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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Cash flow from operating activities:    
Net income $ 1,365.5 $ 912.6
Adjustments to reconcile net income to net cash flow from operating activities:    
Depreciation and amortization 489.2 354.7
Impairment of intangible assets 20.2 0.0
Excess and obsolescence charges related to inventory 68.7 62.1
Amortization of acquired inventory step-up 185.1 0.0
Share-based compensation 216.1 209.3
Contingent consideration 23.8 0.0
Deferred income taxes (99.7) (377.7)
(Gain) loss on strategic investments 22.7 275.7
Gain on sale of priority review voucher, net 88.6 0.0
Other 95.1 98.6
Changes in operating assets and liabilities, net of effects of business acquired:    
Inventory (207.4) (34.9)
Accrued expense and other current liabilities (84.2) 293.9
Income tax assets and liabilities 62.1 (114.8)
Other changes in operating assets and liabilities, net (65.7) (71.4)
Net cash flow provided by (used in) operating activities 2,114.6 1,534.7 Close
Cash flow from investing activities:    
Purchases of property, plant and equipment (114.4) (211.8)
Proceeds from sales and maturities of marketable securities 0.0 7,380.8
Purchases of marketable securities 0.0 (5,140.7)
Acquisition, net of cash acquired 1,074.8 6,335.6
Proceeds from sale of equity interest in Samsung Bioepis 406.8 788.1
Proceeds from sale of priority review voucher 88.6 0.0
Acquisitions of intangible assets (179.1) (34.4)
Proceeds from sales of strategic investments 96.7 106.2
Other (4.4) (1.3)
Net cash flow provided by (used in) investing activities (780.6) (3,448.7) Close
Cash flow from financing activities:    
Payments related to issuance of stock for share-based compensation arrangements, net (34.8) (48.0)
Repayment of borrowings 650.0 159.9
Proceeds from borrowings 0.0 997.2
Net (distribution) contribution to noncontrolling interest 0.0 4.2
Other (6.6) 1.9
Net cash flow provided by (used in) financing activities (691.4) 795.4 Close
Net increase (decrease) in cash and cash equivalents 642.6 (1,118.6) Close
Effect of exchange rate changes on cash and cash equivalents 6.7 (12.8)
Cash and cash equivalents, beginning of the period 1,049.9 3,419.3
Cash and cash equivalents, end of the period 1,699.2 2,287.9
Nonrelated Party    
Changes in operating assets and liabilities, net of effects of business acquired:    
Accounts receivable 127.6 (76.5)
Related Party    
Changes in operating assets and liabilities, net of effects of business acquired:    
Accounts receivable $ (15.9) $ 3.1