Dive Brief:

• Johnson & Johnson’s sales rose 9.1% in the fourth quarter to $24.6 billion, as demand for new medicines helped make up for plummeting revenue from the blockbuster drug Stelara.
• Next year’s sales should increase to between $100 billion and $101 billion, up from $94.2 billion last year, J&J said Wednesday. The company forecast adjusted earnings per share of between $11.43 and $11.63 for 2026. 
• The fourth-quarter sales figure beat the Wall Street consensus by 2%, Leerink Partners analyst David Risinger wrote in a note to clients. And J&J’s guidance for the year was just “marginally” above consensus, with increased sales held back by higher costs, he added.

Dive Insight:

Investors appeared unimpressed with J&J’s report, sending the company’s shares down 1% in early trading Wednesday. Even as CEO Joaquin Duato trumpets the “strongest portfolio in our history,” J&J is fighting through concerns about the loss of exclusivity for top-selling drugs, litigation over talcum powder and sales for several key drugs that fell short of expectations in the fourth quarter.

The most pressing concern for J&J’s portfolio is the autoimmune drug Stelara, which raked in more than $10 billion in 2024 but has been on a downward slope with the loss of U.S. patent protection in 2023. In the fourth quarter, Stelara sales dropped 55% to $766 million in the U.S.; worldwide revenue fell 48% to $1.23 billion for the period.

Meanwhile, a U.S. patent expiration looms in 2029 for the cancer drug Darzalex, which brought in $14.4 billion last year as sales rose 23%. 

J&J isn’t alone in facing the patent cliff. The company has tried to compensate in part by looking outside, paying close to $15 billion to buy psychiatric drug developer Intra-Cellular Therapies and $3 billion to acquire the oncology startup Halda Therapeutics. J&J also spent $1.25 billion to take over Yellow Jersey Therapeutics in 2024, though the main draw of that acquisition – an eczema drug – failed in testing in December. 

J&J is also putting more focus on cancer treatments. The goal “is to become the No. 1 oncology company, reaching $50 billion by the end of the decade,” Duato told analysts and investors on a conference call. “We are very confident on our progress there in our pipeline.”

The company has worked to expand sales of the cell therapy Carvykti by winning approval for use in earlier in treating multiple myeloma. And just last month, J&J shared impressive data on another multiple myeloma treatment, Tecvayli. Carvykti sales soared 66% to $555 million in the fourth quarter, though that was still shy of Wall Street’s expectations, Risinger said. Tecvayli, whose revenue rose 21% to $176 million in the quarter, also fell short of estimates.

J&J is placing bets in immunology, too. A partnership with Protagonist Therapeutics has yielded a psoriasis pill that’s nearing approval and that the company sees becoming a “new blockbuster,” Duato said. It’s being evaluated in other autoimmune conditions as well.

Like rivals, J&J is additionally trying to neutralize political threats to its business. Earlier this month, the company reached an agreement with the White House on drug pricing, becoming one of more than a dozen drugmakers to fall in line amid tariff threats from President Trump. Even so, J&J expects its tariff costs to more than double to about $500 million in 2026, the Wall Street Journal reported.