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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Cash flow from operating activities:      
Net income $ 1,161.5 $ 2,961.6 $ 1,727.6
Adjustments to reconcile net income to net cash flow from operating activities:      
Depreciation and amortization 494.8 518.4 487.7
Impairment of intangible assets 0.0 119.6 629.3
Excess and obsolescence charges related to inventory 124.4 336.2 167.6
Amortization of inventory step-up 31.5 0.0 0.0
Acquired in-process research and development 0.0 0.0 18.0
Share-based compensation 264.2 254.1 238.6
Contingent consideration 0.0 (209.1) (50.7)
Deferred income taxes (305.8) (168.6) (426.8)
(Gain) loss on strategic investments 277.1 265.9 826.8
(Gain) loss on equity method investment 0.0 (2.6) (34.9)
Gain on sale of equity interest in Samsung Bioepis 0.0 (1,505.4) 0.0
Gain on sale of building 0.0 (503.7) 0.0
Other 148.2 208.2 202.2
Changes in operating assets and liabilities, net of effects of business acquired:      
Accounts receivable 61.3 (203.4) 324.8
Due from anti-CD20 therapeutic programs (4.6) (19.0) 1.2
Inventory (130.9) (320.2) (462.4)
Accrued expense and other current liabilities (201.6) (113.4) (95.4)
Income tax assets and liabilities (299.0) (142.3) 230.8
Other changes in operating assets and liabilities, net (73.9) (92.0) (144.5)
Net cash flow provided by (used in) operating activities 1,547.2 1,384.3 3,639.9 Close
Cash flow from investing activities:      
Purchases of property, plant and equipment (277.0) (240.3) (258.1)
Proceeds from sales and maturities of marketable securities 7,380.8 3,671.0 3,405.4
Purchases of marketable securities (5,140.7) (3,448.5) (3,808.7)
Proceeds from sale of building (6,926.1)    
Proceeds from sale of equity interest in Samsung Bioepis 788.1 990.3 0.0
Proceeds from sale of building 0.0 582.6 0.0
Proceeds from divestiture of Hillerød, Denmark manufacturing operations 0.0 0.0 28.1
Acquired in-process research and development     (18.0)
Acquisitions of intangible assets (34.4) (2.9) (18.8)
Proceeds from sales of strategic investments 119.6 0.0 93.5
Other (11.3) 24.4 12.9
Net cash flow provided by (used in) investing activities (4,101.0) 1,576.6 (563.7) Close
Cash flow from financing activities:      
Purchase of treasury stock 0.0 (750.0) (1,800.0)
Payments related to issuance of stock for share-based compensation arrangements, net (44.3) (1.9) (0.7)
Repayments of borrowings and premiums paid (809.9) (1,002.2) (170.0)
Proceeds from borrowings 997.2 0.0 0.0
Net (distribution) contribution to noncontrolling interest 12.3 12.4 (94.4)
Other (6.0) (5.6) (21.1)
Net cash flow provided by (used in) financing activities 149.3 (1,747.3) (2,086.2) Close
Net increase (decrease) in cash and cash equivalents (2,404.5) 1,213.6 990.0 Close
Effect of exchange rate changes on cash and cash equivalents 35.1 (55.7) (59.8)
Cash and cash equivalents, beginning of the year 3,419.3 2,261.4 1,331.2
Cash and cash equivalents, end of the year $ 1,049.9 $ 3,419.3 $ 2,261.4