Ustekinumab

J&J is looking to newly approved psoriasis pill, Icotyde to drive growth to the next decade. Credit: PixelBiss / Shutterstock.com. As companies across the life sciences space gear up to debut their Q1 earnings, Johnson & Johnson (J&J) has kicked off proceedings by posting healthy growth across its pharma portfolio, despite headwinds from Stelara’s (ustekinumab) loss of market exclusivity. In the first quarter of 2026, J&J achieved sales of $24.1bn – up 9.9% from Q1 in 2025 and higher than analyst expectations of $23.61bn – with the New Jersey-based pharma attaining operational growth of 6.4%. J&J’s adjusted earnings per share (EPS) stood at $2.70, beating Wall Street expectations of $2.68. Burgeoning Q1 sales across J&J’s innovative medicines portfolio primarily drove this uptick, as the division saw an 11.2% increase compared with the same quarter in 2025, bringing in $15.4bn. Growth within this segment was primarily supported by ballooning sales across multiple disease areas. Oncology was a big money maker for J&J in Q1, with multiple myeloma therapies like Darzalex (daratumumab) and Carvykti (ciltacabtagene autoleucel), among others, bringing in a total of $6.97bn for the company. Neuroscience also saw strong growth driven by treatment-resistant depression (TRD) therapy, Spravato (esketamine), while Tremfya (guselkumab) offered a boost to sales within the company’s immunology portfolio. Despite the overall growth, biosimilar competition for Stelara did cause some headwinds for J&J this quarter – offsetting the pharma’s growth during this period. Icotyde to drive J&J’s future growth Amid the backdrop of a generally positive Q1, J&J has boosted its 2026 outlook, forecasting that the company will see operational sales growth of 5.6% – 6.6% rather than the 5.4% – 6.4% predicted in January 2026. According to J&J’s CEO, Joaquin Duato, the company is on the right track to post double-digit growth by the end of the decade, with the approval and debut of its IL-23 plaque psoriasis pill, Icotyde (icotrokinra), set to plug the sales gap left by Stelara. Currently, GlobalData analysts tout a blockbuster future for the therapy, with 2032 sales expected to reach $4.4bn globally. In a previous conversation with Pharmaceutical Technology , GlobalData analyst Stephanie Ngan noted that Icotyde’s approval in both the adult and adolescent patient population “immediately casts a wider net” for the drug’s early and broad uptake. J&J hopes to achieve this amid the backdrop of its Most Favored Nation (MFN) pricing deal with the White House, which will see certain branded medicines in the pharma company’s portfolio endure a US price cut in exchange for exemption from 100% tariffs .

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.