Welcome to Johnson & Johnson's annual shareholders' meeting. Please note that today's presentation may include forward-looking statements and non-GAAP financial measures. We encourage you to review the cautionary statements included in today's presentation materials, which identify certain factors that may cause the company's actual results to differ materially from those projected. These factors are described in our SEC filings, which are available at investor.jnj.com, in addition to reconciliations of any non-GAAP financial measures used in today's presentation.
Hello and welcome to our 2024 annual meeting of shareholders. I am Marc Larkins, Corporate Secretary and Worldwide Vice President of Corporate Governance at Johnson & Johnson. At today's meeting, we will provide an update on our business and cover the items described in our Proxy Statement. We will also have time for questions and answers. During this period, we will respond to questions submitted via the voting portal. A copy of today's program, including the agenda and rules of order, are available in the meeting materials section of the meeting website. There you will find links to our 2024 Proxy Statement and 2023 annual report. You will be hearing from our Chairman and CEO, Joaquin Duato, shortly. Together, we are joined by our Executive Committee, as well as Steve Johnson and John Hauselt, representing PricewaterhouseCoopers, our independent auditors. We are also joined by our board of directors.
These incredible leaders bring diverse backgrounds, experiences, and skills to their work in ensuring the long-term success of Johnson & Johnson. With that, I would like to officially call this meeting to order and welcome our Chairman and CEO, Joaquin Duato.
Thank you, Marc, and welcome everyone. We are joining you from our worldwide headquarters in New Brunswick, New Jersey, our home for almost 140 years. I would like to start by congratulating Eugene Woods on his recent appointment to the board. I would also like to acknowledge the many contributions of Ann Mulcahy, who is transitioning her lead director responsibilities to Marillyn Hewson. To Eugene, Ann, Marilyn, and all our directors, thank you for everything you do in support of Johnson & Johnson. 2023 was a defining moment in the history of our company. It was a year of transformation and growth that positioned us to be a leader in global healthcare for decades to come. With the separation of our consumer health business, we entered a new era focused on tackling the world's toughest health challenges through scientific innovation and technology.
Today, we are a more focused and agile organization with a stronger growth and margin profile. By focusing on transformative medicines and medical technology, we have strengthened our position as an innovation powerhouse. In fact, no other company innovates across the full spectrum of healthcare solutions in the way Johnson & Johnson does. We are unique in our industry, and our impact for patients is significant. In 2023, we delivered strong performance. Operational Sales Growth, excluding the COVID-19 vaccine, was 9%, and Adjusted Net Earnings Per Share increased by more than 11%. We maintained a healthy balance sheet and robust credit rating, and executed against all our capital allocation priorities. That includes our investment in innovation, with more than $15 billion invested in R&D in 2023. We also committed over $3 billion to external growth opportunities and signed more than 50 early-stage licensing deals and partnerships.
Together, these investments will enable us to sustain strong performance over the long term. In 2023, we completed our share repurchase program, which together with our dividend returned over $14 billion to shareholders. Just last week, we announced an increase in our 2024 dividend for the 62nd consecutive year. In pharmaceuticals, we are leading where medicine is going. For the 12th consecutive year, our Innovative Medicine business reported above-market growth. Growth was driven by key brands: DARZALEX, ERLEADA, STELARA, and TREMFYA, and the acceleration of recently launched products including CARVYKTI, SPRAVATO, TALVEY, and TECVAYLI. We continue to drive access to our medicines and will be sharing our annual transparency report soon, which will once again show the substantial rebates and discounts we provide to lower the cost of our medicines for patients.
We also continue to make significant advances in our pipeline, with FDA approvals of AKEEGA and TALVEY, positive Phase III readouts for 11 in-line and pipeline medicines, and 19 US and EU filings. We initiated Phase III programs for Milvexian and our targeted oral peptide. We received FDA Breakthrough Therapy designation for TAR200 for the treatment of bladder cancer, and FDA Fast Track designations for Milvexian in atrial fibrillation, stroke, and acute coronary syndrome. In MedTech, we are innovating at the intersection of biology and technology. In 2023, we delivered over $30 billion in sales for the first time, with sales growth across all parts of our business: interventional solutions, orthopedics, surgery, and vision. At the same time, we launched 15 major products. We also advanced more than 20 pipeline programs that each have an expected net present value of greater than $100 million.
I am particularly excited about the progress in our robotics and digital ecosystem, including advances in our OTTAVA general surgery robot, the recent approval of the MONARCH Platform for bronchoscopy in China, and the continued market expansion for our VELYS robotic-assisted solution for total knee replacement. We also continue to move into higher growth markets, building on our commitment to interventional cardiology with the successful integration of Abiomed and the acquisition of Laminar. I have said it before that science and technology will advance human health more in the next decade than in the last century. With our transformative medicines and medical technologies, Johnson & Johnson will be at the forefront of this innovation. A great example is lung cancer. Doctors can use our robotic bronchoscope to help make a diagnosis.
They can use our advanced instruments as a part of a surgical intervention, and they can treat patients with our bispecific antibody. We are energized by our future and our evolution as a company, and we remain grounded in our purpose. For more than 80 years, our Credo has reminded us of our responsibilities to the people we serve: patients, doctors and nurses, employees, communities, and you, our investors. Our Credo values are as strong as ever, and I see them in action every day working with our more than 130,000 colleagues. The people of Johnson & Johnson are my greatest source of inspiration, and they give me great confidence in the future of our business. In so many ways, we are just getting started.
Let's go, J&J!
Thank you for your continued support of Johnson & Johnson, and with that, I will turn the meeting back to Marc.
Thank you, Joaquin. I will now present the formal portion of today's meeting. I'm pleased to announce that we have a quorum of shareholders present today, in person or by proxy, representing more than 83% of the outstanding shares entitled to vote at today's meeting. A list of all shareholders of record entitled to vote at this meeting is available upon request. Please refer to the meeting materials section of the virtual meeting website. The first item of business is the election of directors to serve on the board of directors until the next annual meeting. As described beginning on page 13 of the Proxy Statement, there are 13 nominees for the board of directors: Darius Adamczyk, Mary Beckerle, Scott Davis, Jennifer Doudna, Joaquin Duato, Marilyn Hewson, Paula Johnson, Hubert Joly, Mark McClellan, Anne Mulcahy, Mark Weinberger, Nadja West, and Eugene Woods.
Under our bylaws, the election of each director nominee in today's election requires the affirmative vote of a majority of the votes cast. The board recommends a vote for each of the nominees. The second item of business is an advisory vote to approve the compensation of our named executive officers and the executive compensation philosophy, policies, and procedures described in the compensation discussion and analysis section beginning on page 55 of the Proxy Statement. As an advisory vote, the results of this vote will not be binding on the board or the company. However, the board understands the importance of receiving shareholder feedback on executive compensation. The board recommends a vote for this management proposal.
The third item of business is a ratification of the appointment of PricewaterhouseCoopers LLP as the independent registered public accounting firm for Johnson & Johnson for fiscal year 2024, as described in the Proxy Statement beginning on page 122. The board recommends a vote for this management proposal. The final item of business is a proposal submitted by a shareholder. The shareholder proposal and its supporting statement appear on page 126 of the Proxy Statement and was submitted by the National Legal and Policy Center. Paul Chesser will introduce the proposal on behalf of the proponent and will have two minutes.
Good morning. As our proposal, Proposal 4, points out, Johnson & Johnson is very proud of its 100% score on the Human Rights Campaign's LGBTQ Scorecard, which says a company promotes full equality if it provides sex change operations for employees and dependents in its insurance plans. The company acts as if an employee, or perhaps his or her team dependent, gets a double mastectomy or some form of genital removal, that they will never regret it and that they will be happy the rest of their lives. Unfortunately, in the real world, instead of the fantasy world inhabited by Human Rights Campaign and Johnson & Johnson, that is often not the case. In fact, many sufferers are extremely upset that they were lied to about being able to switch from their birth genders.
Only after it's too late do they learn that even if they wanted to detransition, they can't. There's no restoration to their original bodily condition, either medically or through insurance. I thought Johnson & Johnson was a health and medical company. Isn't the principle supposed to be first, do no harm? Does Johnson & Johnson even research how it can help detransitioners, or is the company too beholden to the Human Rights Campaign's agenda? The answer is obvious. In its response to our proposal, the board says we failed to identify a gap in its pay and benefits offerings. On the contrary, we most certainly did. Detransitioners testify that it is impossible to find doctors to treat them or insurers to insure them. Under EEOC guidelines based on gender identity and sexual orientation, this is discriminatory, and Johnson & Johnson is guilty of it.
The company's whistling past the graveyard if it thinks it will avoid lawsuits based on this inequitable policy. Obviously, Johnson & Johnson has learned nothing from the talcum powder class action lawsuits. Please vote for Proposal 4.
Thank you, Mr. Chesser, for your interest in and engagement with Johnson & Johnson. Directed by the fourth paragraph of our Credo, our management team and the board take their responsibility to our shareholders very seriously. Shareholder engagement has been a hallmark of our corporate governance program here at Johnson & Johnson. In keeping with that commitment, we engage each year with the proponents of shareholder proposals. After careful consideration, the board recommends a vote against the proposal presented today for the reasons more fully described in the Proxy Statement. In summary, the proposal requests the production of a report to address a nonexistent and theoretical gap in healthcare coverage that is not relevant or material to the operations of the company. Contrary to the proponent's claims, the company's benefits programs do not draw distinctions on the basis of gender or other protected characteristics and do not exclude detransitioning care.
It is therefore recommended that shareholders vote against the proposal presented today. The polls will now remain open for a few minutes. We will report on the voting results for each item of business in a few minutes after the polls have closed, and the inspector of elections has had the opportunity to conduct its preliminary tabulation. In the meantime, we would like to share a powerful video with you that articulates our pursuit of healthcare innovation and our legacy of caring.
Healthcare. It's more than a system. It's a fundamental human need, essential to our collective well-being. But healthcare has become disconnected. At Johnson & Johnson, we want to restore it to its true meaning. And the answer is right in front of us in those two simple words: health and care. Connecting the best of both to deliver innovations for patients. Industry-leading product solutions that move people through recovery with greater ease. Advanced treatments for today, unlocking potential cures of tomorrow. Let's connect the best of health and care for every provider, for every patient, for everyone, and show all the amazing things those two simple words: health and care can do. Johnson & Johnson, the health and care company.
The polls have been closed, and I will now report on the preliminary voting results for the items of business that were presented. The preliminary voting results are based on the tabulation received from the inspector of elections today, and are as follows: The 13 director nominees named in the Proxy Statement have been elected to the board of directors. The advisory vote to approve named executive officer compensation has been approved. The ratification of appointment of our independent public accounting firm has been approved. The shareholder proposal did not pass. The board and management appreciate all forms of feedback from our shareholders. Despite the advisory nature of some of today's votes, we will carefully evaluate the voting results as we always do. Final voting results will be published within four business days of this meeting in the Form 8-K that will be filed with the Securities and Exchange Commission.
This now concludes the formal portion of our program, and this year's annual meeting is adjourned. We will now open the meeting for a question and answer session. We want to thank you for all the questions submitted both before and during today's webcast. We will try to get to as many questions as we can over the next 10 minutes. As we reviewed the submissions, there were several questions on the same topic. For those topics, we have selected a representative question to answer today. Our chairman and I will now conduct the question and answer portion of this meeting. For our first question, we received questions from James H. and a number of shareholders regarding financial performance, stock performance, and the company's capital allocation strategy. Can you elaborate on these topics and how the company returns value to investors?
Thank you for the question. At Johnson & Johnson, we believe our long-term success is the result of meeting the responsibilities set forth in our Credo: the responsibility to the patients, doctors, and nurses who use our products, to our employees and our communities, and to you, our shareholders. In 2023, Johnson & Johnson delivered strong and sustained financial performance. As noted during the meeting, we delivered full-year operational sales growth of 9% excluding the COVID-19 vaccine, reflecting the strength and diversity of our business. We are proud of our above-market performance in innovative medicine and our progress in MedTech, which delivered over $30 billion in sales for the first time. We continued our commitment to driving future innovation by investing more than $15 billion in R&D during 2023.
At our enterprise business review in December, we provided guidance of our expected 5%-7% cumulative average growth rate in operational sales in the second half of the decade. We continue to invest in acquisitions, including our recent agreement to acquire Shockwave Medical, a pioneer in developing technologies to treat cardiovascular disease, Ambrx Biopharma, a developer of next-generation antibody-drug conjugates, and Laminar, Inc., with its novel approach to treating atrial fibrillation. Our late 2022 Abiomed acquisition is also delivering results ahead of plan. Our capital allocation commitments have been a top priority for decades. Through the Kenvue separation, we reduced Johnson & Johnson's outstanding share count by approximately 7% without the use of cash and in a tax-free manner. As announced last week, we have now increased our dividend for the 62nd consecutive year.
In 2023, including dividends and the completion of a share repurchase program, we returned over $14 billion to shareholders.
We've received the question from Jeff P. and other shareholders regarding the talc litigation. Can you provide an update?
Thank you for the question. It's important to reiterate that we do not believe that any of the talc-related claims against the company have merit. The company is committed to defending the safety of cosmetic talc while seeking a responsible, final, and comprehensive resolution of the talc litigation, which we are progressing in the interest of the company and all stakeholders.
If I can also add, we continue to pursue the four-pronged strategy we communicated in 2023: one, seeking appellate review of the dismissal of the bankruptcy case; two, working with claimant's counsel to pursue a consensual resolution of the claims through the bankruptcy process; three, vigorously defending the claims in the tort system, where we have prevailed in the vast majority of cases tried to date; and four, challenging problematic aspects of the mass tort litigation structure itself, including the use of third-party litigation financing and reliance on unscientific expert testimony. In a recent positive development, as announced on March 27, the Federal Court in New Jersey has granted the company a new hearing to challenge the unsound expert opinions advanced by the plaintiff's lawyers in the talc litigation. We look forward to shining further light on those baseless expert opinions.
We received questions from JDG and other shareholders concerning navigating the complex business environment across the globe, including Russia, China, and the Middle East. Can you offer comments on our approach?
Thank you for the question. Guided by our Credo, we believe access to healthcare is fundamental, and we strive to bring better health to those who need it around the world. For nearly 140 years, Johnson & Johnson has successfully navigated complex political situations, and we continuously evaluate geopolitical risks for all of our markets. These evaluations inform our business strategy, which includes deploying business continuity plans to maintain critical operations, leveraging partnerships to ensure preparedness, and maintaining a presence in multiple geographies to enhance our ability to respond. Our quality processes and procedures are designed to ensure our products meet our quality standards, which are aligned to or more stringent than industry requirements, and help us provide a reliable supply of high-quality products in the markets we serve.
Our business strategy continues to be focused on generating long-term value for shareholders and addressing the needs of patients across the globe.
For our final question today, we received a question from Dan S. regarding our evaluation of new business segments and M&A opportunities. Can you speak to our thinking on those issues?
Thank you for the question. We consistently evaluate new business opportunities through a strategic and scientific lens to deliver value for patients and for our shareholders. Our preference is to be in areas in which we have internal capabilities and know-how, and also to pursue products that represent progress in improving the current standard of care. We are agnostic to sector and agnostic to size. In addition to the larger acquisitions that I mentioned in response to a prior question, we enter into more than 50 smaller licensing partnerships or deals in 2023. We have a track record of developing successful products with this approach. In evaluating opportunities, we also look at spaces that complement our existing portfolio and enable us to harness the power of our two-sector company. Our impact across the full spectrum of healthcare is unique in our industry and fuels our strength as an innovation powerhouse.
That concludes today's meeting. I want to thank you, our investors, for your time, for your questions, and for your confidence in Johnson & Johnson. Your continued investment is important to our success, and I look forward to sharing with you all that we accomplish in 2024.