Guselkumab

J&J is eying revenues of over $100 billion in 2026. As biosimilar competition to Johnson & Johnson’s Stelara continues to chew off sales, the much-anticipated launch of the company’s new psoriasis pill is quickly taking shape and signaling its potential to become one of the drugmaker’s “largest products ever,” according to CEO Joaquin Duato.Protagonist Therapeutics-partnered Icotyde (icotrokinra) flew out of the gate upon its mid-March approval as the first targeted oral peptide designed to block the interleukin-23 (IL-23) receptor, presenting a new, once-daily alternative to the injectable biologics that make up much of the existing psoriasis market. J&J’s Icotyde launch took off the same day as its FDA approval came in, CEO Duato noted on the company’s first-quarter earnings conference call, with the company noting “strong demand” right away.Together with injectable immunology blockbuster Tremfya, Icotyde forms a key component of J&J’s “dual powerhouse” in immunology. Between the two, Tremfya presents a first-choice biologic for patients with moderate to severe plaque psoriasis and Icotyde is positioned as a systemic treatment, Duato explained. Tremfya, which has been the main contender to pick up the slack for Stelara’s declining sales, is expected to deliver more than $10 billion in peak yearly sales, according to the CEO.  Stelara, meanwhile, is on a vastly different trajectory. The medicine is succumbing to biosimilar competition and served as a serious drag on the company’s innovative medicine division, which delivered $15.4 billion in first-quarter sales.The 7.4% operational sales growth seen across J&J’s innovative medicines category becomes 16.6% when excluding Stelara, Jennifer Taubert, worldwide chairman of innovative medicines at J&J, explained on the call. The double-digit growth seen when excluding Stelara gives the company confidence in its ambitious goal of generating more than $100 billion in annual sales. “It’s already happening today,” Duato said, referring to the performance needed to cross the $100 billion threshold. “It’s based on our product portfolio and pipeline, the strongest in our history.”J&J’s first-quarter innovative medicines growth was largely driven by its oncology and neuroscience sectors, which posted year-over-year operational sales increases of 17.8% and 29.3%, respectively.In oncology, the company’s revenues remain buoyed by its top-selling med Darzalex, the “gold standard” in multiple myeloma, Duato said. The drug has already bagged two new approvals so far this year, most recently with a combo nod alongside J&J’s Tecvayli in previously treated relapsed or refractory multiple myeloma in March. Neuroscience, meanwhile, is highlighted by a November expansion for J&J’s bipolar and schizophrenia med Caplyta as an add-on treatment for major depressive disorder. The drug is seeing “continued momentum” in that space, the company said in its investor presentation (PDF). While J&J’s immunology business saw $3.4 billion in worldwide sales during the period, Tremfya and its “share gains across all indications” couldn’t fully make up for continued biosimilar erosion to Stelara and new biosimilar rivals to older Simponi and Remicade, with the quarter yielding an 11.8% operational decline in immunology sales.Simponi should be up for more erosion this year, too, with biosimilars emerging in Europe over the first half of this year and potentially in the U.S. in the latter half of the year, the company noted.  J&J on M&A  As many of J&J’s peers participate in a recent resurgence of multibillion-dollar M&A deals, the company is content to rest on the major acquisitions it has already wrapped up in recent years. “We have been ahead of the curve in our investment in M&A,” Duato said, pointing to the company’s $14.6 billion purchase of Intra-Cellular Therapies last year and its $13.1 billion deal for Shockwave Medical in 2024.  Instead, the drugmaker is looking to pour its investments into its new product launches and pipeline programs. Although it remains “optimistic” on business development, Duato made it clear that the company does “not depend on M&A” to fulfill its future revenue targets.  For example, Icotyde is one area where J&J is “investing big,” Taubert said, with field teams and patient support services being built out to help patients “get on and be able to stay on” the pill. So far, some 1,500 patients have already had prescriptions written for the med, which can serve the large group of biologic-eligible patients who may be more hesitant to try an injectable therapy, according to Taubert. With the help of a “more pronounced impact” from its newly launched products, J&J lifted its 2026 sales outlook from the $100 billion to $101 billion range it projected in January, adding $300 million on each end.Adding on its medtech sales to its innovative medicines haul, the company collected a total of $24.1 billion over the first quarter, flexing 6.4% overall growth.

Johnson & Johnson executives believe the worst of the biosimilar pressure facing Stelara is behind them, and feel confident enough to predict significant growth through the end of the 2020s. But Wall Street may need convincing. On Tuesday morning’s first-quarter earnings call, J&J leaders repeatedly and eagerly trumpeted the recent approval of Icotyde as a game-changing moment for the company. CEO Joaquin Duato even made the bold claim that the plaque psoriasis pill “has the potential to be one of our largest products ever.” In addition, continued strong sales of the immunology drug Tremfya and the cancer therapy Darzalex, as well as other newer approvals for Inlexzo and Rybrevant in oncology, colored Tuesday’s call with a clear sense of optimism. It’s a departure for the normally tight-lipped company, which usually prefers to let people read between the lines. During the Q&A session, however, analysts pointed out Duato’s claim about Icotyde’s potential would assume at least $10 billion in annual peak sales, something that most prognosticators do not see happening. (J&J’s own guidance projects at least $5 billion as an annual baseline at peak.) So what, if anything, has given Duato reason for such confidence? Duato acknowledged it could be a stretch, rhetorically countering with, “How is that possible for a company that this year, in 2026, is going to deliver more than $100 billion?” But he then launched into a four-minute defense of J&J’s ambitions, noting that sales have already hit double-digit growth year-over-year when excluding the declines in Stelara revenue. He also listed Inlexzo and Rybrevant as “underestimated” products, while touting the last few years of acquisitions — namely for Intra-Cellular Therapies and Shockwave Medical — as “ahead of the curve” compared to J&J’s peers. It’s setting up something of a stable off-ramp for Stelara as one of the company’s biggest drugs. “When you take into consideration all those factors, you are going to get into a similar conclusion of double-digit growth by the end of the decade,” Duato said. First approved in 2009, Stelara — which treats plaque psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis — was J&J’s top-selling drug before Darzalex overtook it last year. The company successfully delayed the emergence of Stelara competitors until 2025, and it’s using AbbVie’s Humira as a model for potential sales decline, though Humira did not face as much sales erosion in the first months competing against biosimilars. Worldwide Stelara sales were down about 60% year-over-year in the first quarter, a faster rate of deceleration than J&J reported last year, when it said sales fell about 43% in the second quarter of 2025 and 38.6% in the first six months of last year. Despite this, J&J raised its full-year sales guidance from $100 billion to $100.2 billion. The optimism is bleeding into other appearances by the J&J C-suite as well. In an interview Tuesday morning on CNBC , CFO Joseph Wolk said the only other pharma company to manage a patent cliff as large as Stelara’s was also J&J back in 2018, when it was dealing with the loss of exclusivity for the inflammation drug Remicade.