provides us the worldwide development and commercialization rights to lebrikizumab, which is branded and trademarked as Ebglyss. Roche receives tiered royalty payments on worldwide net sales ranging in percentages from high single digits to high teens, which we recognize as cost of sales. As of December 31, 2023, Roche is eligible to receive additional payments from us, including up to $115.0 million contingent upon the achievement of additional success-based regulatory milestones and up to $1.03 billion in potential sales-based milestones. During the years ended December 31, 2023 and 2022, milestone payments to Roche were not material. There were no milestone payments to Roche during the year ended December 31, 2021.

We have a license agreement with Almirall, S.A. (Almirall), under which Almirall licensed the rights to develop and commercialize lebrikizumab for the treatment or prevention of dermatology indications, including, but not limited to, atopic dermatitis in Europe. We receive tiered royalty payments on net sales in Europe ranging in percentages from low double digits to low twenties, which we recognize as collaboration and other revenue. During the years ended December 31, 2023, 2022, and 2021, collaboration and other revenue recognized under this license agreement was not material. As of December 31, 2023, we are eligible to receive additional payments up to $1.25 billion in a series of sales-based milestones.

Orforglipron

We have a license agreement with Chugai Pharmaceutical Co., Ltd (Chugai), which provides us with the worldwide development and commercialization rights to orforglipron. Chugai has the right to receive tiered royalty payments on future worldwide net sales from mid single digits to low teens if the product is successfully commercialized. As of December 31, 2023, Chugai is eligible to receive up to $140.0 million contingent upon the achievement of success-based regulatory milestones and up to $250.0 million in a series of sales-based milestones, contingent upon the commercial success of orforglipron. During the years ended December 31, 2023, 2022, and 2021, milestone payments to Chugai were not material.

COVID-19 Antibodies

We have a worldwide license and collaboration agreement with AbCellera Biologics Inc. (AbCellera) to co-develop therapeutic antibodies for the potential prevention and treatment of COVID-19, including bamlanivimab and bebtelovimab, for which we hold development and commercialization rights. AbCellera received royalty payments, recorded as cost of sales, in the mid-teens to mid-twenties on worldwide net sales of bamlanivimab and bebtelovimab.

Pursuant to EUAs or similar regulatory authorizations, we recognized net product revenue associated with our sales of our COVID-19 antibodies of $2.02 billion and $2.24 billion during the years ended December 31, 2022 and 2021, respectively. We had no sales of our COVID-19 antibodies during the year ended December 31, 2023.

Divestitures

Olanzapine Portfolio (including Zyprexa)

In July 2023, we sold the rights for the olanzapine portfolio, including Zyprexa, to Cheplapharm Arzneimittel GmbH (Cheplapharm), a European company. Under the terms of the agreement, we received $1.05 billion in cash and will receive an additional $305.0 million in cash upon the one year anniversary of closing. We included both in the transaction price as of December 31, 2023. We are eligible to receive milestone payments of up to $50.0 million, of which $25.0 million has not been included in the transaction price as of December 31, 2023.

We entered into a supply agreement with Cheplapharm that obligates Cheplapharm to purchase Zyprexa product we are manufacturing at an amount which represents a standalone selling price. As the product we are manufacturing under this supply agreement has no alternative use to us and we have right to payment, we recognize net product revenue over time as we manufacture the product.

During the year ended December 31, 2023, we recognized $1.45 billion in revenue primarily related to the net gain on the sale of rights for the olanzapine portfolio.

Baqsimi

In June 2023, we sold the rights for Baqsimi to Amphastar Pharmaceuticals, Inc. (Amphastar). Under the terms of the agreement, we received $500.0 million in cash and will receive an additional $125.0 million in cash upon the one year anniversary of closing. We included both in the transaction price as of December 31, 2023. We are eligible to receive payments of up to $450.0 million in a series of sales-based milestones, that have not been included in the transaction price as of December 31, 2023.

We entered into a supply agreement with Amphastar that obligates Amphastar to purchase Baqsimi product we are manufacturing at an amount which represents a standalone selling price. As the product we are manufacturing under this supply agreement has no alternative use to us and we have right to payment, we recognize net product revenue over time as we manufacture the product.

During the year ended December 31, 2023, we recognized $579.0 million in revenue primarily related to the net gain on the sale of rights for Baqsimi.

Stock-Based Compensation

12 Months Ended

Dec. 31, 2023

Share-Based Payment Arrangement [Abstract]

Stock-Based Compensation

Our stock-based compensation expense consists of performance awards (PAs), shareholder value awards (SVAs), relative value awards (RVAs), and restricted stock units (RSUs). We recognize the fair value of stock-based compensation as expense over the requisite service period of the individual grantees, which generally equals the vesting period. We provide newly issued shares of our common stock and treasury stock to satisfy the issuance of PA, SVA, RVA, and RSU shares.

Stock-based compensation expense and the related tax benefits were as follows:


	2023		2022		2021
Stock-based compensation expense	$	628.5	$	371.1	$	342.8
Tax benefit	132.0		77.9		72.0

At December 31, 2023, stock-based compensation awards may be granted under the 2002 Lilly Stock Plan for not more than 49.1 million additional shares.

Performance Award Program

PAs are granted to officers and management and are payable in shares of our common stock. The number of PA shares actually issued, if any, varies depending on the achievement of certain pre-established earnings-per-share targets over a two-year period. PA shares are accounted for at fair value based upon the closing stock price on the date of grant and fully vest at the end of the measurement period. The fair values of PAs granted for the years ended December 31, 2023, 2022, and 2021 were $335.86, $234.93, and $198.57, respectively. The number of shares ultimately issued for the PA program is dependent upon the EPS achieved during the vesting period. Pursuant to this program, approximately 0.5 million, 0.7 million, and 0.7 million shares were issued during the years ended December 31, 2023, 2022, and 2021, respectively. Approximately 0.4 million shares are expected to be issued in 2024. As of December 31, 2023, the total estimated remaining unrecognized compensation cost related to nonvested PAs was $111.6 million, which will be amortized over the weighted-average remaining requisite service period of 12 months.

Shareholder Value Award Program

SVAs are granted to officers and management and are payable in shares of our common stock. The number of shares actually issued, if any, varies depending on our stock price at the end of the three-year vesting period compared to pre-established target stock prices. We measure the fair value of the SVA unit on the grant date using a Monte Carlo simulation model. The model utilizes multiple input variables that determine the probability of satisfying the market condition stipulated in the award grant and calculates the fair value of the award. Expected volatilities utilized in the model are based on implied volatilities from traded options on our stock, historical volatility of our stock price, and other factors. Similarly, the dividend yield is based on historical experience and our estimate of future dividend yields. The risk-free interest rate is derived from the U.S. Treasury yield curve in effect at the time of grant. The weighted-average fair values of the SVA units granted during the years ended December 31, 2023, 2022, and 2021 were $349.63, $203.88, and $230.19, respectively, determined using the following assumptions:


	2023		2022		2021
Expected dividend yield	1.07	%	1.60	%	2.50	%
Risk-free interest rate	4.08		1.57		0.19
Volatility	29.87		32.99		31.42

Pursuant to this program, approximately 0.3 million, 0.5 million, and 1.0 million shares were issued during the years ended December 31, 2023, 2022, and 2021, respectively. Approximately 0.2 million shares are expected to be issued in 2024. As of December 31, 2023, the total estimated remaining unrecognized compensation cost related to nonvested SVAs was $51.1 million, which will be amortized over the weighted-average remaining requisite service period of 21 months.

Relative Value Award Program

RVAs are granted to officers and management and are payable in shares of our common stock. The number of shares actually issued, if any, varies depending on the growth of our stock price at the end of the three-year vesting period compared to our peers. We measure the fair value of the RVA unit on the grant date using a Monte Carlo simulation model. The model utilizes multiple input variables that determine the probability of satisfying the market condition stipulated in the award grant and calculates the fair value of the award. Expected volatilities utilized in the model are based on implied volatilities from traded options on our stock, historical volatility of our stock price and our peers' stock price, and other factors. Similarly, the dividend yield is based on historical experience and our estimate of future dividend yields. The risk-free interest rate is derived from the U.S. Treasury yield curve in effect at the time of grant. The weighted-average fair value of the RVA units granted during the years ended December 31, 2023, 2022 and 2021 were $397.95, $230.00, and $286.71, respectively, determined using the following assumptions:


	2023		2022		2021
Expected dividend yield	1.07	%	1.60	%	2.50	%
Risk-free interest rate	4.08		1.57		0.19
Volatility	31.25		32.86		30.95

Pursuant to this program, approximately 0.1 million shares were issued during the year ended December 31, 2023. Approximately 0.1 million shares are expected to be issued in 2024. As of December 31, 2023, the total estimated remaining unrecognized compensation cost related to nonvested RVAs was $21.1 million, which will be amortized over the weighted-average remaining requisite service period of 22 months.

Restricted Stock Units

RSUs are granted to certain employees and are payable in shares of our common stock. RSU shares are accounted for at fair value based upon the closing stock price on the date of grant. The corresponding expense is amortized over the vesting period, typically three years. The weighted-average fair values of RSU awards granted during the years ended December 31, 2023, 2022, and 2021 were $339.30, $239.88, and $196.30, respectively. The number of shares ultimately issued for the RSU program remains constant with the exception of forfeitures. Pursuant to this program, 1.0 million, 1.0 million, and 0.7 million shares were granted and approximately 0.5 million, 0.8 million, and 0.6 million shares were issued during the years ended December 31, 2023, 2022, and 2021, respectively. Approximately 0.4 million shares are expected to be issued in 2024. As of December 31, 2023, the total estimated remaining unrecognized compensation cost related to nonvested RSUs was $275.3 million, which will be amortized over the weighted-average remaining requisite service period of 22 months.

Financial Instruments (Schedule of Short-term and Long-term Classification) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Short-term commercial paper borrowings	$ (6,189.4)	$ (1,498.0)
Long-term debt, including current portion	(19,104.6)	(14,815.3)
Carrying Amount
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Long-term debt, including current portion	(19,035.9)	(14,740.6)
Carrying Amount \| Commercial Paper
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Short-term commercial paper borrowings	(6,189.4)	(1,498.0)
Estimate of Fair Value Measurement
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Long-term debt, including current portion	(17,221.7)	(12,329.3)
Estimate of Fair Value Measurement \| Commercial Paper
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Short-term commercial paper borrowings	(6,166.4)	(1,492.0)
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Estimate of Fair Value Measurement
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Long-term debt, including current portion	0.0	0.0
Quoted Prices in Active Markets for Identical Assets (Level 1) \| Estimate of Fair Value Measurement \| Commercial Paper
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Short-term commercial paper borrowings	0.0	0.0
Significant Other Observable Inputs (Level 2) \| Estimate of Fair Value Measurement
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Long-term debt, including current portion	(17,221.7)	(12,329.3)
Significant Other Observable Inputs (Level 2) \| Estimate of Fair Value Measurement \| Commercial Paper
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Short-term commercial paper borrowings	(6,166.4)	(1,492.0)
Significant Unobservable Inputs (Level 3) \| Estimate of Fair Value Measurement
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Long-term debt, including current portion	0.0	0.0
Significant Unobservable Inputs (Level 3) \| Estimate of Fair Value Measurement \| Commercial Paper
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Short-term commercial paper borrowings	$ 0.0	$ 0.0

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

+ References + Details

Other Comprehensive Income (Loss) (Schedule of Reclassifications Out of Accumulated Other Comprehensive Loss) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Other, net (income) expense	$ (32.7)	$ (14.3)	$ 51.4
Total before tax	6,554.6	6,806.4	6,155.5
Tax benefit	(1,314.2)	(561.6)	(573.8)
Reclassification out of Accumulated Other Comprehensive Income
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Total reclassifications for the period, net of tax	35.8	250.8	357.9
Amortization of retirement benefit items \| Reclassification out of Accumulated Other Comprehensive Income
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Total before tax	65.7	290.9	435.5
Tax benefit	(13.8)	(61.1)	(91.5)
Total reclassifications for the period, net of tax	51.9	229.8	344.0
Prior service benefits, net \| Reclassification out of Accumulated Other Comprehensive Income
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Other, net (income) expense	(50.5)	(52.4)	(55.4)
Actuarial losses \| Reclassification out of Accumulated Other Comprehensive Income
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Other, net (income) expense	116.2	343.3	490.9
Other, net of tax \| Reclassification out of Accumulated Other Comprehensive Income
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Other, net (income) expense	$ (16.1)	$ 21.0	$ 13.9

Cover Page - USD ($) $ in Millions	12 Months Ended
Cover Page - USD ($) $ in Millions	Dec. 31, 2023	Feb. 16, 2024	Jun. 30, 2023
Document Information [Line Items]
Document Type	10-K
Document Period End Date	Dec. 31, 2023
Current Fiscal Year End Date	--12-31
Entity File Number	001-06351
Entity Registrant Name	ELI LILLY AND COMPANY
Entity Incorporation, State or Country Code	IN
Entity Tax Identification Number	35-0470950
Entity Address, Address Line One	Lilly Corporate Center
Entity Address, City or Town	Indianapolis
Entity Address, State or Province	IN
Entity Address, Postal Zip Code	46285
City Area Code	317
Local Phone Number	276-2000
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction Flag	false
Entity Shell Company	false
Entity Public Float			$ 398,291
Entity Common Stock, Shares Outstanding		950,164,452
Documents Incorporated by Reference	Portions of the Registrant's Proxy Statement for the 2024 Annual Meeting of Shareholders have been incorporated by reference into Part III of this Annual Report on Form 10-K.
Document Annual Report	true
Document Transition Report	false
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Entity Central Index Key	0000059478
Common Stock (no par value)
Document Information [Line Items]
Title of 12(b) Security	Common Stock (no par value)
Trading Symbol	LLY
Security Exchange Name	NYSE
7 1/8% Notes due 2025
Document Information [Line Items]
Title of 12(b) Security	7 1/8% Notes due 2025
Trading Symbol	LLY25
Security Exchange Name	NYSE
1.625% Notes due 2026
Document Information [Line Items]
Title of 12(b) Security	1.625% Notes due 2026
Trading Symbol	LLY26
Security Exchange Name	NYSE
2.125% Notes due 2030
Document Information [Line Items]
Title of 12(b) Security	2.125% Notes due 2030
Trading Symbol	LLY30
Security Exchange Name	NYSE
0.625% Notes due 2031
Document Information [Line Items]
Title of 12(b) Security	0.625% Notes due 2031
Trading Symbol	LLY31
Security Exchange Name	NYSE
0.500% Notes due 2033
Document Information [Line Items]
Title of 12(b) Security	0.500% Notes due 2033
Trading Symbol	LLY33
Security Exchange Name	NYSE
6.77% Notes due 2036
Document Information [Line Items]
Title of 12(b) Security	6.77% Notes due 2036
Trading Symbol	LLY36
Security Exchange Name	NYSE
1.625% Notes due 2043
Document Information [Line Items]
Title of 12(b) Security	1.625% Notes due 2043
Trading Symbol	LLY43
Security Exchange Name	NYSE
1.700% Notes due 2049
Document Information [Line Items]
Title of 12(b) Security	1.700% Notes due 2049
Trading Symbol	LLY49A
Security Exchange Name	NYSE
1.125% Notes due 2051
Document Information [Line Items]
Title of 12(b) Security	1.125% Notes due 2051
Trading Symbol	LLY51
Security Exchange Name	NYSE
1.375% Notes due 2061
Document Information [Line Items]
Title of 12(b) Security	1.375% Notes due 2061
Trading Symbol	LLY61
Security Exchange Name	NYSE

Retirement Benefits (Schedule of Weighted Average Assumptions) (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Defined Benefit Pension Plans
Weighted-average assumptions used to determine net periodic benefit costs:
Discount rate	5.10%	2.80%	2.40%
Rate of compensation increase	4.30%	3.50%	3.30%
Expected return on plan assets	8.10%	8.10%	6.80%
Weighted-average assumptions used to determine benefit obligation as of December 31:
Discount rate	4.80%	5.10%	2.80%
Rate of compensation increase	4.30%	4.30%	3.50%
Retiree Health Benefit Plans
Weighted-average assumptions used to determine net periodic benefit costs:
Discount rate	5.20%	3.00%	2.60%
Expected return on plan assets	7.30%	7.30%	5.00%
Weighted-average assumptions used to determine benefit obligation as of December 31:
Discount rate	5.00%	5.20%	3.00%

Financial Instruments (Schedule of Contractual Maturities) (Details) $ in Millions	Dec. 31, 2023 USD ($)
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Total	$ 657.2
Less Than 1 Year	84.1
1-5 Years	227.9
6-10 Years	98.4
More Than 10 Years	$ 246.8

Financial Instruments (Schedule of Effect of Risk Management) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash flow hedges:
Total	$ (68.7)	$ 216.4	$ 263.0
Hedged Fixed Rate Debt
Cash flow hedges:
Effective portion of risk-management instruments that was recognized in other comprehensive income (loss)	(219.9)	324.9	435.0
Cross-currency interest rate swaps
Cash flow hedges:
Effective portion of risk-management instruments that was recognized in other comprehensive income (loss)	(27.4)	52.0	213.7
Effective portion of risk-management instruments that was recognized in other comprehensive income (loss)	15.2	29.8	42.3
Foreign Exchange Contract
Cash flow hedges:
Effective portion of risk-management instruments that was recognized in other comprehensive income (loss)	(107.1)	(15.4)	0.0
Forward-starting interest rate swaps
Cash flow hedges:
Effective portion of risk-management instruments that was recognized in other comprehensive income (loss)	85.6	391.5	97.6
Designated as Hedging Instrument \| Hedged Fixed Rate Debt
Fair value hedges:
Effect from hedged fixed-rate debt	31.5	(209.8)	(78.5)
Designated as Hedging Instrument \| Interest Rate Contract
Fair value hedges:
Effect from interest rate contracts	(31.5)	209.8	78.5
Cash flow hedges:
Effective portion of losses on interest rate contracts reclassified from accumulated other comprehensive loss	13.5	16.5	16.6
Designated as Hedging Instrument \| Cross-currency interest rate swaps
Cash flow hedges:
Effective portion of losses on interest rate contracts reclassified from accumulated other comprehensive loss	(108.6)	8.6	41.8
Not Designated as Hedging Instrument \| Foreign Exchange Contract
Cash flow hedges:
Net losses on foreign currency exchange contracts not designated as hedging instruments	$ 26.4	$ 191.3	$ 204.6

Retirement Benefits (Tables)

12 Months Ended

Dec. 31, 2023

Retirement Benefits [Abstract]

Schedule of Changes in Accumulated Postemployment Benefit Obligations


	Defined Benefit Pension Plans				Retiree Health Benefit Plans
	2023		2022		2023		2022
Change in benefit obligation:
Benefit obligation at beginning of year	$	13,222.0	$	17,565.0	$	1,258.8	$	1,663.8
Service cost	290.4		351.7		31.8		46.6
Interest cost	648.2		398.1		61.3		37.8
Actuarial (gain) loss	590.5		(4,158.9)		34.5		(395.9)
Benefits paid	(610.5)		(608.9)		(80.6)		(86.8)


Foreign currency exchange rate changes and other adjustments	117.3		(325.0)		4.5		(6.7)
Benefit obligation at end of year	14,257.9		13,222.0		1,310.3		1,258.8
Change in plan assets:
Fair value of plan assets at beginning of year	13,195.8		16,416.0		2,492.5		3,361.4
Actual return on plan assets	881.9		(2,388.1)		166.8		(796.0)
Employer contribution	120.6		118.1		1.7		13.9
Benefits paid	(610.5)		(608.9)		(80.6)		(86.8)
Foreign currency exchange rate changes and other adjustments	120.9		(341.3)		(0.1)		—
Fair value of plan assets at end of year	13,708.7		13,195.8		2,580.3		2,492.5

Funded status	(549.2)		(26.2)		1,270.0		1,233.7
Unrecognized net actuarial (gain) loss	3,357.9		2,687.2		109.6		54.5
Unrecognized prior service (benefit) cost	6.4		8.4		(9.5)		(62.2)
Net amount recognized	$	2,815.1	$	2,669.4	$	1,370.1	$	1,226.0


Amounts recognized in the consolidated balance sheet consisted of:
Other noncurrent assets	$	810.6	$	1,208.0	$	1,427.7	$	1,383.4
Other current liabilities	(70.4)		(70.4)		(8.3)		(8.4)
Accrued retirement benefits	(1,289.4)		(1,163.8)		(149.4)		(141.3)
Accumulated other comprehensive (income) loss before income taxes	3,364.3		2,695.6		100.1		(7.7)
Net amount recognized	$	2,815.1	$	2,669.4	$	1,370.1	$	1,226.0

Schedule of Assumptions Used

The following represents our weighted-average assumptions:


	Defined Benefit Pension Plans						Retiree Health Benefit Plans
	2023		2022		2021		2023		2022		2021
Weighted-average assumptions used to determine net periodic benefit costs:
Discount rate	5.1	%	2.8	%	2.4	%	5.2	%	3.0	%	2.6	%
Rate of compensation increase	4.3		3.5		3.3
Expected return on plan assets	8.1		8.1		6.8		7.3		7.3		5.0
Weighted-average assumptions used to determine benefit obligation as of December 31:
Discount rate	4.8	%	5.1	%	2.8	%	5.0	%	5.2	%	3.0	%
Rate of compensation increase	4.3		4.3		3.5

Schedule of Expected Benefit Payments

Expected benefit payments, which reflect expected future service, are as follows:


	2024		2025		2026		2027		2028		2029-2033
Defined benefit pension plans	$	661.2	$	671.4	$	695.0	$	722.5	$	746.5	$	4,160.7
Retiree health benefit plans	93.8		94.5		94.7		95.2		95.6		475.9

Schedule of Benefit Obligations in Excess of Fair Value of Plan Assets

Amounts relating to defined benefit pension plans with projected benefit obligations in excess of plan assets were as follows at December 31:


	2023		2022
Projected benefit obligation	$	2,395.3	$	2,211.2
Fair value of plan assets	1,035.4		977.1

Schedule of Accumulated Benefit Obligations in Excess of Fair Value of Plan Assets

Amounts relating to defined benefit pension plans and retiree health benefit plans with accumulated benefit obligations in excess of plan assets were as follows at December 31:


	Defined Benefit Pension Plans				Retiree Health Benefit Plans
	2023		2022		2023		2022
Accumulated benefit obligation	$	1,659.5	$	1,721.7	$	157.7	$	149.8
Fair value of plan assets	564.3		652.7		—		—

Schedule of Net Periodic (Benefit) Costs

Net periodic (benefit) cost included the following components:


	Defined Benefit Pension Plans						Retiree Health Benefit Plans
	2023		2022		2021		2023		2022		2021
Components of net periodic (benefit) cost:
Service cost	$	290.4	$	351.7	$	369.2	$	31.8	$	46.6	$	49.2
Interest cost	648.2		398.1		337.8		61.3		37.8		32.5
Expected return on plan assets	(1,055.0)		(947.6)		(949.3)		(182.1)		(152.1)		(146.2)
Amortization of prior service (benefit) cost	2.4		2.4		4.2		(52.9)		(54.8)		(59.6)
Recognized actuarial (gain) loss	122.0		342.4		487.7		(5.8)		0.9		3.2


Net periodic (benefit) cost	$	8.0	$	147.0	$	249.6	$	(147.7)	$	(121.6)	$	(120.9)

Schedule of Amounts Recognized in Other Comprehensive Income (Loss)

The following represents the amounts recognized in other comprehensive income (loss) for the years ended December 31, 2023, 2022, and 2021:


	Defined Benefit Pension Plans						Retiree Health Benefit Plans
	2023		2022		2021		2023		2022		2021
Actuarial gain (loss) arising during period	$	(763.9)	$	823.6	$	2,072.4	$	(49.8)	$	(552.2)	$	142.5


Amortization of prior service (benefit) cost included in net income	2.4		2.4		4.2		(52.9)		(54.8)		(59.6)
Amortization of net actuarial (gain) loss included in net income	122.0		342.4		487.7		(5.8)		0.9		3.2
Foreign currency exchange rate changes and other	(29.2)		55.5		47.2		0.7		(0.9)		1.9
Total other comprehensive income (loss) during period	$	(668.7)	$	1,223.9	$	2,611.5	$	(107.8)	$	(607.0)	$	88.0

Schedule of Allocation of Plan Assets

The fair values of our defined benefit pension plan and retiree health plan assets as of December 31, 2023 by asset category were as follows:


			Fair Value Measurements Using
Asset Class	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Investments Valued at Net Asset Value(1)
Defined Benefit Pension Plans
Public equity securities:
U.S.	$	1,379.7	$	490.5	$	0.3	$	—	$	888.9
International	1,408.9		441.2		333.4		—		634.3
Fixed income:
Developed markets	2,783.9		21.2		2,597.3		0.1		165.3
Developed markets - repurchase agreements	(772.8)		13.2		(786.0)		—		—
Emerging markets	295.6		10.4		35.7		—		249.5
Private alternative investments:
Hedge funds	3,125.9		—		—		—		3,125.9
Equity-like funds	4,093.7		—		—		25.1		4,068.6
Real estate	369.7		261.9		—		—		107.8
Other	1,024.1		170.8		42.6		—		810.7
Total	$	13,708.7	$	1,409.2	$	2,223.3	$	25.2	$	10,051.0

Retiree Health Benefit Plans
Public equity securities:
U.S.	$	127.0	$	44.2	$	—	$	—	$	82.8
International	89.9		38.2		—		—		51.7
Fixed income:
Developed markets	74.9		—		74.9		—		—
Emerging markets	23.4		—		—		—		23.4
Private alternative investments:
Hedge funds	281.2		—		—		—		281.2
Equity-like funds	335.1		—		—		2.4		332.7
Cash value of trust owned insurance contract	1,526.5		—		1,526.5		—		—
Real estate	24.5		24.5		—		—		—
Other	97.8		23.2		2.1		—		72.5
Total	$	2,580.3	$	130.1	$	1,603.5	$	2.4	$	844.3

(1) Certain investments that are measured at fair value using the NAV per share (or its equivalent) as a practical expedient have not been classified in the fair value hierarchy.

The fair values of our defined benefit pension plan and retiree health plan assets as of December 31, 2022 by asset category were as follows:


			Fair Value Measurements Using
Asset Class	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)		Investments Valued at Net Asset Value(1)
Defined Benefit Pension Plans
Public equity securities:
U.S.	$	1,132.4	$	396.6	$	0.1	$	—	$	735.7
International	1,177.1		369.4		300.9		—		506.8
Fixed income:
Developed markets	2,445.5		19.8		2,058.2		0.1		367.4
Developed markets - repurchase agreements	(706.6)		6.4		(713.0)		—		—
Emerging markets	273.5		10.6		32.0		—		230.9
Private alternative investments:
Hedge funds	3,249.0		—		—		—		3,249.0
Equity-like funds	4,014.1		—		—		25.4		3,988.7
Real estate	349.1		234.9		—		—		114.2
Other	1,261.7		251.0		(131.8)		—		1,142.5
Total	$	13,195.8	$	1,288.7	$	1,546.4	$	25.5	$	10,335.2

Retiree Health Benefit Plans
Public equity securities:
U.S.	$	104.2	$	35.7	$	—	$	—	$	68.5
International	72.0		31.9		—		—		40.1
Fixed income:
Developed markets	63.1		—		63.1		—		—
Emerging markets	21.0		—		—		—		21.0
Private alternative investments:
Hedge funds	294.9		—		—		—		294.9
Equity-like funds	332.8		—		—		2.4		330.4
Cash value of trust owned insurance contract	1,470.8		—		1,470.8		—		—
Real estate	21.6		21.6		—		—		—
Other	112.1		24.2		(19.9)		—		107.8
Total	$	2,492.5	$	113.4	$	1,514.0	$	2.4	$	862.7

(1) Certain investments that are measured at fair value using the NAV per share (or its equivalent) as a practical expedient have not been classified in the fair value hierarchy.

Leases (Narrative) (Details) - USD ($) $ in Millions	12 Months Ended
Leases (Narrative) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Leases [Abstract]
Remaining lease term (up to)	16 years
Lease expense	$ 171.2	$ 148.8	$ 159.4

Stock-Based Compensation (Narrative) (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares available for grant (in shares)	49.1
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	2 years
Weighted average grant date fair value (in dollars per share)	$ 335.86	$ 234.93	$ 198.57
Shares issued in period (in shares)	0.5	0.7	0.7
Shares expected to be issued (in shares)	0.4
Total compensation cost not yet recognized	$ 111.6
Period for recognition of the compensation cost not yet recognized	12 months
Shareholder Value Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
Weighted average grant date fair value (in dollars per share)	$ 349.63	$ 203.88	$ 230.19
Shares issued in period (in shares)	0.3	0.5	1.0
Shares expected to be issued (in shares)	0.2
Total compensation cost not yet recognized	$ 51.1
Period for recognition of the compensation cost not yet recognized	21 months
Relative Value Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
Weighted average grant date fair value (in dollars per share)	$ 397.95	$ 230.00	$ 286.71
Shares issued in period (in shares)	0.1
Shares expected to be issued (in shares)	0.1
Total compensation cost not yet recognized	$ 21.1
Period for recognition of the compensation cost not yet recognized	22 months
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
Weighted average grant date fair value (in dollars per share)	$ 339.30	$ 239.88	$ 196.30
Shares issued in period (in shares)	0.5	0.8	0.6
Shares expected to be issued (in shares)	0.4
Total compensation cost not yet recognized	$ 275.3
Period for recognition of the compensation cost not yet recognized	22 months
Grants in period (in shares)	1.0	1.0	0.7

Summary of Significant Accounting Policies and Implementation of New Financial Accounting Standards (Policies)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Research and Development Expense	Research and Development Expenses and Acquired In-Process Research and Development (IPR&D) Research and development costs are expensed as incurred. Research and development costs consist of expenses incurred in performing research and development activities, including but not limited to, compensation and benefits, facilities and overhead expense, clinical trial expense and fees paid to contract research organizations.
Acquired In-Process Research and Development (IPR&D)	Acquired IPR&D includes the initial costs and development milestones incurred related to externally developed IPR&D projects, acquired directly in a transaction other than a business combination, that do not have an alternative future use. Development milestones are milestone payment obligations that are incurred prior to regulatory approval of the compound and are expensed when the event triggering an obligation to pay the milestone occurs.
Earnings Per Share (EPS)	Earnings Per Share (EPS) All per-share amounts, unless otherwise noted in the footnotes, are presented on a diluted basis. We calculate basic EPS based on the weighted-average number of common shares outstanding plus the effect of incremental shares from potential participating securities. We calculate diluted EPS based on the weighted-average number of common shares outstanding plus the effect of incremental shares from our stock-based compensation programs.
Foreign Currency Translation	Foreign Currency Translation Operations in our subsidiaries outside the United States (U.S.) are recorded in the functional currency of each subsidiary which is determined by a review of the environment where each subsidiary primarily generates and expends cash. The results of operations for our subsidiaries outside the U.S. are translated from functional currencies into U.S. dollars using the weighted-average currency rate for the period. Assets and liabilities are translated using the period end exchange rates. The U.S. dollar effects that arise from translating the net assets of these subsidiaries are recorded in other comprehensive income (loss).
Advertising Expenses	Advertising Expenses Costs associated with advertising are expensed as incurred and are included in marketing, selling, and administrative expenses.
Reclassifications	Reclassifications Certain reclassifications have been made to prior periods in the consolidated financial statements and accompanying notes to conform with the current presentation. Development milestone payments related to externally developed IPR&D projects, acquired directly in a transaction other than a business combination, were previously included in cash flows from operating activities in the consolidated statements of cash flows and are now included in purchases of IPR&D in cash flows from investing activities.
Implementation of New Financial Accounting Standards	Implementation of New Financial Accounting Standards Accounting Standards Update (ASU) 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, establishes incremental disaggregation of income tax disclosures pertaining to the effective tax rate reconciliation and income taxes paid. This standard is effective for fiscal years beginning after December 15, 2024, and requires prospective application with the option to apply it retrospectively. Early adoption is permitted. We intend to adopt this standard in our Annual Report on Form 10-K for the year ended December 31, 2025. We are currently evaluating the potential impact of adopting this standard on our disclosures. ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, requires disclosures about significant segment expenses and additional interim disclosure requirements. This standard also requires a single reportable segment to provide all disclosures required by ASC 280. This standard is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted, and the amendments should be applied retrospectively for all prior periods presented in the consolidated financial statements. We intend to adopt this standard in our Annual Report on Form 10-K for the year ended December 31, 2024. We are currently evaluating the potential impact of adopting this standard on our disclosures.
Business Combinations	Under this method, the assets acquired and liabilities assumed were recorded at their respective fair values as of the acquisition date in our consolidated financial statements. The determination of estimated fair value required management to make significant estimates and assumptions. The excess of the purchase price over the fair value of the acquired net assets, where applicable, has been recorded as goodwill. The results of operations of these acquisitions have been included in our consolidated financial statements from the date of acquisition.Upon each acquisition, the cost allocated to acquired IPR&D was immediately expensed as acquired IPR&D if the compound has no alternative future use.
Inventories	We use the last-in, first-out (LIFO) method for the majority of our inventories located in the continental U.S. Other inventories are valued by the first-in, first-out (FIFO) method. FIFO cost approximates current replacement cost.
Investment	Our equity investments are accounted for using three different methods depending on the type of equity investment: •Investments in companies over which we have significant influence but not a controlling interest are accounted for using the equity method, with our share of earnings or losses reported in other-net, (income) expense. •For equity investments that do not have readily determinable fair values, we measure these investments at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions for the identical or similar investment of the same issuer. Any change in recorded value is recorded in other-net, (income) expense. •Our public equity investments are measured and carried at fair value. Any change in fair value is recognized in other-net, (income) expense. We adjust our equity investments without readily determinable fair values based upon changes in the equity instruments' values resulting from observable price changes in orderly transactions for an identical or similar investment of the same issuer. Downward adjustments resulting from an impairment are recorded based upon impairment considerations, including the financial condition and near-term prospects of the issuer, general market conditions, and industry specific factors.We record our available-for-sale debt securities at fair value, with changes in fair value reported as a component of accumulated other comprehensive income (loss). We periodically assess our investment in available-for-sale securities for impairment losses and credit losses. The amount of credit losses are determined by comparing the difference between the present value of future cash flows expected to be collected on these securities and the amortized cost. Factors considered in assessing credit losses include the position in the capital structure, vintage and amount of collateral, delinquency rates, current credit support, and geographic concentration.
Concentration Risk, Credit Risk	Financial instruments that potentially subject us to credit risk consist principally of trade receivables and interest-bearing investments. Wholesale distributors of life science products account for a substantial portion of our trade receivables; collateral is generally not required. We seek to mitigate the risk associated with this concentration through our ongoing credit-review procedures and insurance. The majority of our cash is held by a few major financial institutions that have been identified as Global Systemically Important Banks (G-SIBs) by the Financial Stability Board. G-SIBs are subject to rigorous regulatory testing and oversight and must meet certain capital requirements. We monitor our exposures with these institutions and do not expect any of these institutions to fail to meet their obligations. In accordance with documented corporate risk-management policies, we monitor the amount of credit exposure to any one financial institution or corporate issuer based on credit rating of our counterparty. We are exposed to credit-related losses in the event of nonperformance by counterparties to risk-management instruments but do not expect significant counterparties to fail to meet their obligations given their investment grade credit ratings.
Derivatives	Our derivative activities are initiated within the guidelines of documented corporate risk-management policies and are intended to offset losses and gains on the assets, liabilities, and transactions being hedged. Management reviews the correlation and effectiveness of our derivatives on a quarterly basis. For derivative instruments that are designated and qualify as fair value hedges, the derivative instrument is marked to market, with gains and losses recognized currently in income to offset the respective losses and gains recognized on the underlying exposure. For derivative instruments that are designated and qualify as cash flow hedges, gains and losses are reported as a component of accumulated other comprehensive income (loss) (see Note 17) and reclassified into earnings in the same period the hedged transaction affects earnings. For derivative and non-derivative instruments that are designated and qualify as net investment hedges, the foreign currency translation gains or losses due to spot rate fluctuations are reported as a component of accumulated other comprehensive income (loss) (see Note 17). Derivative contracts that are not designated as hedging instruments are recorded at fair value with the gain or loss recognized in earnings during the period of change. We may enter into foreign currency forward or option contracts to reduce the effect of fluctuating currency exchange rates (primarily the euro, Chinese yuan, and Japanese yen). Foreign currency derivatives used for hedging are put in place using the same or like currencies and duration as the underlying exposures. Forward and option contracts are principally used to manage exposures arising from subsidiary trade and loan payables and receivables denominated in foreign currencies. These contracts are recorded at fair value with the gain or loss recognized in other–net, (income) expense. In the normal course of business, our operations are exposed to fluctuations in interest rates which can vary the costs of financing, investing, and operating. We seek to address a portion of these risks through a controlled program of risk management that includes the use of derivative financial instruments. The objective of controlling these risks is to limit the impact of fluctuations in interest rates on earnings. Our primary interest-rate risk exposure results from changes in short-term U.S. dollar interest rates. In an effort to manage interest-rate exposures, we strive to achieve an acceptable balance between fixed- and floating-rate debt and investment positions and may enter into interest rate swaps or collars to help maintain that balance. Interest rate swaps or collars that convert our fixed-rate debt to a floating rate are designated as fair value hedges of the underlying instruments. Interest rate swaps or collars that convert floating-rate debt to a fixed rate are designated as cash flow hedges. Interest expense on the debt is adjusted to include the payments made or received under the swap agreements. Cash proceeds from or payments to counterparties resulting from the termination of interest rate swaps are classified as operating activities in our consolidated statements of cash flows.We also may enter into forward-starting interest rate swaps and treasury locks, which we designate as cash flow hedges, as part of any anticipated future debt issuances in order to reduce the risk of cash flow volatility from future changes in interest rates. The change in fair value of these instruments is recorded as part of other comprehensive income (loss) (see Note 17) and, upon completion of a debt issuance and termination of the instrument, is amortized to interest expense over the life of the underlying debt.
Goodwill and Intangible Assets	Goodwill results from excess consideration in a business combination over the fair value of identifiable net assets acquired. Goodwill is not amortized but is reviewed for impairment at least annually, or more frequently if impairment indicators are present, by first assessing qualitative factors to determine whether it is more likely than not that the fair value is less than its carrying amount. If we conclude it is more likely than not that the fair value is less than the carrying amount, a quantitative test that compares the fair value to its carrying value is performed to determine the amount of any impairment.For transactions other than a business combination, we capitalize milestone payments incurred at or after the product has obtained regulatory approval for marketing.The costs of acquired IPR&D projects acquired directly in a transaction other than a business combination are capitalized as other intangible assets if the projects have an alternative future use; otherwise, they are expensed immediately. See Note 3 for significant acquired IPR&D projects that had no alternative future use. Several methods may be used to determine the estimated fair value of other intangibles acquired in a business combination. We utilize the "income method," which is a Level 3 fair value measurement and applies a probability weighting that considers the risk of development and commercialization to the estimated future net cash flows that are derived from projected revenues and estimated costs. These projections are based on factors such as relevant market size, patent protection, historical pricing of similar products, analyst expectations, and expected industry trends. The estimated future net cash flows are then discounted to the present value using an appropriate discount rate. This analysis is performed for each asset independently. The acquired IPR&D assets are treated as indefinite-lived intangible assets until completion or abandonment of the projects, at which time the assets are tested for impairment and amortized over the remaining useful life or written off, as appropriate.Indefinite-lived intangible assets are reviewed for impairment at least annually, or more frequently if impairment indicators are present, by first assessing qualitative factors to determine whether it is more likely than not that the fair value of the asset is less than its carrying amount. If we conclude it is more likely than not that the fair value is less than the carrying amount, a quantitative test that compares the fair value of the intangible asset to its carrying value is performed to determine the amount of any impairment. Finite-lived intangible assets are reviewed for impairment when an indicator of impairment is present. When required, a comparison of fair value to the carrying amount of assets is performed to determine the amount of any impairment. When determining the fair value of indefinite-lived acquired IPR&D as well as the fair value of finite-lived intangible assets for impairment testing purposes, we utilize the "income method" discussed above.
Property, Plant and Equipment	Property and equipment is stated on the basis of cost. Provisions for depreciation of buildings and equipment are computed generally by the straight-line method at rates based on their estimated useful lives (12 to 50 years for buildings and three to 25 years for equipment). We review the carrying value of long-lived assets for potential impairment on a periodic basis and whenever events or changes in circumstances indicate the carrying value of an asset may not be recoverable. Impairment is determined by comparing projected undiscounted cash flows to be generated by the asset to its carrying value. If an impairment is identified, a loss is recorded equal to the excess of the asset's net book value over its fair value, and the cost basis is adjusted.
Share-based Compensation, Option and Incentive Plans	We recognize the fair value of stock-based compensation as expense over the requisite service period of the individual grantees, which generally equals the vesting period. We provide newly issued shares of our common stock and treasury stock to satisfy the issuance of PA, SVA, RVA, and RSU shares.
Income Taxes	Deferred taxes are recognized for the future tax effects of temporary differences between financial and income tax reporting based on enacted tax laws and rates. Deferred taxes related to global intangible low-taxed income (GILTI) are also recognized for the future tax effects of temporary differences. We recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position, based on its technical merits, will be sustained upon examination by the taxing authority. The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than 50 percent likelihood of being realized upon ultimate resolution.

Other Comprehensive Income (Loss) (Schedule of Tax Effects) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Accumulated Other Comprehensive Income (Loss) [Line Items]
Benefit (expense) for income taxes related to other comprehensive income (loss)	$ 196.3	$ (250.0)	$ (695.3)
Foreign currency translation gains/losses
Accumulated Other Comprehensive Income (Loss) [Line Items]
Benefit (expense) for income taxes related to other comprehensive income (loss)	81.0	(75.9)	(136.2)
Net unrealized gains/losses on available-for-sale securities
Accumulated Other Comprehensive Income (Loss) [Line Items]
Benefit (expense) for income taxes related to other comprehensive income (loss)	(3.2)	12.4	4.7
Retirement benefit plans
Accumulated Other Comprehensive Income (Loss) [Line Items]
Benefit (expense) for income taxes related to other comprehensive income (loss)	141.5	(95.6)	(532.0)
Net unrealized gains/losses on cash flow hedges
Accumulated Other Comprehensive Income (Loss) [Line Items]
Benefit (expense) for income taxes related to other comprehensive income (loss)	$ (23.0)	$ (90.9)	$ (31.8)

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

Amount of tax expense (benefit) allocated to other comprehensive income (loss).

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section 45
-Paragraph 12
-SubTopic 10
-Topic 220
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482790/220-10-45-12

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482765/220-10-50-4

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 830
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481674/830-30-50-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 830
-SubTopic 30
-Name Accounting Standards Codification
-Section 45
-Paragraph 17
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481694/830-30-45-17

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 830
-SubTopic 30
-Name Accounting Standards Codification
-Section 45
-Paragraph 20
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481694/830-30-45-20

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(19))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483586/944-220-S99-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-10

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 20
-Name Accounting Standards Codification
-Section 45
-Paragraph 11
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482659/740-20-45-11

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(21))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483621/220-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-04(23))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483589/942-220-S99-1

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 20
-Name Accounting Standards Codification
-Section 45
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482659/740-20-45-2

+ Details

Leases (Tables)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Schedule of Impact of Leases to Consolidated Condensed Financial Statements

Supplemental balance sheet information related to operating leases as of December 31, 2023 and 2022 was as follows:


	2023		2022
Weighted-average remaining lease term	9 years		7 years
Weighted-average discount rate	4.4	%	3.6	%

Supplemental cash flow information related to operating leases during the years ended December 31, 2023, 2022, and 2021 was as follows:


	2023		2022		2021
Operating cash flows from operating leases	$	171.0	$	149.7	$	156.7
Right-of-use assets obtained in exchange for new operating lease liabilities	590.0		155.4		163.5

Schedule of Maturities of Operating Lease Liabilities

The annual minimum lease payments of our operating lease liabilities as of December 31, 2023 were as follows:



2024	$	197.0
2025	180.2
2026	153.9
2027	138.2
2028	108.1
After 2028	614.7
Total lease payments	1,392.1
Less imputed interest	284.8
Total	$	1,107.4

Other - Net, (Income) Expense (Tables)

12 Months Ended

Dec. 31, 2023

Nonoperating Income (Expense) [Abstract]

Schedule of Other Nonoperating Income (Expense)

Other–net, (income) expense consisted of the following:


	2023		2022		2021
Interest expense	$	485.9	$	331.6	$	339.8
Interest income	(173.6)		(62.8)		(25.4)
Net investment (gains) losses on equity securities (Note 7)	20.2		410.7		(176.9)
Debt extinguishment loss (Note 11)	—		—		405.2
Retirement benefit plans	(461.9)		(372.9)		(289.7)
Other (income) expense	32.7		14.3		(51.4)
Other–net, (income) expense	$	(96.7)	$	320.9	$	201.6

Asset Impairment, Restructuring, and Other Special Charges (Tables)

12 Months Ended

Dec. 31, 2023

Restructuring and Related Activities [Abstract]

Schedule of Other Operating Cost and Expense, by Component

The components of the charges included in asset impairment, restructuring, and other special charges in our consolidated statements of operations are described below:


	2023		2022		2021
Asset impairment and other special charges	$	22.2	$	221.6	$	303.1
Severance	45.5		23.0		13.0

Total asset impairment, restructuring, and other special charges	$	67.7	$	244.6	$	316.1

Revenue (Schedule of Revenue Recognized) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Revenue	$ 34,124.1	$ 28,541.4	$ 28,318.4
Net product revenue
Disaggregation of Revenue [Line Items]
Revenue	28,813.9	25,462.8	25,957.9
Collaboration and other revenue
Disaggregation of Revenue [Line Items]
Revenue	5,310.2	3,078.6	2,360.5
Collaboration and other revenue associated with prior period transfers of intellectual property
Disaggregation of Revenue [Line Items]
Revenue	$ 191.6	$ 163.4	$ 175.0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

+ Details

Asset Impairment, Restructuring, and Other Special Charges (Narrative) (Details) $ in Millions	12 Months Ended
	Dec. 31, 2021 USD ($)
Restructuring and Related Activities [Abstract]
Impairment, Intangible Asset, Finite-Lived, Statement of Income or Comprehensive Income [Extensible Enumeration]	Asset impairment, restructuring, and other special charges (Note 5)
Impairment, Intangible Asset, Indefinite-Lived (Excluding Goodwill), Statement of Income or Comprehensive Income [Extensible Enumeration]	Asset impairment, restructuring, and other special charges (Note 5)
Impairment of intangible assets, finite-lived	$ 128.0
Impairment of intangible assets, indefinite-lived	$ 108.1

Goodwill and Other Intangibles

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Other Intangibles

Goodwill

Goodwill results from excess consideration in a business combination over the fair value of identifiable net assets acquired. Goodwill is not amortized but is reviewed for impairment at least annually, or more frequently if impairment indicators are present, by first assessing qualitative factors to determine whether it is more likely than not that the fair value is less than its carrying amount. If we conclude it is more likely than not that the fair value is less than the carrying amount, a quantitative test that compares the fair value to its carrying value is performed to determine the amount of any impairment. The change in goodwill during 2023 was primarily related to our acquisition of POINT. See Note 3 for additional information.

No impairments occurred with respect to the carrying value of goodwill for the years ended December 31, 2023, 2022, and 2021.

Other Intangibles

The components of intangible assets other than goodwill at December 31 were as follows:


	2023						2022
	Carrying Amount, Gross		Accumulated Amortization		Carrying Amount, Net		Carrying Amount, Gross		Accumulated Amortization		Carrying Amount, Net
Finite-lived intangible assets:
Marketed products	$	8,216.8	$	(2,277.0)	$	5,939.8	$	7,957.5	$	(2,622.7)	$	5,334.8


Indefinite-lived intangible assets:
Acquired IPR&D	966.8		—		966.8		1,871.8		—		1,871.8
Other intangibles	$	9,183.6	$	(2,277.0)	$	6,906.6	$	9,829.3	$	(2,622.7)	$	7,206.6

Marketed products consist primarily of the amortized cost of the rights to assets acquired in business combinations and approved for marketing in a significant global jurisdiction (U.S., Europe, and Japan) and capitalized milestone payments. For transactions other than a business combination, we capitalize milestone payments incurred at or after the product has obtained regulatory approval for marketing.

Acquired IPR&D consists of the fair values of acquired IPR&D projects acquired in business combination, adjusted for subsequent impairments, if any. The costs of acquired IPR&D projects acquired directly in a transaction other than a business combination are capitalized as other intangible assets if the projects have an alternative future use; otherwise, they are expensed immediately. See Note 3 for significant acquired IPR&D projects that had no alternative future use.

Several methods may be used to determine the estimated fair value of other intangibles acquired in a business combination. We utilize the "income method," which is a Level 3 fair value measurement and applies a probability weighting that considers the risk of development and commercialization to the estimated future net cash flows that are derived from projected revenues and estimated costs. These projections are based on factors such as relevant market size, patent protection, historical pricing of similar products, analyst expectations, and expected industry trends. The estimated future net cash flows are then discounted to the present value using an appropriate discount rate. This analysis is performed for each asset independently. The acquired IPR&D assets are treated as indefinite-lived intangible assets until completion or abandonment of the projects, at which time the assets are tested for impairment and amortized over the remaining useful life or written off, as appropriate.

The increase in marketed products and the decrease in acquired IPR&D in 2023 primarily relates to the reclassification of our $1.03 billion intangible asset for lebrikizumab (Ebglyss) from indefinite-lived to finite-lived as it was approved in Europe in the fourth quarter of 2023. This decrease in acquired IPR&D in 2023 was partially offset by acquired IPR&D assets recognized from the acquisition of POINT. See Note 3 for additional information.

Indefinite-lived intangible assets are reviewed for impairment at least annually, or more frequently if impairment indicators are present, by first assessing qualitative factors to determine whether it is more likely than not that the fair value of the asset is less than its carrying amount. If we conclude it is more likely than not that the fair value is less than the carrying amount, a quantitative test that compares the fair value of the intangible asset to its carrying value is performed to determine the amount of any impairment. Finite-lived intangible assets are reviewed for impairment when an indicator of impairment is present. When required, a comparison of fair value to the carrying amount of assets is performed to determine the amount of any impairment. When determining the fair value of indefinite-lived acquired IPR&D as well as the fair value of finite-lived intangible assets for impairment testing purposes, we utilize the "income method" discussed above.

Intangible assets with finite lives are capitalized and are amortized primarily to cost of sales over their estimated useful lives, ranging from one to 20 years. As of December 31, 2023, the remaining weighted-average amortization period for finite-lived intangible assets was approximately 12 years.

Amortization expense related to finite-lived intangible assets was as follows:


	2023		2022		2021
Amortization expense	$	505.6	$	579.7	$	628.8

The estimated amortization expense for each of the next five years associated with our finite-lived intangible assets as of December 31, 2023 is as follows:


	2024		2025		2026		2027		2028
Estimated amortization expense	$	542.5	$	530.3	$	519.7	$	517.7	$	511.6

Revenue (Tables)

12 Months Ended

Dec. 31, 2023

Revenue from Contract with Customer [Abstract]

Schedule of Disaggregation of Revenue

The following table summarizes our revenue recognized in our consolidated statements of operations:


	2023		2022		2021
Net product revenue	$	28,813.9	$	25,462.8	$	25,957.9
Collaboration and other revenue(1)	5,310.2		3,078.6		2,360.5
Revenue	$	34,124.1	$	28,541.4	$	28,318.4

The following table summarizes revenue, including net product revenue and collaboration and other revenue, by product:


	U.S.						Outside U.S.
	2023		2022		2021		2023		2022		2021



Diabetes and obesity:
Trulicity®	$	5,433.3	$	5,688.8	$	4,914.4	$	1,699.2	$	1,750.9	$	1,557.6
Mounjaro®	4,834.2		366.6		—		328.9		115.9		—
Jardiance(1)	1,600.4		1,194.5		807.3		1,144.2		871.5		683.5
Humalog® (2)	863.2		1,191.9		1,320.7		800.2		868.7		1,132.3
Humulin®	610.1		730.2		832.9		242.0		289.2		389.6
Basaglar® (3)	443.1		470.7		588.3		285.2		289.7		304.2
Baqsimi	645.7		110.4		96.4		31.9		28.9		16.8
Zepbound®	175.8		—		—		—		—		—
Other diabetes and obesity	175.0		158.0		159.3		355.2		338.9		384.8
Total diabetes and obesity	14,780.8		9,911.1		8,719.3		4,886.8		4,553.7		4,468.8

Oncology:
Verzenio®	2,509.0		1,653.2		834.9		1,354.3		830.3		515.0
Cyramza®	402.3		351.4		358.1		572.4		620.0		674.8
Erbitux®	528.9		500.1		481.8		67.6		66.4		66.4
Tyvyt®	—		—		—		393.4		293.3		418.1
Alimta®	72.9		543.7		1,233.9		144.6		384.0		827.5
Other oncology	283.9		169.7		120.1		329.0		254.1		210.7
Total oncology	3,797.0		3,218.1		3,028.8		2,861.3		2,448.1		2,712.5

Immunology:
Taltz®	1,831.6		1,724.6		1,542.4		928.0		757.4		670.4
Olumiant® (4)	225.5		148.2		324.1		697.2		682.3		791.0
Other immunology	0.8		20.0		15.3		114.4		12.1		17.6
Total immunology	2,057.9		1,892.8		1,881.8		1,739.6		1,451.8		1,479.0

Neuroscience:
Zyprexa(5)	79.4		30.4		39.6		1,615.4		306.5		390.7
Emgality®	482.2		462.8		434.5		196.0		188.1		142.7
Other neuroscience	134.4		119.2		140.7		371.1		439.2		750.3
Total neuroscience	696.0		612.4		614.8		2,182.5		933.8		1,283.7

Other:
Forteo®	335.5		367.3		441.6		197.7		245.8		360.3
Cialis®	26.1		35.2		10.6		355.3		552.1		707.9
COVID-19 antibodies(6)	—		2,008.9		1,978.0		—		14.7		261.4
Other	97.7		144.2		136.1		109.9		151.3		233.9
Total other	459.3		2,555.7		2,566.4		662.9		964.0		1,563.5

Revenue	$	21,791.0	$	18,190.0	$	16,811.0	$	12,333.1	$	10,351.3	$	11,507.4

Numbers may not add due to rounding.

(1) Jardiance revenue includes Glyxambi®, Synjardy®, and Trijardy® XR.

(2) Humalog revenue includes insulin lispro.

(3) Basaglar revenue includes Rezvoglar®.

(4) Olumiant revenue includes sales for baricitinib that were made pursuant to Emergency Use Authorization (EUA) or similar regulatory authorizations.

(5) Zyprexa revenue includes sale of the rights for the olanzapine portfolio.

The following table summarizes revenue by geographical area:


	2023		2022		2021

Revenue(1):
U.S.	$	21,791.0	$	18,190.0	$	16,811.0
Europe	6,174.7		4,299.2		4,776.8
Japan	1,672.6		1,747.3		2,367.0
China	1,539.7		1,452.8		1,661.4
Other foreign countries	2,946.2		2,852.0		2,702.2
Revenue	$	34,124.1	$	28,541.4	$	28,318.4

Numbers may not add due to rounding.

(1) Revenue is attributed to the countries based on the location of the customer or other party

Schedule of Amounts Recorded for Contract Liabilities

The following table summarizes contract liability balances:


	2023		2022
Contract liabilities	$	193.6	$	219.2

Collaborations and Other Arrangements (Net Product Revenue) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Revenue	$ 34,124.1	$ 28,541.4	$ 28,318.4
Jardiance
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Revenue	2,744.7	2,066.0	1,490.8
Basaglar
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Revenue	728.3	760.4	892.5
Trajenta
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Revenue	386.9	383.7	372.5
Olumiant
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Revenue	922.6	830.5	1,115.1
Tyvyt®
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Revenue	$ 393.4	$ 293.3	$ 418.1

- Definition

+ References

+ Details

Leases (Maturities of Operating Lease Liabilities) (Details) $ in Millions	Dec. 31, 2023 USD ($)
Leases [Abstract]
2024	$ 197.0
2025	180.2
2026	153.9
2027	138.2
2028	108.1
After 2028	614.7
Total lease payments	1,392.1
Less imputed interest	284.8
Total	$ 1,107.4
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration]	Other noncurrent liabilities

Asset Impairment, Restructuring, and Other Special Charges

12 Months Ended

Dec. 31, 2023

Restructuring and Related Activities [Abstract]

Asset Impairment, Restructuring, And Other Special Charges

Asset Impairment, Restructuring, and Other Special Charges

The components of the charges included in asset impairment, restructuring, and other special charges in our consolidated statements of operations are described below:


	2023		2022		2021
Asset impairment and other special charges	$	22.2	$	221.6	$	303.1
Severance	45.5		23.0		13.0

Total asset impairment, restructuring, and other special charges	$	67.7	$	244.6	$	316.1

Asset impairment, restructuring, and other special charges recognized during the year ended December 31, 2022 were primarily related to an intangible asset impairment for GBA1 Gene Therapy, acquired in the Prevail acquisition, as a result of changes in key assumptions used in the valuation due to delays in estimated launch timing.

During the year ended December 31, 2021, we recognized $128.0 million of intangible asset impairment as a result of the decision by Bayer AG to discontinue the development of a Phase I molecule related to a contract-based intangible asset from our acquisition of Loxo Oncology, Inc. Additionally, we recognized $108.1 million of intangible asset impairment from the sale of the rights to Qbrexza®, as well as acquisition and integration costs associated with the acquisition of Prevail.

Goodwill and Other Intangibles (Schedule of Amortization Expense) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 505.6	$ 579.7	$ 628.8

Contingencies	12 Months Ended
Contingencies	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Contingencies	Contingencies We are involved in various lawsuits, claims, government investigations and other legal proceedings that arise in the ordinary course of business. These claims or proceedings can involve various types of parties, including governments, competitors, customers, suppliers, service providers, licensees, employees, or shareholders, among others. These matters may involve patent infringement, antitrust, securities, pricing, access, sales and marketing practices, environmental, commercial, contractual rights, licensing obligations, health and safety matters, consumer fraud, employment matters, product liability, insurance coverage, and regulatory compliance, among others. The resolution of these matters often develops over a long period of time and expectations can change as a result of new findings, rulings, appeals or settlement arrangements. Legal proceedings that are significant or that we believe could become significant or material are described below. We are defending against the legal proceedings in which we are named as defendants vigorously. It is not possible to determine the final outcome of these matters, and we cannot reasonably estimate the maximum potential exposure or the range of possible loss in excess of amounts accrued for any of these matters; however, we believe that the resolution of all such matters will not have a material adverse effect on our consolidated financial position or liquidity, but could possibly be material to our consolidated results of operations in any one accounting period. Litigation accruals and environmental liabilities and the related estimated insurance recoverables are reflected on a gross basis as liabilities and assets, respectively, on our consolidated balance sheets. With respect to the product liability claims currently asserted against us, we have accrued for our estimated exposures to the extent they are both probable and reasonably estimable based on the information available to us. We accrue for certain product liability claims incurred but not filed to the extent we can formulate a reasonable estimate of their costs. We estimate these expenses based primarily on historical claims experience and data regarding product usage. Legal defense costs expected to be incurred in connection with significant product liability loss contingencies are accrued when both probable and reasonably estimable. Because of the nature of pharmaceutical products, it is possible that we could become subject to large numbers of additional product liability and related claims in the future. Due to a very restrictive market for litigation liability insurance, we are self-insured for litigation liability losses for all our currently and previously marketed products. Patent Litigation Emgality Patent Litigation We are a named defendant in litigation filed by Teva Pharmaceuticals International GMBH and Teva Pharmaceuticals USA, Inc. (collectively, Teva) in the U.S. District Court for the District of Massachusetts seeking a ruling that various claims in three different Teva patents would be infringed by our launch and continued sales of Emgality for the prevention of migraine in adults. Following a trial, in November 2022, a jury returned a verdict in favor of Teva. In September 2023, the court granted our motion to overrule the jury verdict and found all asserted claims of the three patents invalid. Teva has appealed the decision. This matter is ongoing. In June 2021, we were named as a defendant in a second litigation filed by Teva in the U.S. District Court for the District of Massachusetts seeking a ruling that two of Teva's patents, which are directed toward use of the active ingredient in Emgality to treat migraine, would be infringed by our continued sales of Emgality. We challenged these two patents by filing requests for Inter Partes Review with the Patent Trial and Appeal Board (PTAB) and in October 2022, the PTAB granted our requests. In September 2023, the PTAB issued decisions finding all claims of both patents invalid. Teva has agreed not to appeal the decisions and has dismissed the corresponding district court litigation. This matter is closed. Environmental Proceedings Under the Comprehensive Environmental Response, Compensation, and Liability Act, commonly known as "Superfund," we have been designated as one of several potentially responsible parties with respect to the cleanup of fewer than 10 sites. Under Superfund, each responsible party may be jointly and severally liable for the entire amount of the cleanup. Other Matters Actos® Litigation We are named along with Takeda Chemical Industries, Ltd. and Takeda affiliates (collectively, Takeda) in a third party payor class action in the U.S. District Court for the Central District of California. Plaintiffs claim that they and similarly situated class members are entitled to recover money paid for or to reimburse Actos prescriptions because of alleged concealment of bladder cancer risk. Our agreement with Takeda calls for Takeda to defend and indemnify us against our losses and expenses with respect to U.S. litigation arising out of the manufacture, use, or sale of Actos and other related expenses in accordance with the terms of the agreement. In August 2023, the Ninth Circuit granted our and Takeda's petition for permission to appeal the class certification order, and briefing was submitted in January 2024. This matter is ongoing. Mounjaro and Trulicity Product Liability Litigation We, along with Novo Nordisk A/S (Novo) and other related Novo entities, are named in numerous lawsuits by plaintiffs alleging injuries following purported use of incretin products. Certain complaints name us and allege injuries that plaintiffs claim are associated with the use of Mounjaro and/or Trulicity. These lawsuits were filed beginning in August 2023 and are pending in various federal courts. In February 2024, the Judicial Panel on Multi-District Litigation established Multi-District Litigation for coordinated and consolidated pretrial proceedings in the Eastern District of Pennsylvania. This matter is ongoing. 340B Litigation and Investigations We are the plaintiff in a lawsuit filed in January 2021 in the U.S. District Court for the Southern District of Indiana against the U.S. Department of Health and Human Services (HHS), the Secretary of HHS, the Health Resources and Services Administration (HRSA), and the Administrator of HRSA. The lawsuit challenges HHS's December 30, 2020 advisory opinion stating that drug manufacturers are required to deliver discounts under the 340B program to all contract pharmacies and HHS's Administrative Dispute Resolution regulations. We seek a declaratory judgment that the defendants violated the Administrative Procedure Act and the U.S. Constitution, a preliminary injunction enjoining implementation of the administrative dispute resolution process created by defendants and, with it, their application of the advisory opinion, and other related relief. In March 2021, the court entered an order preliminarily enjoining the government's enforcement of the administrative dispute resolution process against us. In May 2021, HRSA sent us an enforcement letter notifying us that it determined that our policy was contrary to the 340B statute. In response, in May 2021, we amended our complaint to bring claims related to HRSA's determination. In June 2021, the defendants withdrew the HHS December 30, 2020 advisory opinion. In July 2021, the court held oral argument on the parties' cross motions for summary judgment and the defendants' motion to dismiss. In October 2021, the court denied the defendants' motion to dismiss, and granted in part and denied in part the parties' cross motions for summary judgment. Both parties filed notices of appeal related to the court's summary judgment order. In October 2022, the U.S. Court of Appeals for the Seventh Circuit held oral argument. This matter is ongoing. We, along with other pharmaceutical manufacturers, have been named as a defendant in petitions filed in 2021 and 2023 and currently pending before the HHS Administrative Dispute Resolution Panel. Petitioners seek declaratory, injunctive, and/or monetary relief related to the 340B program. The U.S. District Court for the Southern District of Indiana has entered a preliminary injunction enjoining the government's enforcement of this administrative dispute resolution process against us. In July 2021, we, along with Sanofi-Aventis U.S., LLC (Sanofi), Novo Nordisk Inc. (Novo Nordisk), and AstraZeneca Pharmaceuticals LP (AstraZeneca), were named as a defendant in a purported class action lawsuit filed in the U.S. District Court for the Western District of New York by Mosaic Health, Inc. alleging antitrust and unjust enrichment claims related to the defendants' 340B distribution programs. We, with Sanofi, Novo Nordisk, and AstraZeneca, filed a motion to dismiss the lawsuit, which was granted in September 2022. In October 2022, the plaintiffs filed a motion for leave to amend their complaint. In January 2024, the court denied the motion for leave to amend and dismissed the case. We received a civil investigative subpoena in February 2021 from the Office of the Attorney General for the State of Vermont relating to the sale of pharmaceutical products to Vermont covered entities under the 340B program. We are cooperating with this subpoena. Branchburg Manufacturing Facility In May 2021, we received a subpoena from the U.S. Department of Justice requesting the production of certain documents relating to our manufacturing site in Branchburg, New Jersey. We are cooperating with the subpoena. Brazil Litigation – Cosmopolis Facility Labor Attorney Litigation First initiated in 2008, Eli Lilly do Brasil Limitada (Lilly Brasil) is named in a Public Civil Action brought by the Labor Public Attorney (LPA) alleging harm to employees and former employees caused by alleged exposure to soil and groundwater contaminants at a former manufacturing facility in Cosmopolis, operated by the company between 1977 and 2003. In May 2014, the trial Court ruled against Lilly Brasil, ordering it to undertake several remedial and compensatory actions, including health coverage for a class of individuals and certain of their children. In July 2018, the appeals court generally affirmed the trial Court's ruling, which included a liquidated award of 300 million Brazilian reais, which, when adjusted for inflation, is approximately 1.26 billion Brazilian reais (approximately $260 million as of December 31, 2023). In August 2019, Lilly Brasil appealed to the superior labor court (TST) and in June 2021, the majority of the elements of Lilly Brasil's appeal were admitted; elements not proceeding are subject to an interlocutory appeal to the TST that was filed in June 2021. Mediation hearings are ongoing. In July 2019, at the LPA's request, the trial Court ordered a freeze of Lilly Brasil’s immovable property in the amount of 500 million Brazilian reais, which was reduced on Lilly Brasil's appeal and, when adjusted for inflation, is approximately 131 million Brazilian reais (approximately $27 million as of December 31, 2023). The parties appealed to the TST, which appeal is under review. The trial Court is currently assessing the status of Lilly Brasil’s compliance with the obligations as to the land and an inspection in the industrial plant occurred in October 2023. These matters are ongoing. Individual Former Employee Litigation Lilly Brasil is also named in various pending lawsuits filed in the trial Court by individual former employees making related claims. These individual lawsuits are at various stages in the litigation process. Puerto Rico Tax Matter In May 2013, the Municipality of Carolina in Puerto Rico (Municipality) filed a lawsuit against us alleging noncompliance with respect to a contract with the Municipality and seeking a declaratory judgment. In December 2020, the Puerto Rico Appellate Court (AP) reversed the summary judgment previously granted by the Court of First Instance (CFI) in our favor, dismissing the Municipality's complaint in its entirety. The AP remanded the case to the CFI for trial on the merits. The trial began in May 2022; however, the Municipality filed a new motion requesting the CFI to execute an alleged judgment. The request was denied by the CFI in our favor and the Municipality filed for revision at the AP, which we opposed, staying the case. The AP denied the Municipality's motion for revision. This matter is ongoing and trial has been scheduled for August 2024. Average Manufacturer Price Litigation In November 2014, we, along with another pharmaceutical manufacturer, were named as co-defendants in United States et al. ex rel. Streck v. Takeda Pharm. Am., Inc., et al., which was filed in November 2014 and unsealed in the U.S. District Court for the Northern District of Illinois. The complaint alleges that the defendants should have treated certain credits from distributors as retroactive price increases and included such increases in calculating average manufacturer prices. Following a trial in August 2022, the jury returned a verdict in favor of the plaintiff. Lilly appealed to the Seventh Circuit and the appeal is pending. This matter is ongoing. Health Choice Alliance We are named as a defendant in two lawsuits filed in Texas and New Jersey state courts in October 2019 seeking damages under the Texas Medicaid Fraud Prevention Act and New Jersey Medicaid False Claims Act, respectively, for certain patient support programs related to our products Humalog, Humulin, and Forteo. The Texas state court action has been stayed. The New Jersey state court action was dismissed with prejudice pending an ongoing appeal before the Appellate Division of the New Jersey Superior Court. This matter is ongoing. Pricing Litigation We, along with Sanofi, Novo Nordisk, and, in some matters, certain pharmacy benefit managers, have been named in numerous lawsuits, including putative class actions, by states and state attorneys general, counties, municipalities, third-party payers, consumers, and other parties related to insulin pricing and rebates paid by manufacturers to pharmacy benefit managers. These lawsuits assert various theories, including consumer protection and deceptive trade practice, fraud, false advertising, unjust enrichment, civil conspiracy, federal and state RICO statutes, antitrust, and unfair competition claims. These lawsuits have been brought in various state and federal courts since 2017 and are at various stages in the litigation process. Starting in August 2023 after a ruling by the Judicial Panel for Multi-District Litigation, several of these cases were transferred to or filed in the District of New Jersey for coordinated or consolidated pre-trial proceedings. In May 2023, we reached a settlement in the In re Insulin Pricing Litigation consumer class action. A motion for preliminary approval of our settlement is pending. In January 2024, the Multi-District Litigation court denied the consumer class plaintiffs’ motion for class certification and ordered the parties to submit briefs addressing the impact of that denial on the motion for preliminary approval of the settlement. In February 2024, we entered into a non-monetary settlement with the Minnesota Attorney General's Office that resolved all matters related to Minnesota's insulin pricing lawsuit. Investigations, Subpoenas, and Inquiries We have been subject to various investigations and received subpoenas, civil investigative demand requests, information requests, interrogatories, and other inquiries from various governmental entities related to pricing issues, including the pricing and sale of insulins and other products and calculations of AMP and best price. These include subpoenas from the Vermont Attorney General Office, civil investigative demands from the Washington, New Mexico, Colorado, Louisiana, Texas and Ohio Attorney General Offices, the U.S. Department of Justice, and the U.S. Federal Trade Commission, as well as information requests from the Mississippi, Washington D.C., California, Florida, Hawaii, and Nevada Attorney General Offices. In January 2022, the Michigan Attorney General filed a petition in Michigan state court seeking authorization to investigate Lilly for potential violations of the Michigan Consumer Protection Act (MCPA), and a complaint seeking a declaratory judgment that the Attorney General has authority to investigate Lilly's sale of insulin under the MCPA. The court authorized the proposed investigation and the issuance of civil investigative subpoenas. In April 2022, the parties entered into a stipulation providing that the State of Michigan will not issue any civil investigative subpoena to us under the MCPA until the declaratory judgment action is resolved. In July 2022, the court dismissed the case in its entirety. In June 2023, the Michigan Court of Appeals affirmed the judgment in our favor. In August 2023, the Michigan Attorney General filed an application for leave to appeal to the Michigan Supreme Court, which is being set for argument. We are cooperating with all of the aforementioned investigations, subpoenas, and inquiries. Research Corporation Technologies, Inc. In April 2016, we were named as a defendant in litigation filed by Research Corporation Technologies, Inc. (RCT) in the U.S. District Court for the District of Arizona. RCT is seeking damages for breach of contract, unjust enrichment, and conversion related to processes used to manufacture certain products, including Humalog and Humulin. In October 2021, the court issued a summary judgment decision in favor of RCT on certain issues, including with respect to a disputed royalty. Trial is scheduled for August 2024. Potential damages payable under the litigation, if finally awarded after an appeal, could be material but are not currently reasonably estimable. This matter is ongoing.

Asset Impairment, Restructuring, and Other Special Charges - Schedule of Other Operating Cost and Expense, by Component (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Restructuring and Related Activities [Abstract]
Asset impairment and other special charges	$ 22.2	$ 221.6	$ 303.1
Severance	45.5	23.0	13.0
Total asset impairment, restructuring, and other special charges	$ 67.7	$ 244.6	$ 316.1

Contingencies (Details) R$ in Millions, $ in Millions	1 Months Ended		12 Months Ended
Contingencies (Details) R$ in Millions, $ in Millions	Jul. 31, 2019 BRL (R$)	Jul. 31, 2018 BRL (R$)	Dec. 31, 2023 USD ($) patent site	Dec. 31, 2023 BRL (R$) patent site	Jun. 30, 2021 patent	Oct. 31, 2019 lawsuit
Unfavorable Regulatory Action
Loss Contingencies [Line Items]
Number of sites jointly and severally liable for cleanup (fewer than) \| site			10	10
Humalog, Humulin and Forteo
Loss Contingencies [Line Items]
Number of pending lawsuits \| lawsuit						2
Emgality Patent Litigation
Loss Contingencies [Line Items]
Number of patents \| patent			3	3	2
Employee Litigation, July 2018 Ruling \| Brazil
Loss Contingencies [Line Items]
Damages awarded, value		R$ 300	$ 260	R$ 1,260
Employee Litigation, July 2019 Ruling \| Brazil
Loss Contingencies [Line Items]
Damages awarded, value	R$ 500		$ 27	R$ 131

Goodwill and Other Intangibles (Tables)

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Finite-lived Intangible Assets other than Goodwill

The components of intangible assets other than goodwill at December 31 were as follows:


	2023						2022
	Carrying Amount, Gross		Accumulated Amortization		Carrying Amount, Net		Carrying Amount, Gross		Accumulated Amortization		Carrying Amount, Net
Finite-lived intangible assets:
Marketed products	$	8,216.8	$	(2,277.0)	$	5,939.8	$	7,957.5	$	(2,622.7)	$	5,334.8


Indefinite-lived intangible assets:
Acquired IPR&D	966.8		—		966.8		1,871.8		—		1,871.8
Other intangibles	$	9,183.6	$	(2,277.0)	$	6,906.6	$	9,829.3	$	(2,622.7)	$	7,206.6

Schedule of Indefinite-lived Intangible Assets other than Goodwill

The components of intangible assets other than goodwill at December 31 were as follows:


	2023						2022
	Carrying Amount, Gross		Accumulated Amortization		Carrying Amount, Net		Carrying Amount, Gross		Accumulated Amortization		Carrying Amount, Net
Finite-lived intangible assets:
Marketed products	$	8,216.8	$	(2,277.0)	$	5,939.8	$	7,957.5	$	(2,622.7)	$	5,334.8


Indefinite-lived intangible assets:
Acquired IPR&D	966.8		—		966.8		1,871.8		—		1,871.8
Other intangibles	$	9,183.6	$	(2,277.0)	$	6,906.6	$	9,829.3	$	(2,622.7)	$	7,206.6

Schedule of finite-lived Intangible Assets Amortization Expense

Amortization expense related to finite-lived intangible assets was as follows:


	2023		2022		2021
Amortization expense	$	505.6	$	579.7	$	628.8

Schedule of Finite-Lived Intangible Assets, Future Amortization Expense

The estimated amortization expense for each of the next five years associated with our finite-lived intangible assets as of December 31, 2023 is as follows:


	2024		2025		2026		2027		2028
Estimated amortization expense	$	542.5	$	530.3	$	519.7	$	517.7	$	511.6

Income Taxes (Schedule of Future Cash Payments Relating to the Toll Tax) (Details) $ in Millions	Dec. 31, 2023 USD ($)
2017 Tax Act Toll Tax
Total	$ 1,427.0
2024	634.2
1-3 Years	$ 792.8

Other Comprehensive Income (Loss) (Tables)

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Schedule of Accumulated Other Comprehensive Income (Loss)

The following table summarizes the activity related to each component of other comprehensive income (loss):



(Amounts presented net of taxes)	Foreign Currency Translation Gains (Losses)		Net Unrealized Gains (Losses) on Available-For-Sale Securities		Retirement Benefit Plans		Net Unrealized Gains (Losses) on Cash Flow Hedges		Accumulated Other Comprehensive Loss
Beginning balance at January 1, 2021	$	(1,427.5)	$	14.8	$	(4,751.0)	$	(332.7)	$	(6,496.4)

Other comprehensive income (loss) before reclassifications	(122.7)		(11.9)		1,823.4		106.6		1,795.4
Net amount reclassified from accumulated other comprehensive loss	—		0.8		344.0		13.1		357.9
Net other comprehensive income (loss)	(122.7)		(11.1)		2,167.4		119.7		2,153.3



Balance at December 31, 2021	(1,550.2)		3.7		(2,583.6)		(213.0)		(4,343.1)


Other comprehensive income (loss) before reclassifications	(324.4)		(52.2)		291.5		332.8		247.7
Net amount reclassified from accumulated other comprehensive loss	0.4		11.4		229.8		9.2		250.8
Net other comprehensive income (loss)	(324.0)		(40.8)		521.3		342.0		498.5

Balance at December 31, 2022	(1,874.2)		(37.1)		(2,062.3)		129.0		(3,844.6)

Other comprehensive income (loss) before reclassifications	78.9		10.1		(686.9)		79.7		(518.2)
Net amount reclassified from accumulated other comprehensive loss	(23.7)		0.8		51.9		6.8		35.8
Net other comprehensive income (loss)	55.2		10.9		(635.0)		86.5		(482.4)

Ending balance at December 31, 2023	$	(1,819.0)	$	(26.2)	$	(2,697.3)	$	215.5	$	(4,327.0)

The tax effects on the net activity related to each component of other comprehensive income (loss) for the years ended December 31, were as follows:


Tax benefit (expense)	2023		2022		2021
Foreign currency translation gains/losses	$	81.0	$	(75.9)	$	(136.2)
Net unrealized gains/losses on available-for-sale securities	(3.2)		12.4		4.7
Retirement benefit plans	141.5		(95.6)		(532.0)
Net unrealized gains/losses on cash flow hedges	(23.0)		(90.9)		(31.8)
Benefit (expense) for income taxes related to other comprehensive income (loss)	$	196.3	$	(250.0)	$	(695.3)

Schedule of Amounts Recognized in Other Comprehensive Loss

Reclassifications out of accumulated other comprehensive loss were as follows:


	Year Ended December 31,						Affected Line Item in the Consolidated Statements of Operations
	2023		2022		2021
Amortization of retirement benefit items:
Prior service benefits, net	$	(50.5)	$	(52.4)	$	(55.4)	Other—net, (income) expense
Actuarial losses	116.2		343.3		490.9		Other—net, (income) expense
Total before tax	65.7		290.9		435.5
Tax benefit	(13.8)		(61.1)		(91.5)		Income taxes
Net of tax	51.9		229.8		344.0

Other, net of tax	(16.1)		21.0		13.9		Other—net, (income) expense
Total reclassifications for the period, net of tax	$	35.8	$	250.8	$	357.9

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Property, Plant and Equipment

At December 31, property and equipment consisted of the following:


	2023		2022
Land	$	319.8	$	256.6
Buildings	8,280.0		7,915.9
Equipment	10,329.0		9,406.3

Construction in progress	5,084.1		2,798.6
	24,012.9		20,377.4
Less accumulated depreciation	(11,099.3)		(10,233.4)
Property and equipment, net	$	12,913.6	$	10,144.0

Depreciation expense related to property and equipment was as follows:


	2023		2022		2021
Depreciation expense	$	901.9	$	816.6	$	787.0

Long-lived Assets by Geographic Areas

The following table summarizes long-lived assets by geographical area:


	2023		2022

Long-lived assets(1):
U.S. and Puerto Rico	$	9,993.2	$	7,709.7
Ireland	2,722.6		1,898.5
Other foreign countries	1,784.2		1,625.9
Long-lived assets	$	14,500.0	$	11,234.1

(1) Long-lived assets consist of property and equipment, net, operating lease assets, and unamortized computer software costs.

Property and Equipment (Narrative) (Details)	Dec. 31, 2023
Building \| Minimum
Property, Plant and Equipment [Line Items]
Estimated useful life	12 years
Building \| Maximum
Property, Plant and Equipment [Line Items]
Estimated useful life	50 years
Equipment \| Minimum
Property, Plant and Equipment [Line Items]
Estimated useful life	3 years
Equipment \| Maximum
Property, Plant and Equipment [Line Items]
Estimated useful life	25 years

Borrowings (Summary of Long-term Notes) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Feb. 28, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Unamortized note discounts	$ (121.2)		$ (96.1)
Total long-term notes	$ 19,104.6		14,815.3
Senior Notes \| 0.15% Swiss franc denominated notes due 2024
Debt Instrument [Line Items]
Stated interest rate	0.15%
Long-term notes, gross	$ 714.6		649.5
Senior Notes \| 7.125% notes due 2025
Debt Instrument [Line Items]
Stated interest rate	7.125%
Long-term notes, gross	$ 217.5		217.5
Senior Notes \| 2.75% notes due 2025
Debt Instrument [Line Items]
Stated interest rate	2.75%
Long-term notes, gross	$ 560.6		560.6
Senior Notes \| 5.0% notes due 2026
Debt Instrument [Line Items]
Stated interest rate	5.00%	5.00%
Long-term notes, gross	$ 750.0		0.0
Senior Notes \| 1.625% euro denominated notes due 2026
Debt Instrument [Line Items]
Stated interest rate	1.625%
Long-term notes, gross	$ 830.7		799.3
Senior Notes \| 5.5% notes due 2027
Debt Instrument [Line Items]
Stated interest rate	5.50%
Long-term notes, gross	$ 364.3		364.3
Senior Notes \| 3.1% notes due 2027
Debt Instrument [Line Items]
Stated interest rate	3.10%
Long-term notes, gross	$ 401.5		401.5
Senior Notes \| 0.45% Swiss franc denominated notes due 2028
Debt Instrument [Line Items]
Stated interest rate	0.45%
Long-term notes, gross	$ 476.4		433.0
Senior Notes \| 3.375% notes due 2029
Debt Instrument [Line Items]
Stated interest rate	3.375%
Long-term notes, gross	$ 930.6		930.6
Senior Notes \| 0.42% Japanese yen denominated notes due 2029
Debt Instrument [Line Items]
Stated interest rate	0.42%
Long-term notes, gross	$ 162.5		172.1
Senior Notes \| 2.125% euro denominated notes due 2030
Debt Instrument [Line Items]
Stated interest rate	2.125%
Long-term notes, gross	$ 830.7		799.3
Senior Notes \| 0.625% euro denominated notes due 2031
Debt Instrument [Line Items]
Stated interest rate	0.625%
Long-term notes, gross	$ 664.6		639.4
Senior Notes \| 4.7% notes due 2033
Debt Instrument [Line Items]
Stated interest rate	4.70%	4.70%
Long-term notes, gross	$ 1,000.0		0.0
Senior Notes \| 0.50% euro denominated notes due 2033
Debt Instrument [Line Items]
Stated interest rate	0.50%
Long-term notes, gross	$ 664.6		639.4
Senior Notes \| 0.56% Japanese yen denominated notes due 2034
Debt Instrument [Line Items]
Stated interest rate	0.56%
Long-term notes, gross	$ 65.8		69.7
Senior Notes \| 6.77% notes due 2036
Debt Instrument [Line Items]
Stated interest rate	6.77%
Long-term notes, gross	$ 158.6		158.6
Senior Notes \| 5.55% notes due 2037
Debt Instrument [Line Items]
Stated interest rate	5.55%
Long-term notes, gross	$ 444.7		444.7
Senior Notes \| 5.95% notes due 2037
Debt Instrument [Line Items]
Stated interest rate	5.95%
Long-term notes, gross	$ 266.8		266.8
Senior Notes \| 3.875% notes due 2039
Debt Instrument [Line Items]
Stated interest rate	3.875%
Long-term notes, gross	$ 240.3		240.3
Senior Notes \| 1.625% Notes due 2043
Debt Instrument [Line Items]
Stated interest rate	1.625%
Long-term notes, gross	$ 318.5		301.2
Senior Notes \| 4.65% notes due 2044
Debt Instrument [Line Items]
Stated interest rate	4.65%
Long-term notes, gross	$ 38.3		38.3
Senior Notes \| 3.7% notes due 2045
Debt Instrument [Line Items]
Stated interest rate	3.70%
Long-term notes, gross	$ 386.8		386.8
Senior Notes \| 3.95% notes due 2047
Debt Instrument [Line Items]
Stated interest rate	3.95%
Long-term notes, gross	$ 347.0		347.0
Senior Notes \| 3.95% notes due 2049
Debt Instrument [Line Items]
Stated interest rate	3.95%
Long-term notes, gross	$ 958.2		958.2
Senior Notes \| 1.70% euro denominated notes due 2049
Debt Instrument [Line Items]
Stated interest rate	1.70%
Long-term notes, gross	$ 1,107.6		1,065.7
Senior Notes \| 0.97% Japanese yen denominated notes due 2049
Debt Instrument [Line Items]
Stated interest rate	0.97%
Long-term notes, gross	$ 54.2		57.4
Senior Notes \| 2.25% notes due 2050
Debt Instrument [Line Items]
Stated interest rate	2.25%
Long-term notes, gross	$ 1,250.0		1,250.0
Senior Notes \| 1.125% euro denominated notes due 2051
Debt Instrument [Line Items]
Stated interest rate	1.125%
Long-term notes, gross	$ 553.8		532.9
Senior Notes \| 4.875% notes due 2053
Debt Instrument [Line Items]
Stated interest rate	4.875%	4.875%
Long-term notes, gross	$ 1,250.0		0.0
Senior Notes \| 4.15% notes due 2059
Debt Instrument [Line Items]
Stated interest rate	4.15%
Long-term notes, gross	$ 591.3		591.3
Senior Notes \| 2.50% notes due 2060
Debt Instrument [Line Items]
Stated interest rate	2.50%
Long-term notes, gross	$ 850.0		850.0
Senior Notes \| 1.375% euro denominated notes due 2061
Debt Instrument [Line Items]
Stated interest rate	1.375%
Long-term notes, gross	$ 775.3		746.0
Senior Notes \| 4.95% notes due 2063
Debt Instrument [Line Items]
Stated interest rate	4.95%	4.95%
Long-term notes, gross	$ 1,000.0		$ 0.0

Financial Instruments (Schedule of Fair Value Measurement) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Statement [Line Items]
Noncurrent investments	$ 3,052.2	$ 2,901.8
Carrying Amount
Statement [Line Items]
Cash equivalents	1,088.4	657.4
Short-term investments	109.1	144.8
Equity investments without readily determinable fair values	608.0	478.4
Noncurrent investments	3,052.2	2,901.8
Carrying Amount \| U.S. government and agency securities
Statement [Line Items]
Short-term investments	32.1	30.8
Noncurrent investments	148.1	146.4
Carrying Amount \| Corporate debt securities
Statement [Line Items]
Short-term investments	52.0	53.4
Noncurrent investments	214.3	213.9
Carrying Amount \| Mortgage-backed securities
Statement [Line Items]
Noncurrent investments	157.3	149.2
Carrying Amount \| Asset-backed securities
Statement [Line Items]
Short-term investments		2.0
Noncurrent investments	53.5	50.6
Carrying Amount \| Other securities
Statement [Line Items]
Short-term investments	25.0	58.6
Carrying Amount \| Other securities, noncurrent investments
Statement [Line Items]
Equity securities	197.4	398.6
Carrying Amount \| Marketable equity securities
Statement [Line Items]
Equity securities	711.3	683.6
Carrying Amount \| Equity method investments
Statement [Line Items]
Equity method investments	962.3	781.1
Cost
Statement [Line Items]
Cash equivalents	1,088.4	657.4
Cost \| U.S. government and agency securities
Statement [Line Items]
Short-term investments	32.3	31.1
Noncurrent investments	161.0	163.2
Cost \| Corporate debt securities
Statement [Line Items]
Short-term investments	52.1	53.5
Noncurrent investments	226.6	235.8
Cost \| Mortgage-backed securities
Statement [Line Items]
Noncurrent investments	167.1	161.5
Cost \| Asset-backed securities
Statement [Line Items]
Short-term investments		2.0
Noncurrent investments	54.4	52.5
Cost \| Other securities
Statement [Line Items]
Short-term investments	25.0	58.6
Cost \| Other securities, noncurrent investments
Statement [Line Items]
Equity securities	100.2	34.5
Cost \| Marketable equity securities
Statement [Line Items]
Equity securities	493.2	484.7
Estimate of Fair Value Measurement
Statement [Line Items]
Cash equivalents	1,088.4	657.4
Estimate of Fair Value Measurement \| U.S. government and agency securities
Statement [Line Items]
Short-term investments	32.1	30.8
Noncurrent investments	148.1	146.4
Estimate of Fair Value Measurement \| Corporate debt securities
Statement [Line Items]
Short-term investments	52.0	53.4
Noncurrent investments	214.3	213.9
Estimate of Fair Value Measurement \| Mortgage-backed securities
Statement [Line Items]
Noncurrent investments	157.3	149.2
Estimate of Fair Value Measurement \| Asset-backed securities
Statement [Line Items]
Short-term investments		2.0
Noncurrent investments	53.5	50.6
Estimate of Fair Value Measurement \| Other securities
Statement [Line Items]
Short-term investments	25.0	58.6
Estimate of Fair Value Measurement \| Other securities, noncurrent investments
Statement [Line Items]
Equity securities	197.4	398.6
Estimate of Fair Value Measurement \| Marketable equity securities
Statement [Line Items]
Equity securities	711.3	683.6
Estimate of Fair Value Measurement \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Statement [Line Items]
Cash equivalents	1,079.3	650.4
Estimate of Fair Value Measurement \| Quoted Prices in Active Markets for Identical Assets (Level 1) \| U.S. government and agency securities
Statement [Line Items]
Short-term investments	32.1	30.8
Noncurrent investments	148.1	146.4
Estimate of Fair Value Measurement \| Quoted Prices in Active Markets for Identical Assets (Level 1) \| Corporate debt securities
Statement [Line Items]
Short-term investments	0.0	0.0
Noncurrent investments	0.0	0.0
Estimate of Fair Value Measurement \| Quoted Prices in Active Markets for Identical Assets (Level 1) \| Mortgage-backed securities
Statement [Line Items]
Noncurrent investments	0.0	0.0
Estimate of Fair Value Measurement \| Quoted Prices in Active Markets for Identical Assets (Level 1) \| Asset-backed securities
Statement [Line Items]
Short-term investments		0.0
Noncurrent investments	0.0	0.0
Estimate of Fair Value Measurement \| Quoted Prices in Active Markets for Identical Assets (Level 1) \| Other securities
Statement [Line Items]
Short-term investments	0.0	0.0
Estimate of Fair Value Measurement \| Quoted Prices in Active Markets for Identical Assets (Level 1) \| Other securities, noncurrent investments
Statement [Line Items]
Equity securities	0.0	0.0
Estimate of Fair Value Measurement \| Quoted Prices in Active Markets for Identical Assets (Level 1) \| Marketable equity securities
Statement [Line Items]
Equity securities	711.3	683.6
Estimate of Fair Value Measurement \| Significant Other Observable Inputs (Level 2)
Statement [Line Items]
Cash equivalents	9.1	7.0
Estimate of Fair Value Measurement \| Significant Other Observable Inputs (Level 2) \| U.S. government and agency securities
Statement [Line Items]
Short-term investments	0.0	0.0
Noncurrent investments	0.0	0.0
Estimate of Fair Value Measurement \| Significant Other Observable Inputs (Level 2) \| Corporate debt securities
Statement [Line Items]
Short-term investments	52.0	53.4
Noncurrent investments	214.3	213.9
Estimate of Fair Value Measurement \| Significant Other Observable Inputs (Level 2) \| Mortgage-backed securities
Statement [Line Items]
Noncurrent investments	157.3	149.2
Estimate of Fair Value Measurement \| Significant Other Observable Inputs (Level 2) \| Asset-backed securities
Statement [Line Items]
Short-term investments		2.0
Noncurrent investments	53.5	50.6
Estimate of Fair Value Measurement \| Significant Other Observable Inputs (Level 2) \| Other securities
Statement [Line Items]
Short-term investments	13.6	39.1
Estimate of Fair Value Measurement \| Significant Other Observable Inputs (Level 2) \| Other securities, noncurrent investments
Statement [Line Items]
Equity securities	23.5	311.0
Estimate of Fair Value Measurement \| Significant Other Observable Inputs (Level 2) \| Marketable equity securities
Statement [Line Items]
Equity securities	0.0	0.0
Estimate of Fair Value Measurement \| Significant Unobservable Inputs (Level 3)
Statement [Line Items]
Cash equivalents	0.0	0.0
Estimate of Fair Value Measurement \| Significant Unobservable Inputs (Level 3) \| U.S. government and agency securities
Statement [Line Items]
Short-term investments	0.0	0.0
Noncurrent investments	0.0	0.0
Estimate of Fair Value Measurement \| Significant Unobservable Inputs (Level 3) \| Corporate debt securities
Statement [Line Items]
Short-term investments	0.0	0.0
Noncurrent investments	0.0	0.0
Estimate of Fair Value Measurement \| Significant Unobservable Inputs (Level 3) \| Mortgage-backed securities
Statement [Line Items]
Noncurrent investments	0.0	0.0
Estimate of Fair Value Measurement \| Significant Unobservable Inputs (Level 3) \| Asset-backed securities
Statement [Line Items]
Short-term investments		0.0
Noncurrent investments	0.0	0.0
Estimate of Fair Value Measurement \| Significant Unobservable Inputs (Level 3) \| Other securities
Statement [Line Items]
Short-term investments	11.4	19.5
Estimate of Fair Value Measurement \| Significant Unobservable Inputs (Level 3) \| Other securities, noncurrent investments
Statement [Line Items]
Equity securities	173.9	87.6
Estimate of Fair Value Measurement \| Significant Unobservable Inputs (Level 3) \| Marketable equity securities
Statement [Line Items]
Equity securities	$ 0.0	$ 0.0

Acquisitions

12 Months Ended

Dec. 31, 2023

Business Combination and Asset Acquisition [Abstract]

Acquisitions

We engage in various forms of business development activities to enhance or refine our product pipeline, including acquisitions, collaborations, investments, and licensing arrangements. In connection with these arrangements, our partners may be entitled to future royalties and/or commercial milestones based on sales should products be approved for commercialization and/or milestones based on the successful progress of compounds through the development process.

In December 2023, December 2022, and January 2021, we completed the acquisitions of POINT Biopharma Global Inc. (POINT), Akouos, Inc. (Akouos), and Prevail Therapeutics Inc. (Prevail), respectively. These transactions, as further discussed below in Acquisitions of Businesses, were accounted for as business combinations under the acquisition method of accounting. Under this method, the assets acquired and liabilities assumed were recorded at their respective fair values as of the acquisition date in our consolidated financial statements. The determination of estimated fair value required management to make significant estimates and assumptions. The excess of the purchase price over the fair value of the acquired net assets, where applicable, has been recorded as goodwill. The results of operations of these acquisitions have been included in our consolidated financial statements from the date of acquisition.

We also acquired assets in development in 2023, 2022, and 2021, which are further discussed below in Asset Acquisitions. Upon each acquisition, the cost allocated to acquired IPR&D was immediately expensed as acquired IPR&D if the compound has no alternative future use. Milestone payment obligations incurred prior to regulatory approval of the compound are expensed when the event triggering an obligation to pay the milestone occurs. We recognized acquired IPR&D charges of $3.80 billion, $908.5 million, and $970.1 million for the years ended December 31, 2023, 2022, and 2021, respectively.

Acquisitions of Businesses

POINT Acquisition

Overview of Transaction

In December 2023, we acquired all shares of POINT for a purchase price of $12.50 per share in cash (or an aggregate of $1.04 billion, net of cash acquired). Under the terms of the agreement, we acquired capabilities to advance our radiopharmaceutical discovery, development, and manufacturing efforts, as well as clinical and pre-clinical radioligand therapies in development for the treatment of cancer.

Assets Acquired and Liabilities Assumed

Our access to POINT information was limited prior to the acquisition. As a consequence, we are in the process of determining fair values and tax bases of a significant portion of the assets acquired and liabilities assumed, including the identification and valuation of intangible assets and tax exposures. The final determination of these amounts will be completed as soon as possible but no later than one year from the acquisition date. The final determination may result in asset and liability fair values and tax bases that differ from the preliminary estimates and require changes to the preliminary amounts recognized.

The following table summarizes the preliminary amounts recognized for assets acquired and liabilities assumed as of the acquisition date:


Estimated Fair Value at December 27, 2023
Cash	$	302.7
Acquired IPR&D	196.0
Goodwill(1)	859.1

Other assets and liabilities, net	(19.3)
Acquisition date fair value of consideration transferred	1,338.5
Less:
Cash acquired	(302.7)
Cash paid, net of cash acquired	$	1,035.8

(1) The goodwill recognized from this acquisition is attributable primarily to the radiopharmaceutical discovery, development, and manufacturing capabilities and the assembled workforce for POINT, which is not deductible for tax purposes.

The results of operations attributable to POINT for the year ended December 31, 2023 were immaterial.

Pro forma information has not been included as this acquisition did not have a material impact on our consolidated statements of operations for the years ended December 31, 2023 and 2022.

Akouos Acquisition

Overview of Transaction

In December 2022, we acquired all shares of Akouos for a purchase price that included $12.50 per share in cash (or an aggregate of $327.2 million, net of cash acquired) plus one non-tradable contingent value right (CVR) per share. The CVR entitles the Akouos shareholders up to an additional $3.00 per share in cash (or an aggregate of approximately $122 million) payable, subject to certain terms and conditions, upon the achievement of certain specified milestones prior to December 2028.

Under the terms of the agreement, we acquired potential gene therapy treatments for hearing loss and other inner ear conditions. The lead gene therapies in clinical development that we acquired included GJB2 (which encodes connexin 26) for a common form of monogenic deafness and hearing loss; AK-OTOF for hearing loss due to mutations in the otoferlin gene; AK-CLRN1 for Usher Type 3A, an autosomal recessive disorder characterized by progressive loss of both hearing and vision; and AK-antiVEGF for vestibular schwannoma.

Assets Acquired and Liabilities Assumed

The following table summarizes the amounts recognized for assets acquired and liabilities assumed as of the acquisition date:


Estimated Fair Value at December 1, 2022
Cash	$	153.2
Acquired IPR&D(1)	184.0
Goodwill(2)	185.6

Other assets and liabilities, net	24.5
Acquisition date fair value of consideration transferred	547.3
Less:
Cash acquired	(153.2)
Fair value of CVR liability(3)	(66.9)
Cash paid, net of cash acquired	$	327.2

(1) Acquired IPR&D intangibles primarily relate to GJB2.

(2) The goodwill recognized from this acquisition is attributable primarily to future unidentified projects and products and the assembled workforce for Akouos and is not deductible for tax purposes.

(3) See Note 7 for a discussion on the estimation of the CVR liability.

The results of operations attributable to Akouos for the year ended December 31, 2023 and 2022 were immaterial.

Pro forma information has not been included as this acquisition did not have a material impact on our consolidated statements of operations for the years ended December 31, 2022 and 2021.

Prevail Acquisition

Overview of Transaction

In January 2021, we acquired all shares of Prevail for a purchase price that included $22.50 per share in cash (or an aggregate of $747.4 million, net of cash acquired) plus one non-tradable CVR per share. The CVR entitles Prevail stockholders up to an additional $4.00 per share in cash (or an aggregate of approximately $160 million) payable, subject to certain terms and conditions, upon the first regulatory approval of a Prevail product in one of the following countries: U.S., Japan, United Kingdom, Germany, France, Italy, or Spain. To achieve the full value of the CVR, such regulatory approval must occur by December 31, 2024. If such regulatory approval occurs after December 31, 2024, the value of the CVR will be reduced by approximately 8.3 cents per month until December 1, 2028, at which point the CVR will expire without payment.

Under the terms of the agreement, we acquired potentially disease-modifying AAV9-based gene therapies for patients with neurodegenerative diseases. The acquisition established a new modality for drug discovery and development, extending our research efforts through the creation of a gene therapy program that is being anchored by Prevail's portfolio of assets. The lead gene therapies in clinical development that we acquired were PR001 (GBA1 Gene Therapy) for patients with Parkinson's disease with GBA1 mutations and neuronopathic Gaucher disease and PR006 for patients with frontotemporal dementia with GRN mutations. Both PR001 and PR006 were granted Fast Track designation from the U.S. Food and Drug Administration.

Assets Acquired and Liabilities Assumed

The following table summarizes the amounts recognized for assets acquired and liabilities assumed as of the acquisition date:


Estimated Fair Value at January 22, 2021
Cash	$	90.5
Acquired IPR&D(1)	824.0
Goodwill(2)	126.8
Deferred tax liabilities	(106.0)
Other assets and liabilities, net	(31.5)
Acquisition date fair value of consideration transferred	903.8
Less:
Cash acquired	(90.5)
Fair value of CVR liability(3)	(65.9)
Cash paid, net of cash acquired	$	747.4

(1) Acquired IPR&D intangibles primarily relate to PR001 (GBA1 Gene Therapy). In 2022, we impaired the intangible asset related to GBA1 Gene Therapy. See Note 5 for additional information.

(2) The goodwill recognized from this acquisition is not deductible for tax purposes.

(3) See Note 7 for a discussion on the estimation of the CVR liability.

The results of operations attributable to Prevail for the years ended December 31, 2023, 2022, and 2021 were immaterial.

Pro forma information has not been included as this acquisition did not have a material impact on our consolidated statements of operations for the year ended December 31, 2021.

Asset Acquisitions

The following table summarizes our significant asset acquisitions during 2023, 2022, and 2021.

Counterparty

Compound(s),Therapy, or Asset

Acquisition Month

Phase of Development(1)

Acquired IPR&D Expense

Mablink Biosciences SAS

MBK-103, a folate receptor alpha antibody drug conjugate for the treatment of ovarian cancer

December 2023

Pre-clinical

256.6

Beam Therapeutics Inc.

Opt-in right for programs targeting PCSK9, ANGPTL3 and an undisclosed liver-mediated, cardiovascular target

October 2023

Phase I

216.3

DICE Therapeutics, Inc. (DICE)

DC-806, an oral IL-17 inhibitor for the treatment of chronic diseases in immunology

August 2023

Phase II

1,915.5

Versanis Bio, Inc. (Versanis)

Bimagrumab, a monoclonal antibody for the treatment of people living with obesity and obesity-related complications

August 2023

Phase II

604.1

Emergence Therapeutics AG

ETx-22, a Nectin-4 antibody-drug conjugate for the treatment of urothelial cancer

August 2023

Pre-clinical

406.5

BioMarin Pharmaceutical Inc.

Priority Review Voucher

February 2022

Not applicable

110.0

Foghorn Therapeutics Inc.

Pre-clinical targets that could lead to potential new oncology medicines

December 2021

Pre-clinical

316.6

Rigel Pharmaceuticals, Inc.

R552, a receptor-interacting serine/threonine-protein kinase 1 (RIPK1) inhibitor, for the potential treatment of autoimmune and inflammatory diseases

March 2021

Phase I

125.0

Precision Biosciences, Inc.

Potential in vivo therapies for genetic disorders

January 2021

Pre-clinical

107.8

(1) The phase of development presented is as of the date of the arrangement and represents the phase of development of the most advanced asset acquired, where applicable.

In connection with our acquisition of Petra Pharma Corporation (Petra) in 2020, we were required to make milestone payments to Petra shareholders contingent upon the occurrence of certain future events linked to the success of the mutant-selective PI3Kα inhibitor. In 2022, we entered into agreements with substantially all Petra shareholders to acquire their rights to receive any future milestone payments in exchange for a one-time payment. As a result of these agreements, we recognized a charge of $333.8 million as acquired IPR&D in 2022. Any remaining contingent milestones payments linked to the success of the mutant-selective PI3Kα inhibitor are not expected to be material.

We recognized no other significant acquired IPR&D charges during the years ended December 31, 2023, 2022, and 2021.

Acquisitions

Acquisitions of Businesses

POINT Acquisition

Overview of Transaction

Assets Acquired and Liabilities Assumed

The following table summarizes the preliminary amounts recognized for assets acquired and liabilities assumed as of the acquisition date:


Estimated Fair Value at December 27, 2023
Cash	$	302.7
Acquired IPR&D	196.0
Goodwill(1)	859.1

Other assets and liabilities, net	(19.3)
Acquisition date fair value of consideration transferred	1,338.5
Less:
Cash acquired	(302.7)
Cash paid, net of cash acquired	$	1,035.8

The results of operations attributable to POINT for the year ended December 31, 2023 were immaterial.

Pro forma information has not been included as this acquisition did not have a material impact on our consolidated statements of operations for the years ended December 31, 2023 and 2022.

Akouos Acquisition

Overview of Transaction

Assets Acquired and Liabilities Assumed

The following table summarizes the amounts recognized for assets acquired and liabilities assumed as of the acquisition date:


Estimated Fair Value at December 1, 2022
Cash	$	153.2
Acquired IPR&D(1)	184.0
Goodwill(2)	185.6

Other assets and liabilities, net	24.5
Acquisition date fair value of consideration transferred	547.3
Less:
Cash acquired	(153.2)
Fair value of CVR liability(3)	(66.9)
Cash paid, net of cash acquired	$	327.2

(1) Acquired IPR&D intangibles primarily relate to GJB2.

(2) The goodwill recognized from this acquisition is attributable primarily to future unidentified projects and products and the assembled workforce for Akouos and is not deductible for tax purposes.

(3) See Note 7 for a discussion on the estimation of the CVR liability.

The results of operations attributable to Akouos for the year ended December 31, 2023 and 2022 were immaterial.

Pro forma information has not been included as this acquisition did not have a material impact on our consolidated statements of operations for the years ended December 31, 2022 and 2021.

Prevail Acquisition

Overview of Transaction

Assets Acquired and Liabilities Assumed

The following table summarizes the amounts recognized for assets acquired and liabilities assumed as of the acquisition date:


Estimated Fair Value at January 22, 2021
Cash	$	90.5
Acquired IPR&D(1)	824.0
Goodwill(2)	126.8
Deferred tax liabilities	(106.0)
Other assets and liabilities, net	(31.5)
Acquisition date fair value of consideration transferred	903.8
Less:
Cash acquired	(90.5)
Fair value of CVR liability(3)	(65.9)
Cash paid, net of cash acquired	$	747.4

(1) Acquired IPR&D intangibles primarily relate to PR001 (GBA1 Gene Therapy). In 2022, we impaired the intangible asset related to GBA1 Gene Therapy. See Note 5 for additional information.

(2) The goodwill recognized from this acquisition is not deductible for tax purposes.

(3) See Note 7 for a discussion on the estimation of the CVR liability.

The results of operations attributable to Prevail for the years ended December 31, 2023, 2022, and 2021 were immaterial.

Pro forma information has not been included as this acquisition did not have a material impact on our consolidated statements of operations for the year ended December 31, 2021.

Asset Acquisitions

The following table summarizes our significant asset acquisitions during 2023, 2022, and 2021.

Counterparty

Compound(s),Therapy, or Asset

Acquisition Month

Phase of Development(1)

Acquired IPR&D Expense

Mablink Biosciences SAS

MBK-103, a folate receptor alpha antibody drug conjugate for the treatment of ovarian cancer

December 2023

Pre-clinical

256.6

Beam Therapeutics Inc.

Opt-in right for programs targeting PCSK9, ANGPTL3 and an undisclosed liver-mediated, cardiovascular target

October 2023

Phase I

216.3

DICE Therapeutics, Inc. (DICE)

DC-806, an oral IL-17 inhibitor for the treatment of chronic diseases in immunology

August 2023

Phase II

1,915.5

Versanis Bio, Inc. (Versanis)

Bimagrumab, a monoclonal antibody for the treatment of people living with obesity and obesity-related complications

August 2023

Phase II

604.1

Emergence Therapeutics AG

ETx-22, a Nectin-4 antibody-drug conjugate for the treatment of urothelial cancer

August 2023

Pre-clinical

406.5

BioMarin Pharmaceutical Inc.

Priority Review Voucher

February 2022

Not applicable

110.0

Foghorn Therapeutics Inc.

Pre-clinical targets that could lead to potential new oncology medicines

December 2021

Pre-clinical

316.6

Rigel Pharmaceuticals, Inc.

R552, a receptor-interacting serine/threonine-protein kinase 1 (RIPK1) inhibitor, for the potential treatment of autoimmune and inflammatory diseases

March 2021

Phase I

125.0

Precision Biosciences, Inc.

Potential in vivo therapies for genetic disorders

January 2021

Pre-clinical

107.8

(1) The phase of development presented is as of the date of the arrangement and represents the phase of development of the most advanced asset acquired, where applicable.

We recognized no other significant acquired IPR&D charges during the years ended December 31, 2023, 2022, and 2021.

Retirement Benefits (Schedule of Benefit Obligations and Plan Assets and Funded Status) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Change in plan assets:
Accrued retirement benefits	$ (1,438.8)	$ (1,305.1)
Defined Benefit Pension Plans
Change in benefit obligation:
Benefit obligation at beginning of year	13,222.0	17,565.0
Service cost	290.4	351.7	$ 369.2
Interest cost	648.2	398.1	337.8
Actuarial (gain) loss	590.5	(4,158.9)
Benefits paid	(610.5)	(608.9)
Foreign currency exchange rate changes and other adjustments	117.3	(325.0)
Benefit obligation at end of year	14,257.9	13,222.0	17,565.0
Change in plan assets:
Fair value of plan assets at beginning of year	13,708.7	13,195.8	16,416.0
Actual return on plan assets	881.9	(2,388.1)
Employer contribution	120.6	118.1
Benefits paid	(610.5)	(608.9)
Foreign currency exchange rate changes and other adjustments	120.9	(341.3)
Fair value of plan assets at end of year	13,708.7	13,195.8	16,416.0
Funded status	(549.2)	(26.2)
Unrecognized net actuarial (gain) loss	3,357.9	2,687.2
Unrecognized prior service (benefit) cost	6.4	8.4
Net amount recognized	2,815.1	2,669.4
Other noncurrent assets	810.6	1,208.0
Other current liabilities	(70.4)	(70.4)
Accrued retirement benefits	(1,289.4)	(1,163.8)
Accumulated other comprehensive (income) loss before income taxes	3,364.3	2,695.6
Retiree Health Benefit Plans
Change in benefit obligation:
Benefit obligation at beginning of year	1,258.8	1,663.8
Service cost	31.8	46.6	49.2
Interest cost	61.3	37.8	32.5
Actuarial (gain) loss	34.5	(395.9)
Benefits paid	(80.6)	(86.8)
Foreign currency exchange rate changes and other adjustments	4.5	(6.7)
Benefit obligation at end of year	1,310.3	1,258.8	1,663.8
Change in plan assets:
Fair value of plan assets at beginning of year	2,580.3	2,492.5	3,361.4
Actual return on plan assets	166.8	(796.0)
Employer contribution	1.7	13.9
Benefits paid	(80.6)	(86.8)
Foreign currency exchange rate changes and other adjustments	(0.1)	0.0
Fair value of plan assets at end of year	2,580.3	2,492.5	$ 3,361.4
Funded status	1,270.0	1,233.7
Unrecognized net actuarial (gain) loss	109.6	54.5
Unrecognized prior service (benefit) cost	(9.5)	(62.2)
Net amount recognized	1,370.1	1,226.0
Other noncurrent assets	1,427.7	1,383.4
Other current liabilities	(8.3)	(8.4)
Accrued retirement benefits	(149.4)	(141.3)
Accumulated other comprehensive (income) loss before income taxes	$ 100.1	$ (7.7)

Stock-Based Compensation (Schedule of Assumptions Used) (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Shareholder Value Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected dividend yield	1.07%	1.60%	2.50%
Risk-free interest rate	4.08%	1.57%	0.19%
Volatility	29.87%	32.99%	31.42%
Relative Value Awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected dividend yield	1.07%	1.60%	2.50%
Risk-free interest rate	4.08%	1.57%	0.19%
Volatility	31.25%	32.86%	30.95%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 35
-Paragraph 1D
-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 35
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480483/718-10-35-3

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
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-Topic 718
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-Name Accounting Standards Codification
-Section 50
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-Subparagraph (a)(2)
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)(3)
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
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-Subparagraph (c)(1)(iii)
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(1)(iv)
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(1)(iv)(01)
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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Reference 24: http://www.xbrl.org/2003/role/disclosureRef
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Reference 25: http://www.xbrl.org/2003/role/disclosureRef
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Reference 26: http://www.xbrl.org/2003/role/disclosureRef
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Reference 27: http://www.xbrl.org/2003/role/disclosureRef
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Reference 28: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
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-URI https://asc.fasb.org//1943274/2147480429/718-10-50-2

+ Details

Borrowings

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Borrowings

Debt at December 31 consisted of the following:


	2023		2022
Short-term commercial paper borrowings	$	6,189.4	$	1,498.0
Long-term notes	19,104.6		14,815.3
Other long-term debt	6.5		6.9
Unamortized debt issuance costs	(90.5)		(77.2)
Fair value adjustment on hedged long-term notes	15.3		(4.4)
Total debt	25,225.3		16,238.6
Less current portion	(6,904.5)		(1,501.1)
Long-term debt	$	18,320.8	$	14,737.5

The weighted-average effective borrowing rates on short-term commercial paper borrowings were 5.39 percent and 4.20 percent at December 31, 2023 and 2022, respectively.

The following table summarizes long-term notes at December 31:


	2023		2022



0.15% Swiss franc denominated notes due 2024	$	714.6	$	649.5
7.125% notes due 2025	217.5		217.5
2.75% notes due 2025	560.6		560.6
5.0% notes due 2026	750.0		—
1.625% euro denominated notes due 2026	830.7		799.3
5.5% notes due 2027	364.3		364.3
3.1% notes due 2027	401.5		401.5
0.45% Swiss franc denominated notes due 2028	476.4		433.0
3.375% notes due 2029	930.6		930.6
0.42% Japanese yen denominated notes due 2029	162.5		172.1
2.125% euro denominated notes due 2030	830.7		799.3
0.625% euro denominated notes due 2031	664.6		639.4
4.7% notes due 2033	1,000.0		—
0.50% euro denominated notes due 2033	664.6		639.4
0.56% Japanese yen denominated notes due 2034	65.8		69.7
6.77% notes due 2036	158.6		158.6
5.55% notes due 2037	444.7		444.7
5.95% notes due 2037	266.8		266.8
3.875% notes due 2039	240.3		240.3
1.625% British pound denominated notes due 2043	318.5		301.2
4.65% notes due 2044	38.3		38.3
3.7% notes due 2045	386.8		386.8
3.95% notes due 2047	347.0		347.0
3.95% notes due 2049	958.2		958.2
1.70% euro denominated notes due 2049	1,107.6		1,065.7
0.97% Japanese yen denominated notes due 2049	54.2		57.4
2.25% notes due 2050	1,250.0		1,250.0

1.125% euro denominated notes due 2051	553.8		532.9
4.875% notes due 2053	1,250.0		—
4.15% notes due 2059	591.3		591.3
2.50% notes due 2060	850.0		850.0
1.375% euro denominated notes due 2061	775.3		746.0
4.95% notes due 2063	1,000.0		—
Unamortized note discounts	(121.2)		(96.1)
Total long-term notes	$	19,104.6	$	14,815.3

The weighted-average effective borrowing rate for each issuance of the long term-notes approximates the stated interest rate.

At December 31, 2023, we had a total of $7.42 billion of unused committed bank credit facilities, which consisted primarily of a $3.00 billion credit facility that expires in December 2027 and a $4.00 billion 364-day facility that expires in September 2024, both of which are available to support our commercial paper program. We have not drawn against the $3.00 billion and $4.00 billion facilities as of December 31, 2023. Of the remaining committed bank credit facilities, the outstanding balances as of December 31, 2023 and 2022 were not material. Compensating balances and commitment fees are not material, and there are no conditions that are probable of occurring under which the lines may be withdrawn.

In February 2024, we issued $1.00 billion of 4.500 percent fixed-rate notes due in 2027, $1.00 billion of 4.500 percent fixed-rate notes due in 2029, $1.50 billion of 4.700 percent fixed-rate notes due in 2034, $1.50 billion of 5.000 percent fixed-rate notes due in 2054, and $1.50 billion of 5.100 percent fixed-rate notes due in 2064, all with interest to be paid semi-annually. We used, or will be using, the net cash proceeds from the offering of $6.45 billion for general business purposes, including the repayment of outstanding commercial paper, repayment of current maturities of long-term debt, and repayment of the $750.0 million of 5.000 percent fixed-rate notes due in 2026, which are callable at par beginning February 27, 2024.

In February 2023, we issued $750.0 million of 5.000 percent fixed-rate notes due in 2026, which are callable at par after one year, $1.00 billion of 4.700 percent fixed-rate notes due in 2033, $1.25 billion of 4.875 percent fixed-rate notes due in 2053, and $1.00 billion of 4.950 percent fixed-rate notes due in 2063, all with interest to be paid semi-annually. We used the net cash proceeds from the offering of $3.96 billion for general business purposes, including the repayment of outstanding commercial paper.

In September 2021, we issued euro-denominated notes totaling €1.80 billion and British pound-denominated notes totaling £250.0 million. We paid $1.91 billion of the net cash proceeds from the offering to purchase and redeem certain higher interest rate U.S. dollar-denominated notes with an aggregate principal amount of $1.50 billion, resulting in a debt extinguishment loss of $405.2 million. This loss was included in other-net, (income) expense in our consolidated statement of operations for the year ended December 31, 2021.

The aggregate amounts of maturities on long-term debt for the next five years are as follows:


	2024		2025		2026		2027		2028
Maturities on long-term debt	$	717.5	$	778.1	$	1,580.7	$	765.8	$	476.4

We have converted approximately 12 percent of our long-term fixed-rate notes to floating rates through the use of interest rate swaps. The weighted-average effective borrowing rates based on long-term debt obligations and interest rates at December 31, 2023 and 2022, including the effects of interest rate swaps for hedged debt obligations, were 3.37 percent and 2.87 percent, respectively.

The aggregate amount of cash payments for interest on borrowings, net of capitalized interest, are as follows:


	2023		2022		2021
Cash payments for interest on borrowings	$	404.2	$	323.7	$	338.0

In accordance with the requirements of derivatives and hedging guidance, the portion of our fixed-rate debt obligations that is hedged as a fair value hedge is reflected in the consolidated balance sheets as an amount equal to the sum of the debt's carrying value plus the fair value adjustment representing changes in fair value of the hedged debt attributable to movements in market interest rates subsequent to the inception of the hedge.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 470
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//470/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1E
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1E

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details

Retirement Benefits (Schedule of Expected Benefit Payments, Contributions and Expense) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Defined Benefit Plan, Pension Plan with Project Benefit Obligation in Excess of Plan Assets [Abstract]
Projected benefit obligation	$ 2,395.3	$ 2,211.2
Fair value of plan assets	1,035.4	977.1
Defined Benefit Plan, Plan with Accumulated Benefit Obligation in Excess of Plan Assets [Abstract]
Fair value of plan assets	1,035.4	977.1
Other Comprehensive (Income) Loss, Defined Benefit Plan, before Reclassification Adjustment and Tax [Abstract]
Total other comprehensive income (loss) during period	(776.5)	616.9	$ 2,699.4
Defined Benefit Pension Plans
Defined Benefit Plan, Expected Future Benefit Payment [Abstract]
2023	661.2
2024	671.4
2025	695.0
2026	722.5
2027	746.5
2029-2033	4,160.7
Defined Benefit Plan, Pension Plan with Project Benefit Obligation in Excess of Plan Assets [Abstract]
Fair value of plan assets	564.3	652.7
Defined Benefit Plan, Plan with Accumulated Benefit Obligation in Excess of Plan Assets [Abstract]
Accumulated benefit obligation	1,659.5	1,721.7
Fair value of plan assets	564.3	652.7
Components of net periodic (benefit) cost:
Service cost	290.4	351.7	369.2
Interest cost	648.2	398.1	337.8
Expected return on plan assets	(1,055.0)	(947.6)	(949.3)
Amortization of prior service (benefit) cost	2.4	2.4	4.2
Recognized actuarial (gain) loss	122.0	342.4	487.7
Net periodic (benefit) cost	8.0	147.0	249.6
Other Comprehensive (Income) Loss, Defined Benefit Plan, before Reclassification Adjustment and Tax [Abstract]
Actuarial gain (loss) arising during period	(763.9)	823.6	2,072.4
Amortization of prior service (benefit) cost included in net income	2.4	2.4	4.2
Amortization of net actuarial (gain) loss included in net income	122.0	342.4	487.7
Foreign currency exchange rate changes and other	(29.2)	55.5	47.2
Total other comprehensive income (loss) during period	(668.7)	1,223.9	2,611.5
Retiree Health Benefit Plans
Defined Benefit Plan, Expected Future Benefit Payment [Abstract]
2023	93.8
2024	94.5
2025	94.7
2026	95.2
2027	95.6
2029-2033	475.9
Defined Benefit Plan, Pension Plan with Project Benefit Obligation in Excess of Plan Assets [Abstract]
Fair value of plan assets	0.0	0.0
Defined Benefit Plan, Plan with Accumulated Benefit Obligation in Excess of Plan Assets [Abstract]
Accumulated benefit obligation	157.7	149.8
Fair value of plan assets	0.0	0.0
Components of net periodic (benefit) cost:
Service cost	31.8	46.6	49.2
Interest cost	61.3	37.8	32.5
Expected return on plan assets	(182.1)	(152.1)	(146.2)
Amortization of prior service (benefit) cost	(52.9)	(54.8)	(59.6)
Recognized actuarial (gain) loss	(5.8)	0.9	3.2
Net periodic (benefit) cost	(147.7)	(121.6)	(120.9)
Other Comprehensive (Income) Loss, Defined Benefit Plan, before Reclassification Adjustment and Tax [Abstract]
Actuarial gain (loss) arising during period	(49.8)	(552.2)	142.5
Amortization of prior service (benefit) cost included in net income	(52.9)	(54.8)	(59.6)
Amortization of net actuarial (gain) loss included in net income	(5.8)	0.9	3.2
Foreign currency exchange rate changes and other	0.7	(0.9)	1.9
Total other comprehensive income (loss) during period	$ (107.8)	$ (607.0)	$ 88.0

Shareholders' Equity	12 Months Ended
Shareholders' Equity	Dec. 31, 2023
Stockholders' Equity Note [Abstract]
Shareholders' Equity	Shareholders' Equity In 2023, 2022, and 2021, we repurchased $750.0 million, $1.50 billion, and $1.25 billion, respectively, of shares associated with our share repurchase programs. As of December 31, 2023, we had $2.50 billion remaining under our $5.00 billion share repurchase program that our board authorized in May 2021. We have 5.0 million authorized shares of preferred stock. As of December 31, 2023 and 2022, no preferred stock was issued. We have an employee benefit trust that held 50.0 million shares of our common stock at both December 31, 2023 and 2022, to provide a source of funds to assist us in meeting our obligations under various employee benefit plans. The cost basis of the shares held in the trust was $3.01 billion at both December 31, 2023 and 2022, and is shown as a reduction of shareholders' equity. Any dividend transactions between us and the trust are eliminated. Stock held by the trust is not considered outstanding in the computation of EPS. The assets of the trust were not used to fund any of our obligations under these employee benefit plans during the years ended December 31, 2023, 2022, and 2021.

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 1
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 1
-Subparagraph (SX 210.4-08(e)(1))
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-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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-URI https://asc.fasb.org//505/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Income Taxes (Schedule of Deferred Tax Asset and Liabilities) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Deferred tax assets:
Capitalized research and development	$ 2,997.5	$ 1,615.4
Purchases of intangible assets	1,981.9	2,071.3
Sales rebates and discounts	1,632.5	1,312.9
Correlative tax adjustments	1,031.3	752.5
Tax credit carryforwards	577.0	477.6
Tax loss and other tax carryforwards	527.2	626.0
Compensation and benefits	521.4	427.9
Foreign tax redeterminations	323.7	267.8
Operating lease liabilities	253.3	147.5
Other	463.4	361.0
Total gross deferred tax assets	10,309.2	8,059.9
Valuation allowances	(913.5)	(775.1)
Total deferred tax assets	9,395.7	7,284.8
Deferred tax liabilities:
Intangibles	(1,338.2)	(1,387.9)
Earnings of foreign subsidiaries	(796.6)	(1,226.0)
Inventories	(619.5)	(639.5)
Property and equipment	(495.2)	(433.5)
Prepaid employee benefits	(460.6)	(546.5)
Operating lease assets	(237.1)	(130.7)
Financial instruments	(75.1)	(215.0)
Total deferred tax liabilities	(4,022.3)	(4,579.1)
Deferred tax assets, net	$ 5,373.4	$ 2,705.7

Goodwill and Other Intangibles (Schedule of Finite-lived and Indefinite-lived Intangible Assets other than Goodwill) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Finite-lived intangible assets:
Accumulated Amortization	$ (2,277.0)	$ (2,622.7)
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Carrying Amount, Gross	9,183.6	9,829.3
Accumulated Amortization	(2,277.0)	(2,622.7)
Carrying Amount, Net	6,906.6	7,206.6
Acquired IPR&D
Indefinite-lived Intangible Assets [Line Items]
Indefinite-lived intangible assets	966.8	1,871.8
Marketed products
Finite-lived intangible assets:
Carrying Amount, Gross	8,216.8	7,957.5
Accumulated Amortization	(2,277.0)	(2,622.7)
Carrying Amount, Net	5,939.8	5,334.8
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Accumulated Amortization	$ (2,277.0)	$ (2,622.7)

Property and Equipment (Schedule of Geographic Information) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	$ 14,500.0	$ 11,234.1
U.S. and Puerto Rico
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	9,993.2	7,709.7
Ireland
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	2,722.6	1,898.5
Other foreign countries
Revenues from External Customers and Long-Lived Assets [Line Items]
Long-lived assets	$ 1,784.2	$ 1,625.9

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Schedule of Components of Income Tax Expense

Following is the composition of income tax expense:


	2023		2022		2021
Current:
Federal(1)	$	3,017.9	$	2,153.6	$	938.5
Foreign	613.0		547.7		466.0
State	24.3		45.5		(28.4)
Total current tax expense	3,655.2		2,746.8		1,376.1
Deferred:
Federal	(2,369.0)		(1,992.4)		(977.5)
Foreign	34.2		(78.2)		174.6
State	(6.2)		(114.6)		0.6
Total deferred tax benefit	(2,341.0)		(2,185.2)		(802.3)
Income taxes	$	1,314.2	$	561.6	$	573.8

Schedule of Deferred Tax Assets and Liabilities

Significant components of our deferred tax assets and liabilities as of December 31 were as follows:


	2023		2022
Deferred tax assets:
Capitalized research and development	$	2,997.5	$	1,615.4
Purchases of intangible assets	1,981.9		2,071.3
Sales rebates and discounts	1,632.5		1,312.9
Correlative tax adjustments	1,031.3		752.5
Tax credit carryforwards	577.0		477.6
Tax loss and other tax carryforwards	527.2		626.0
Compensation and benefits	521.4		427.9
Foreign tax redeterminations	323.7		267.8
Operating lease liabilities	253.3		147.5
Other	463.4		361.0
Total gross deferred tax assets	10,309.2		8,059.9
Valuation allowances	(913.5)		(775.1)
Total deferred tax assets	9,395.7		7,284.8
Deferred tax liabilities:
Intangibles	(1,338.2)		(1,387.9)
Earnings of foreign subsidiaries	(796.6)		(1,226.0)
Inventories	(619.5)		(639.5)
Property and equipment	(495.2)		(433.5)
Prepaid employee benefits	(460.6)		(546.5)
Operating lease assets	(237.1)		(130.7)
Financial instruments	(75.1)		(215.0)
Total deferred tax liabilities	(4,022.3)		(4,579.1)
Deferred tax assets - net	$	5,373.4	$	2,705.7

Schedule of Cash Payments Relating to Income Taxes and Tax Act Toll Tax

Cash payments of U.S. federal, state, and foreign income taxes, net of refunds, were as follows:


	2023		2022		2021
Cash payments of income taxes	$	5,558.8	$	2,672.9	$	1,598.8

Having made this election, our future cash payments relating to the Toll Tax as of December 31, 2023 are as follows:


	Total		2024		2025
2017 Tax Act Toll Tax	$	1,427.0	$	634.2	$	792.8

Schedule of Effective Income Tax Rate Reconciliation

Following is a reconciliation of the consolidated income tax expense applying the U.S. federal statutory rate to income before income taxes to reported consolidated income tax expense:


	2023		2022		2021
Income tax at the U.S. federal statutory tax rate	$	1,376.5	$	1,429.3	$	1,292.6
Add (deduct):
Non-deductible acquired IPR&D(1)	677.2		68.3		10.5
General business credits	(258.0)		(155.0)		(100.5)
Foreign-derived intangible income deduction	(236.7)		(287.5)		(86.7)
International operations, including Puerto Rico(2)	(187.1)		(299.5)		(447.5)
Stock-based compensation(3)	(79.9)		(48.9)		(55.7)

Valuation allowance release	(4.2)		(116.4)		(19.0)
Other	26.4		(28.7)		(19.9)
Income taxes	$	1,314.2	$	561.6	$	573.8

(1) Non-deductible acquired IPR&D was primarily related to the acquisitions of DICE, Versanis, and Emergence in 2023. See Note 3 for additional information related to acquisitions.

(2) Includes the impact of GILTI tax, Puerto Rico Excise Tax (for 2022 and 2021), and other U.S. taxation of foreign income.

(3) Includes excess tax benefits from stock-based compensation and non-deductible stock-based compensation.

Summary of Income Tax Contingencies

A reconciliation of the beginning and ending amount of gross unrecognized tax benefits is as follows:


	2023		2022		2021
Beginning balance at January 1	$	2,987.0	$	2,798.3	$	2,551.9
Additions based on tax positions related to the current year	364.3		274.2		310.3
Additions for tax positions of prior years	78.2		34.6		98.6
Reductions for tax positions of prior years	(39.0)		(10.9)		(8.1)
Settlements	(4.7)		(44.8)		(38.5)
Lapses of statutes of limitation	(21.5)		(11.8)		(49.7)
Changes related to the impact of foreign currency translation	30.7		(52.6)		(66.2)
Ending balance at December 31	$	3,395.0	$	2,987.0	$	2,798.3

Summary of Significant Accounting Policies and Implementation of New Financial Accounting Standards	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies and Implementation of New Financial Accounting Standards	Summary of Significant Accounting Policies and Implementation of New Financial Accounting Standards Basis of Presentation The accompanying consolidated financial statements include Eli Lilly and Company and all subsidiaries and have been prepared in accordance with accounting principles generally accepted in the United States (GAAP). We consider majority voting interests, as well as effective economic or other control over an entity when deciding whether or not to consolidate an entity. We generally do not have control by means other than voting interests. Where our ownership of consolidated subsidiaries is less than 100 percent, the noncontrolling shareholders' interests are reflected as a separate component of equity. All intercompany balances and transactions have been eliminated. The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues, expenses, and related disclosures at the date of the financial statements and during the reporting period. Actual results could differ from those estimates. We issued our financial statements by filing with the Securities and Exchange Commission (SEC) and have evaluated subsequent events up to the time of the filing of this Annual Report on Form 10-K. We operate as a single operating segment engaged in the discovery, development, manufacturing, marketing, and sales of pharmaceutical products worldwide. A global research and development organization and a supply chain organization are responsible for the discovery, development, manufacturing, and supply of our products. Regional commercial organizations market, distribute, and sell the products. The business is also supported by global corporate staff functions. Our determination that we operate as a single segment is consistent with the financial information regularly reviewed by the chief operating decision maker for purposes of evaluating performance, allocating resources, setting incentive compensation targets, and planning and forecasting for future periods. Research and Development Expenses and Acquired In-Process Research and Development (IPR&D) Research and development costs are expensed as incurred. Research and development costs consist of expenses incurred in performing research and development activities, including but not limited to, compensation and benefits, facilities and overhead expense, clinical trial expense and fees paid to contract research organizations. Acquired IPR&D includes the initial costs and development milestones incurred related to externally developed IPR&D projects, acquired directly in a transaction other than a business combination, that do not have an alternative future use. Development milestones are milestone payment obligations that are incurred prior to regulatory approval of the compound and are expensed when the event triggering an obligation to pay the milestone occurs. Earnings Per Share (EPS) All per-share amounts, unless otherwise noted in the footnotes, are presented on a diluted basis. We calculate basic EPS based on the weighted-average number of common shares outstanding plus the effect of incremental shares from potential participating securities. We calculate diluted EPS based on the weighted-average number of common shares outstanding plus the effect of incremental shares from our stock-based compensation programs. Foreign Currency Translation Operations in our subsidiaries outside the United States (U.S.) are recorded in the functional currency of each subsidiary which is determined by a review of the environment where each subsidiary primarily generates and expends cash. The results of operations for our subsidiaries outside the U.S. are translated from functional currencies into U.S. dollars using the weighted-average currency rate for the period. Assets and liabilities are translated using the period end exchange rates. The U.S. dollar effects that arise from translating the net assets of these subsidiaries are recorded in other comprehensive income (loss). Advertising Expenses Costs associated with advertising are expensed as incurred and are included in marketing, selling, and administrative expenses. Advertising expenses, comprised primarily of online marketing and television advertising, totaled $1.12 billion, $966.8 million, and $1.24 billion in 2023, 2022, and 2021, respectively, which was less than 5 percent of revenue each year. Other Significant Accounting Policies Our other significant accounting policies are described in the remaining appropriate notes to the consolidated financial statements. Reclassifications Certain reclassifications have been made to prior periods in the consolidated financial statements and accompanying notes to conform with the current presentation. Development milestone payments related to externally developed IPR&D projects, acquired directly in a transaction other than a business combination, were previously included in cash flows from operating activities in the consolidated statements of cash flows and are now included in purchases of IPR&D in cash flows from investing activities. The reclassification resulted in an increase to net cash provided by operating activities and net cash used in investing activities of $501.3 million and $105.2 million in 2022 and 2021, respectively. Implementation of New Financial Accounting Standards Accounting Standards Update (ASU) 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, establishes incremental disaggregation of income tax disclosures pertaining to the effective tax rate reconciliation and income taxes paid. This standard is effective for fiscal years beginning after December 15, 2024, and requires prospective application with the option to apply it retrospectively. Early adoption is permitted. We intend to adopt this standard in our Annual Report on Form 10-K for the year ended December 31, 2025. We are currently evaluating the potential impact of adopting this standard on our disclosures. ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, requires disclosures about significant segment expenses and additional interim disclosure requirements. This standard also requires a single reportable segment to provide all disclosures required by ASC 280. This standard is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted, and the amendments should be applied retrospectively for all prior periods presented in the consolidated financial statements. We intend to adopt this standard in our Annual Report on Form 10-K for the year ended December 31, 2024. We are currently evaluating the potential impact of adopting this standard on our disclosures.

Revenue (Disaggregation of Revenue by Geographical Area) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue [Line Items]
Revenue	$ 34,124.1	$ 28,541.4	$ 28,318.4
U.S.
Disaggregation of Revenue [Line Items]
Revenue	21,791.0	18,190.0	16,811.0
Europe
Disaggregation of Revenue [Line Items]
Revenue	6,174.7	4,299.2	4,776.8
Japan
Disaggregation of Revenue [Line Items]
Revenue	1,672.6	1,747.3	2,367.0
China
Disaggregation of Revenue [Line Items]
Revenue	1,539.7	1,452.8	1,661.4
Other foreign countries
Disaggregation of Revenue [Line Items]
Revenue	$ 2,946.2	$ 2,852.0	$ 2,702.2

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

+ References

+ Details

Collaborations and Other Arrangements (Tables)

12 Months Ended

Dec. 31, 2023

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Collaborative Arrangements

The following table summarizes our revenue recognized:


	2023		2022		2021
Jardiance	$	2,744.7	$	2,066.0	$	1,490.8
Basaglar	728.3		760.4		892.5
Trajenta	386.9		383.7		372.5

The following table summarizes our net product revenue recognized:


	2023		2022		2021
Olumiant	$	922.6	$	830.5	$	1,115.1

The following table summarizes our revenue recognized:


	2023		2022		2021
Tyvyt	$	393.4	$	293.3	$	418.1

Inventories (Details) - USD ($) $ in Millions	12 Months Ended
Inventories (Details) - USD ($) $ in Millions	Dec. 31, 2021	Dec. 31, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Finished products		$ 791.7	$ 901.2
Work in process		3,248.6	2,597.7
Raw materials and supplies		1,630.1	801.9
Total (approximates replacement cost)		5,670.4	4,300.8
Increase to LIFO cost		102.4	8.9
Inventories		5,772.8	4,309.7
LIFO inventory amount		$ 1,770.0	$ 1,230.0
Inventory write-down	$ 339.7

Stock-Based Compensation (Schedule of Stock-based Compensation Expense) (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-Based Payment Arrangement [Abstract]
Stock-based compensation expense	$ 628.5	$ 371.1	$ 342.8
Tax benefit	$ 132.0	$ 77.9	$ 72.0

Leases

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Leases

We determine if an arrangement is a lease at inception. We have leases with terms up to 16 years primarily for corporate offices, research and development facilities, vehicles, and equipment, including some of which have options to extend and/or early-terminate the leases. We determine the lease term by assuming the exercise of any renewal and/or early-termination options that are reasonably assured.

Operating lease right-of-use assets are presented as other noncurrent assets in our consolidated balance sheets, and the current and long-term portions of operating lease liabilities are included in other current liabilities and other noncurrent liabilities, respectively, in our consolidated balance sheets. Short-term leases, which are deemed at inception to have a lease term of 12 months or less, are not recorded on the consolidated balance sheets.

Operating lease assets represent our right to use an underlying asset for the lease term, and operating lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease term. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments.

Lease expense for operating lease assets, which is recognized on a straight-line basis over the lease term, was $171.2 million, $148.8 million, and $159.4 million during the years ended December 31, 2023, 2022, and 2021, respectively. Variable lease payments, which represent non-lease components such as maintenance, insurance and taxes, and which vary due to changes in facts or circumstances occurring after the commencement date other than the passage of time, are expensed in the period in which the payment obligation is incurred and were not material during the years ended December 31, 2023, 2022, and 2021. Short-term lease expense was not material during the years ended December 31, 2023, 2022, and 2021.

Supplemental balance sheet information related to operating leases as of December 31, 2023 and 2022 was as follows:


	2023		2022
Weighted-average remaining lease term	9 years		7 years
Weighted-average discount rate	4.4	%	3.6	%

Supplemental cash flow information related to operating leases during the years ended December 31, 2023, 2022, and 2021 was as follows:


	2023		2022		2021
Operating cash flows from operating leases	$	171.0	$	149.7	$	156.7
Right-of-use assets obtained in exchange for new operating lease liabilities	590.0		155.4		163.5

The right-of-use assets obtained in exchange for new operating lease liabilities in 2023 primarily related to the addition of our research and development facility in Boston, Massachusetts.

The annual minimum lease payments of our operating lease liabilities as of December 31, 2023 were as follows:



2024	$	197.0
2025	180.2
2026	153.9
2027	138.2
2028	108.1
After 2028	614.7
Total lease payments	1,392.1
Less imputed interest	284.8
Total	$	1,107.4

Finance leases are included in property and equipment, short-term borrowings and current maturities of long-term debt, and long-term debt in our consolidated balance sheets. Finance leases are not material to our consolidated financial statements.

Leases

Supplemental balance sheet information related to operating leases as of December 31, 2023 and 2022 was as follows:


	2023		2022
Weighted-average remaining lease term	9 years		7 years
Weighted-average discount rate	4.4	%	3.6	%

Supplemental cash flow information related to operating leases during the years ended December 31, 2023, 2022, and 2021 was as follows:


	2023		2022		2021
Operating cash flows from operating leases	$	171.0	$	149.7	$	156.7
Right-of-use assets obtained in exchange for new operating lease liabilities	590.0		155.4		163.5

The right-of-use assets obtained in exchange for new operating lease liabilities in 2023 primarily related to the addition of our research and development facility in Boston, Massachusetts.

The annual minimum lease payments of our operating lease liabilities as of December 31, 2023 were as follows:



2024	$	197.0
2025	180.2
2026	153.9
2027	138.2
2028	108.1
After 2028	614.7
Total lease payments	1,392.1
Less imputed interest	284.8
Total	$	1,107.4

Acquisitions (Tables)

12 Months Ended

Dec. 31, 2023

Business Combination and Asset Acquisition [Abstract]

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed

The following table summarizes the preliminary amounts recognized for assets acquired and liabilities assumed as of the acquisition date:


Estimated Fair Value at December 27, 2023
Cash	$	302.7
Acquired IPR&D	196.0
Goodwill(1)	859.1

Other assets and liabilities, net	(19.3)
Acquisition date fair value of consideration transferred	1,338.5
Less:
Cash acquired	(302.7)
Cash paid, net of cash acquired	$	1,035.8

The following table summarizes the amounts recognized for assets acquired and liabilities assumed as of the acquisition date:


Estimated Fair Value at December 1, 2022
Cash	$	153.2
Acquired IPR&D(1)	184.0
Goodwill(2)	185.6

Other assets and liabilities, net	24.5
Acquisition date fair value of consideration transferred	547.3
Less:
Cash acquired	(153.2)
Fair value of CVR liability(3)	(66.9)
Cash paid, net of cash acquired	$	327.2

(1) Acquired IPR&D intangibles primarily relate to GJB2.

(2) The goodwill recognized from this acquisition is attributable primarily to future unidentified projects and products and the assembled workforce for Akouos and is not deductible for tax purposes.

(3) See Note 7 for a discussion on the estimation of the CVR liability.

The following table summarizes the amounts recognized for assets acquired and liabilities assumed as of the acquisition date:


Estimated Fair Value at January 22, 2021
Cash	$	90.5
Acquired IPR&D(1)	824.0
Goodwill(2)	126.8
Deferred tax liabilities	(106.0)
Other assets and liabilities, net	(31.5)
Acquisition date fair value of consideration transferred	903.8
Less:
Cash acquired	(90.5)
Fair value of CVR liability(3)	(65.9)
Cash paid, net of cash acquired	$	747.4

(1) Acquired IPR&D intangibles primarily relate to PR001 (GBA1 Gene Therapy). In 2022, we impaired the intangible asset related to GBA1 Gene Therapy. See Note 5 for additional information.

(2) The goodwill recognized from this acquisition is not deductible for tax purposes.

(3) See Note 7 for a discussion on the estimation of the CVR liability.

Schedule of Research and Development Assets Acquired Other than Through Business Combination

The following table summarizes our significant asset acquisitions during 2023, 2022, and 2021.

Counterparty

Compound(s),Therapy, or Asset

Acquisition Month

Phase of Development(1)

Acquired IPR&D Expense

Mablink Biosciences SAS

MBK-103, a folate receptor alpha antibody drug conjugate for the treatment of ovarian cancer

December 2023

Pre-clinical

256.6

Beam Therapeutics Inc.

Opt-in right for programs targeting PCSK9, ANGPTL3 and an undisclosed liver-mediated, cardiovascular target

October 2023

Phase I

216.3

DICE Therapeutics, Inc. (DICE)

DC-806, an oral IL-17 inhibitor for the treatment of chronic diseases in immunology

August 2023

Phase II

1,915.5

Versanis Bio, Inc. (Versanis)

Bimagrumab, a monoclonal antibody for the treatment of people living with obesity and obesity-related complications

August 2023

Phase II

604.1

Emergence Therapeutics AG

ETx-22, a Nectin-4 antibody-drug conjugate for the treatment of urothelial cancer

August 2023

Pre-clinical

406.5

BioMarin Pharmaceutical Inc.

Priority Review Voucher

February 2022

Not applicable

110.0

Foghorn Therapeutics Inc.

Pre-clinical targets that could lead to potential new oncology medicines

December 2021

Pre-clinical

316.6

Rigel Pharmaceuticals, Inc.

R552, a receptor-interacting serine/threonine-protein kinase 1 (RIPK1) inhibitor, for the potential treatment of autoimmune and inflammatory diseases

March 2021

Phase I

125.0

Precision Biosciences, Inc.

Potential in vivo therapies for genetic disorders

January 2021

Pre-clinical

107.8

(1) The phase of development presented is as of the date of the arrangement and represents the phase of development of the most advanced asset acquired, where applicable.

Financial Instruments (Schedule of Risk Management Instruments) (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other current liabilities
Other current liabilities	$ (2.4)
Carrying Amount
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(39.5)	$ (39.5)
Other noncurrent liabilities	(64.4)	(70.6)
Carrying Amount \| Foreign Exchange Contract \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(115.8)
Carrying Amount \| Foreign Exchange Contract \| Not Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(55.9)	(21.5)
Other receivables	129.6	26.6
Estimate of Fair Value Measurement
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(39.5)	(39.5)
Other noncurrent liabilities	(64.4)	(70.6)
Estimate of Fair Value Measurement \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	0.0	0.0
Other noncurrent liabilities	0.0	0.0
Estimate of Fair Value Measurement \| Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	0.0	0.0
Other noncurrent liabilities	0.0	0.0
Estimate of Fair Value Measurement \| Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(39.5)	(39.5)
Other noncurrent liabilities	(64.4)	(70.6)
Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(115.8)
Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Designated as Hedging Instrument \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	0.0
Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Designated as Hedging Instrument \| Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(115.8)
Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Designated as Hedging Instrument \| Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	0.0
Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Not Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(55.9)	(21.5)
Other receivables	129.6	26.6
Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Not Designated as Hedging Instrument \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	0.0	0.0
Other receivables	0.0	0.0
Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Not Designated as Hedging Instrument \| Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(55.9)	(21.5)
Other receivables	129.6	26.6
Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Not Designated as Hedging Instrument \| Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	0.0	0.0
Other receivables	0.0	0.0
Fair value hedges \| Carrying Amount \| Interest Rate Contract \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(2.4)
Other noncurrent liabilities	(100.3)	(134.3)
Fair value hedges \| Estimate of Fair Value Measurement \| Interest Rate Contract \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other noncurrent liabilities	(100.3)	(134.3)
Fair value hedges \| Estimate of Fair Value Measurement \| Interest Rate Contract \| Designated as Hedging Instrument \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	0.0
Other noncurrent liabilities	0.0	0.0
Fair value hedges \| Estimate of Fair Value Measurement \| Interest Rate Contract \| Designated as Hedging Instrument \| Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(2.4)
Other noncurrent liabilities	(100.3)	(134.3)
Fair value hedges \| Estimate of Fair Value Measurement \| Interest Rate Contract \| Designated as Hedging Instrument \| Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	0.0
Other noncurrent liabilities	0.0	0.0
Cash flow hedges \| Carrying Amount \| Interest Rate Contract \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other receivables		162.9
Other noncurrent assets	291.2	246.0
Cash flow hedges \| Carrying Amount \| Cross-currency interest rate swaps \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other receivables	113.8
Other noncurrent assets	63.1	53.1
Cash flow hedges \| Estimate of Fair Value Measurement \| Interest Rate Contract \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other receivables		162.9
Other noncurrent assets	291.2	246.0
Cash flow hedges \| Estimate of Fair Value Measurement \| Interest Rate Contract \| Designated as Hedging Instrument \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other receivables		0.0
Other noncurrent assets	0.0	0.0
Cash flow hedges \| Estimate of Fair Value Measurement \| Interest Rate Contract \| Designated as Hedging Instrument \| Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other receivables		162.9
Other noncurrent assets	291.2	246.0
Cash flow hedges \| Estimate of Fair Value Measurement \| Interest Rate Contract \| Designated as Hedging Instrument \| Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other receivables		0.0
Other noncurrent assets	0.0	0.0
Cash flow hedges \| Estimate of Fair Value Measurement \| Cross-currency interest rate swaps \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other receivables	113.8
Other noncurrent assets	63.1	53.1
Cash flow hedges \| Estimate of Fair Value Measurement \| Cross-currency interest rate swaps \| Designated as Hedging Instrument \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other receivables	0.0
Other noncurrent assets	0.0	0.0
Cash flow hedges \| Estimate of Fair Value Measurement \| Cross-currency interest rate swaps \| Designated as Hedging Instrument \| Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other receivables	113.8
Other noncurrent assets	63.1	53.1
Cash flow hedges \| Estimate of Fair Value Measurement \| Cross-currency interest rate swaps \| Designated as Hedging Instrument \| Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other receivables	0.0
Other noncurrent assets	0.0	0.0
Net investment hedges \| Carrying Amount \| Cross-currency interest rate swaps \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(28.4)
Other noncurrent liabilities	(3.5)
Other receivables		67.6
Net investment hedges \| Carrying Amount \| Foreign Exchange Contract \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities		(38.3)
Net investment hedges \| Estimate of Fair Value Measurement \| Cross-currency interest rate swaps \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(28.4)
Other noncurrent liabilities	(3.5)
Other receivables		67.6
Net investment hedges \| Estimate of Fair Value Measurement \| Cross-currency interest rate swaps \| Designated as Hedging Instrument \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	0.0
Other noncurrent liabilities	0.0
Other receivables		0.0
Net investment hedges \| Estimate of Fair Value Measurement \| Cross-currency interest rate swaps \| Designated as Hedging Instrument \| Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	(28.4)
Other noncurrent liabilities	(3.5)
Other receivables		67.6
Net investment hedges \| Estimate of Fair Value Measurement \| Cross-currency interest rate swaps \| Designated as Hedging Instrument \| Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities	0.0
Other noncurrent liabilities	$ 0.0
Other receivables		0.0
Net investment hedges \| Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Designated as Hedging Instrument
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities		(38.3)
Net investment hedges \| Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Designated as Hedging Instrument \| Quoted Prices in Active Markets for Identical Assets (Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities		0.0
Net investment hedges \| Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Designated as Hedging Instrument \| Significant Other Observable Inputs (Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities		(38.3)
Net investment hedges \| Estimate of Fair Value Measurement \| Foreign Exchange Contract \| Designated as Hedging Instrument \| Significant Unobservable Inputs (Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Other current liabilities		$ 0.0