Stock Markets April 14, 2026 06:27 AM

Johnson & Johnson posts first-quarter beat and raises guidance despite steep Stelara decline

Strength in Darzalex and Tremfya offsets heavy losses in Stelara sales as company tightens full-year outlook upward

By Marcus Reed JNJ
Johnson & Johnson posts first-quarter beat and raises guidance despite steep Stelara decline
JNJ

Johnson & Johnson reported first-quarter revenue and adjusted earnings that topped analyst expectations, driven by robust demand for cancer drug Darzalex and psoriasis treatment Tremfya. Those gains helped offset a roughly 60% drop in sales of Stelara after it lost patent protection. The company raised its full-year 2026 revenue and adjusted earnings outlooks, while management voiced opposition to codifying most-favored-nation drug pricing.

Key Points

  • J&J reported first-quarter revenue of $24.1 billion, up nearly 10% from a year earlier, and adjusted earnings of $2.70 per share, above expectations.
  • Strong sales of Darzalex ($4.0 billion) and Tremfya ($1.6 billion) helped offset a roughly 60% year-over-year decline in Stelara sales to $656 million.
  • The company raised its full-year 2026 revenue midpoint to about $100.8 billion and the adjusted earnings outlook to $11.55 per share at the midpoint; medical technology sales rose 7.7% to $8.6 billion.

Quarterly results and topline

Johnson & Johnson reported first-quarter revenue of $24.1 billion, an increase of nearly 10% year over year, and well above analysts' estimates of $23.6 billion, according to LSEG data. Adjusted earnings came to $2.70 per share, surpassing the consensus forecast of $2.66.

Product performance

J&J's results were supported by strong sales of several key medicines. Darzalex, the company's blood cancer therapy introduced in 2015, generated $4.0 billion in sales for the quarter, comfortably outpacing analysts' expectations of $3.4 billion. Tremfya, used to treat psoriasis and inflammatory bowel diseases, produced $1.6 billion in revenue for the period, above the $1.2 billion analysts had forecast.

Those gains helped offset a sharp contraction in sales of Stelara, the company's once-blockbuster autoimmune therapy. Stelara, which exceeded $10 billion in annual sales at its peak, lost patent protection last year and faced biosimilar competition in the quarter. Sales of Stelara declined by about 60% from a year earlier to $656 million.

Medical technology and overall business

The company's medical technology segment reported quarterly sales of $8.6 billion, a 7.7% increase that was in line with analyst expectations.

Management commentary on patient choice and new launches

Chief Financial Officer Joseph Wolk said in an interview that many patients have not switched to biosimilars following Stelara's loss of exclusivity, and instead have chosen alternative treatments such as Tremfya. "We are seeing increased share in Tremfya and we anticipate we’ll see something similar in the new oral offering," Wolk said, referring to the newly approved oral drug Icotyde.

Guidance and outlook

The company raised its full-year 2026 revenue forecast range, setting a new midpoint of about $100.8 billion, slightly above Wall Street's estimate of $100.6 billion. J&J also lifted its adjusted earnings outlook to $11.55 per share at the midpoint, which was roughly in line with prevailing expectations.

Policy stance and pricing deals

J&J is among several top global drugmakers that have entered so-called most-favored-nation drug pricing agreements with the Trump administration, under which the companies agreed to lower U.S. drug prices to match those charged in other developed countries in exchange for tariff relief. President Donald Trump has asked Congress to codify the most-favored-nation deals into law. Wolk said the company opposes such codification. "We’re not a fan of codifying" MFN, he said. "It’s really kind of a back door to price controls and we’ve seen what happens in countries with price controls - patients have less access to the most important medicines and innovation goes down."

Market reaction

Shares of the company, which have risen 15% so far this year, were marginally down in premarket trading.


Bottom line

Johnson & Johnson reported better-than-expected first-quarter results, driven by Darzalex and Tremfya, while navigating a steep decline in Stelara sales following biosimilar entry. Management raised full-year revenue and earnings guidance and reiterated opposition to legislative codification of most-favored-nation pricing.

Risks

  • Stelara faces material revenue erosion following patent loss and biosimilar competition, as evidenced by a roughly 60% drop in sales - affects pharmaceutical revenue streams and investor expectations.
  • Potential policy changes around most-favored-nation pricing, including calls to codify such deals, represent a regulatory risk that management says could lead to price controls and reduced access - impacting pharmaceutical pricing and margins.
  • Uncertainty around how patients and prescribers shift treatments after biosimilar entry creates execution risk for revenue recovery, relying on uptake of alternative products like Tremfya and the new oral offering Icotyde.

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