As biosimilar competition from Johnson & Johnson’s Stelara continues to weigh on sales, the long-awaited launch of the company’s new psoriasis treatment is rapidly taking shape, indicating it has the potential to be one of the drugmaker’s “biggest products of all time,” CEO Joaquín Duato said.
Icotyde (icotrokinra), in partnership with Protagonist Therapeutics, was approved in mid-March as the first targeted oral peptide designed to block the interleukin-23 (IL-23) receptor, providing a new once-daily alternative to the injectable biologics that currently dominate the psoriasis market.
CEO Duat said during the company’s first-quarter earnings call that J&J’s launch of Icotyde began on the same day as FDA approval, and the company quickly noted “strong demand.”
Icotyde, along with Tremfya, a blockbuster product in injectable immunology, forms a key element of J&J’s “dual engine” in immunology. Of the two, Tremfya is the first-line biologic for patients with moderate to severe plaque psoriasis, while Icotyde is positioned as a systemic treatment, Duato explained.
Tremfya is a prime candidate to fill the gap in Stelara’s declining sales, with peak annual sales expected to exceed $10 billion, according to the CEO.
Stelara, on the other hand, is following a very different trajectory. The drug is losing out to biosimilar competition, a serious drag on the company’s innovative medicines division, which had sales of $15.4 billion in the first quarter.
The 7.4% operating sales growth seen across J&J’s Innovative Medicines division would be 16.6% excluding Stelara, Jennifer Taubert, J&J’s Innovative Medicines Worldwide Chairman, explained on a conference call.
The double-digit growth seen excluding Stelara gives the company confidence in its ambitious goal of exceeding $100 billion in annual sales.
“That’s already happening today,” Duato said, referring to the achievements needed to cross the $100 billion threshold. “This builds on our strongest product portfolio and pipeline in our history.”
J&J’s innovative medicines growth in the first quarter was primarily driven by its Oncology and Neuroscience segments, which posted operating sales increases of 17.8% and 29.3% year-over-year, respectively.
In oncology, Duato said the company’s top-selling drug, Darzalex, the “gold standard” for multiple myeloma, continues to support the company’s revenue. The drug has already won two new approvals so far this year, most recently in March for use in combination with J&J’s Tekvayli to treat previously treated relapsed or refractory multiple myeloma.
Meanwhile, neuroscience is in the spotlight with J&J’s bipolar disorder and schizophrenia drug Caplyta being expanded in November as an additional treatment for major depressive disorder. The company said in an investor presentation (PDF) that the drug is seeing “continued momentum” in the space.
J&J’s immunology business posted worldwide sales of $3.4 billion in the same period, but Tremfya and its “share gains across all indications” could not fully offset continued biosimilar erosion to Stelara and new biosimilar competitors to legacy Simponi and Remicade, resulting in an 11.8% operating decline in immunology sales for the quarter.
Simponi should be exposed to further erosion this year, the company said, with biosimilars likely to appear in Europe in the first half of the year and in the United States in the second half.
J&J regarding M&A
The company is pleased with the large acquisitions it has already completed in recent years, as many of J&J’s peers have recently participated in a resurgence of multibillion-dollar M&A deals.
“We’ve been ahead of the curve with our M&A investments,” Duato said, citing the company’s $14.6 billion acquisition of Intracellular Therapies last year and its $13.1 billion acquisition of Shockwave Medical in 2024.
Instead, the drugmaker is looking to funnel investment into new product launches and pipeline programs. Duato remains “optimistic” about business development, but clarified that the company is “not relying on M&A” to meet its future revenue targets.
Icotide, for example, is one area where J&J is making “significant investments,” Taubert said, building on-site teams and patient support services to help patients “stay on” the pill. To date, about 1,500 patients have already written prescriptions for the drug, which could help a large group of biologic-eligible patients who are reluctant to try injectable therapy, Torbert said.
With a “more pronounced impact” from newly launched products, J&J raised its 2026 sales outlook to a range of $101 billion from the $100 billion it expected in January, adding $300 million each.
Adding medical technology sales to innovative drug sales, the company raised a total of $24.1 billion in the first quarter, for an overall growth rate of 6.4%.
