Johnson & Johnson NYSE: JNJ reported first-quarter 2026 results that executives said put the company “off to a fast start” in what management has described as a year of accelerated growth. On the earnings call, Chairman and CEO Joaquin Duato pointed to a “beat on consensus and raised guidance,” driven by operational sales growth of 6.4% and momentum across both Innovative Medicine and MedTech.
First-quarter sales grew 6.4% operationally, with Stelara a major headwind
Vice President of Investor Relations Darren Snellgrove said worldwide sales were $24.1 billion, up 6.4% operationally, despite an “approximate 540 basis point headwind” from Stelara. U.S. growth was 8.3% and growth outside the U.S. was 3.9%.
Snellgrove added that acquisitions and divestitures provided a net positive 110 basis-point impact to worldwide growth, “primarily driven by the Intra-Cellular acquisition.”
Innovative Medicine: oncology strength and new immunology launch
Innovative Medicine sales were $15.4 billion, up 7.4% operationally, despite an “approximate 920 basis point headwind from Stelara,” Snellgrove said. Growth was 9.6% in the U.S. and 4.3% outside the U.S., with a net positive 180 basis-point contribution from acquisitions and divestitures, again “primarily due to the Intra-Cellular acquisition.”
Duato highlighted multiple myeloma as a key driver, calling DARZALEX the company’s “number one product,” with sales of $4 billion and operational growth of 18%. Snellgrove said DARZALEX growth of 17.8% was driven by share gains “across all lines of therapy,” including nearly 12 points in the frontline setting. He also cited continued growth in newer myeloma assets, including CARVYKTI (approximately $600 million in sales, up 57.4%), TECVAYLI (up 30.1% with sequential growth of 14.2%), and TALVEY (up 72.8%).
Duato said Johnson & Johnson received FDA approval of TECVAYLI plus DARZALEX FASPRO for relapsed or refractory multiple myeloma, which he said positions the regimen as a potential new standard of care as early as second-line.
In solid tumors, Duato said RYBREVANT FASPRO received FDA approval for subcutaneous monthly dosing for EGFR-mutated non-small cell lung cancer, and RYBREVANT received FDA breakthrough therapy designation in advanced head and neck cancer. Snellgrove said RYBREVANT plus Lazcluze delivered $257 million in sales, up 80.5%, with sequential growth of 18.8% supported by share gains in the first and second lines.
In immunology, Duato emphasized growth in Tremfya, which he said rose 64% and is now a share leader for new patient starts in inflammatory bowel disease. Snellgrove reported Tremfya growth of 63.8%, while Stelara declined 61.7% due to biosimilar competition, adoption of novel classes, and patient mix.
Duato also highlighted the FDA approval of “ikotide” for first-line plaque psoriasis, describing it as the “first and only IL-23-targeted oral peptide” and noting a same-day full launch. In Q&A, Jennifer Taubert, Executive Vice President and Worldwide Chairman of Innovative Medicine, said the product is “off to a very fast start” and described its label as differentiated, citing “no lab monitoring,” TB language reflecting physician judgment, and no black box warning. Taubert said the company has seen “about 1,500 patients already” with prescriptions going into its access and support service center, and “over 1,000 unique customers” writing prescriptions, while noting it was still early to break down switching versus new patient sources.
John C. Reed, Executive Vice President of Innovative Medicine R&D, added that a psoriatic arthritis study for icotrokinra should read out later this year, and that phase III programs in Crohn’s disease and ulcerative colitis are enrolling.
In neuroscience, Duato said the U.S. launch of Caplyta in adjunctive major depressive disorder is “building momentum,” and Snellgrove reported Spravato growth of 44.5%. Caplyta delivered $270 million in quarterly sales following the Intra-Cellular acquisition, with Snellgrove saying new patient starts have reached “highest ever” volumes across indications since the aMDD approval.
MedTech: cardiovascular outperformance, robotics progress, and vision catalysts
MedTech sales were $8.6 billion, up 4.6% operationally, with 5.9% growth in the U.S. and 3.2% growth outside the U.S., Snellgrove said. Duato said MedTech growth was supported across cardiovascular, surgery, and vision.
Cardiovascular strength was led by electrophysiology growth of 9.5%, and strong results in Abiomed and Shockwave, Snellgrove said. Abiomed grew 14.4% and Shockwave grew 18.1%.
In electrophysiology, Duato said VARIPULSE momentum continued, and management highlighted the European launch of VARIPULSE Pro and data presented showing “zero reported strokes” for VARIPURE 12-month outcomes. CFO Joe Wolk said VARIPULSE Pro reduces ablation time by 85% and noted Johnson & Johnson expects “some second-half impact from volume-based procurement in China for electrophysiology products,” which has been incorporated into guidance.
In surgery, Duato said the company made progress on the OTTAVA robotic surgical system and has a second investigational device exemption trial underway for inguinal hernia repair. In Vision, Duato highlighted FDA approval for TECNIS PureC and said 97% of patients reported no very bothersome disturbances such as halos or glare.
During Q&A, Tim Schmid, Executive Vice President and Worldwide Chairman of MedTech, said underlying demand was “solid and underlying demand is what we expected,” while noting “some procedural softness early in the quarter” and localized effects from severe U.S. weather that he said were not material overall. Schmid also described a competitive U.S. environment in surgical vision, but said the company expects acceleration later in the year as it prepares for the U.S. launch of TECNIS PureC.
Profitability and cash flow: margins pressured by investment, tariffs, and comparisons
Snellgrove reported net earnings of $5.2 billion and diluted EPS of $2.14, compared with $4.54 a year ago. Adjusted net earnings were $6.6 billion and adjusted diluted EPS was $2.70, down 1.4% and 2.5%, respectively, versus the prior-year quarter.
He attributed several year-over-year P&L shifts to items including:
- Cost of goods sold deleveraging by 10 basis points, driven by tariffs and other operational drivers in MedTech and unfavorable mix in Innovative Medicine.
- Selling, marketing, and administrative expense deleveraging by 180 basis points due to heavier early-year launch investment and increased investment tied to the Intra-Cellular acquisition.
- Other income/expense shifting to a net expense of $294 million from $7.3 billion of income a year earlier, primarily due to an “approximate $7 billion talc reserve reversal” in Q1 2025.
Adjusted income before tax margin declined in both segments, with Innovative Medicine falling to 39.7% from 42.5% and MedTech falling to 22.3% from 25.9%, Snellgrove said.
On cash and balance sheet, Wolk said Johnson & Johnson ended the quarter with about $22 billion of cash and marketable securities and $55 billion of debt, for net debt of about $33 billion. Free cash flow was about $1.5 billion, which Wolk said reflected expected timing changes in certain U.S. rebate programs and increased U.S. capital expenditures. He reiterated confidence in full-year free cash flow of approximately $21 billion.
Guidance raised; dividend increased for 64th consecutive year
Wolk said the company raised full-year 2026 operational sales growth guidance to 5.9% to 6.9%, with a midpoint of $100.2 billion (6.4%). He noted the 2026 financial calendar includes a 53rd week that benefits sales growth by about 100 basis points. Based on currency assumptions, the company estimated reported sales growth of 6.5% to 7.5%, with a midpoint of $100.8 billion.
Johnson & Johnson also raised adjusted operational EPS guidance by $0.02 to a range of $11.30 to $11.50, Wolk said, representing 5.7% growth at the midpoint. He added the company expects reported adjusted EPS of $11.55 at the midpoint, or 7.1% growth.
Wolk also announced a 3.1% dividend increase to an annual rate of $5.36 per share, which he said marks the company’s 64th consecutive year of dividend growth. He reiterated ongoing investment plans tied to the previously announced intention to invest $55 billion in U.S.-based manufacturing technology and R&D through early 2029, noting that through the end of 2025, the company had invested roughly $12 billion.
Looking longer term, Duato told analysts the company’s “line of sight to double-digit growth by the end of the decade” is based on its current portfolio and pipeline and “do[es] not include business development,” though he said business development remains an important capital allocation lever. Management said it will provide more detail at its Enterprise Business Review on December 8.
About Johnson & Johnson NYSE: JNJ
Johnson & Johnson is a multinational healthcare company headquartered in New Brunswick, New Jersey, that develops, manufactures and markets a broad range of products across pharmaceuticals, medical devices and previously consumer health. Founded in 1886 by the Johnson family, the company has grown into a global healthcare organization with operations and sales in many countries around the world.
The company's pharmaceuticals business, organized largely under its Janssen research and development organization, focuses on prescription medicines across therapeutic areas such as immunology, infectious disease, oncology and neuroscience.
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