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 2025 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, is available in the Meeting Materials section of the meeting website. There you will find links to our 2025 proxy statement and 2024 annual report. You will be hearing shortly from our Chairman and CEO, Joaquin Duato. Together, we are joined by our Executive Committee, as well as John Hirschfeld, representing PricewaterhouseCoopers, our independent auditors. We are also joined by our Board of Directors.
These extraordinary leaders bring unique backgrounds, experiences, and skills to their work in ensuring the long-term success of Johnson & Johnson. I would like to officially call this meeting to order and welcome our Chairman and CEO, Joaquin Duato.
Thank you, , and greetings to all of you. 2024 was a year of solid growth and continual transformation for our company. Our success further established Johnson & Johnson as the leader in healthcare innovation, and we look forward to sharing many of our highlights during today's meeting. First, I want to thank our directors who retired during the last year, Scott Davis and Anne Mulcahy. The Executive Committee and I are grateful for your leadership and service on the board. I also want to extend a thank you to all of our directors. Your oversight of the company and commitment to our patients, shareholders, employees, and other key stakeholders is invaluable. 2024 began with a unified vision of what Johnson & Johnson could accomplish, and I'm proud and energized by the progress we have made.
Today, Johnson & Johnson stands alone in our ability to impact the patient journey by covering the full spectrum of disease. From cardiology to cancer, mental health to vision, cell therapies to robotics, the depth and breadth of our expertise and capabilities are unmatched. With our unique focus on pharmaceuticals and medical technology, we deliver best-in-class solutions for patients at every step of their journey. We are not just a pharmaceutical company or a medical technology company; we are a healthcare innovation powerhouse. It was our many innovations that helped make 2024 another successful year. Operational sales growth was 7%, and adjusted net earnings were $24.2 billion. We continued to execute against our capital allocation priorities and generated a notable increase in our free cash flow to approximately $20 billion.
As announced recently, our progress enabled us to increase our dividend for a 63rd consecutive year, which we know is important for Johnson & Johnson shareholders. Our portfolio, current and future, positions us for significant growth throughout the rest of the decade and beyond. Fueled by a strong balance sheet, we have deployed and committed approximately $50 billion in R&D and other inorganic growth opportunities since January 2024. Major acquisitions included Shockwave Medical and V-Wave in MedTech, and Ambrx, Proteologix and the NM26 bispecific antibody in Innovative Medicine, as well as the acquisition of Intra-Cellular Therapies announced in January this year. With more than 40 smaller collaborations, partnerships, and licenses signed in 2024, we are investing for the long term. In March this year, we also announced manufacturing, R&D, and technology investments of more than $55 billion in the United States over the next four years.
This represents a 25% increase in investment compared to the previous four years and builds upon the company's already elevated commitment to the U.S. economy, innovation, and capacity building. In Innovative Medicine, we are developing breakthrough treatments that will transform the future of healthcare. Innovative Medicine reported $57 billion in annual sales. Darzalex became our first brand to exceed $3 billion in sales in a single quarter, and Spravato became Johnson & Johnson's 26th platform to generate at least $1 billion in annual revenue. Other key growth drivers included Erleada, Carvykti, and Tremfya. Equally impressive was our pace of innovation, which resulted in 27 approvals in major markets. Among the most notable were FDA approvals of Tremfya for the treatment of ulcerative colitis and Rybrevant plus Lazertinib for first-line treatment of EGFR-mutated advanced non-small cell lung cancer. We reported 18 positive readouts for registrational studies.
We initiated 17 phase III studies and submitted 49 filings across major markets, with the FDA granting priority review designations to five indications for our Innovative Medicine. In MedTech, we are developing next-generation solutions that will solve the most pressing health challenges. For the second year in a row, we reported more than $30 billion in sales in MedTech, with particularly strong momentum in cardiovascular. We launched 15 major products in 2024. Highlights include the approval of our VARIPULSE Pulsed Field A blation platform in several major markets and the FDA clearance of our VELYS System for both robotic-assisted spine and partial knee surgery. We also received an expanded FDA indication for our Impella heart pumps to treat pediatric patients, as well as FDA clearance of Shockwave's Javelin peripheral IVL catheter. Looking to the future, we progressed 18 clinical trial programs last year.
These included investigational device exemption approval of our OTTAVA robotic surgical system, which allows clinical trials to begin in the U.S. Johnson & Johnson's portfolio and pipeline have never been stronger. We have incredible opportunities to improve patient lives, advance the standard of care, and drive growth. Let me give you just a few examples. During the last decade, more than half of the new medicines approved to treat multiple myeloma have been developed by Johnson & Johnson. We aim to have a product for every line of therapy, and our suite of medicines have helped change the conversation from treating to progression to treating to cure. In cardiovascular, we are leaders in heart recovery, intravascular lithotripsy, and in 3D mapping to diagnose and treat arrhythmias. In the future, we expect to strengthen our position in cardiovascular with the most comprehensive Factor XI anticoagulant development program underway.
In neuroscience, we have the first and only standalone medicine for treatment-resistant depression. Having pioneered advancements in neuroscience for nearly 70 years, the acquisition of Intra-Cellular Therapies will advance the standard of care for millions of patients living with mental health disorders. By combining our expertise in pharmaceuticals and medical devices, our therapy for the treatment of non-muscle-invasive bladder cancer has the potential to transform the current standard of care. You know, we could not achieve any of this without our most important source of innovation: our more than 138,000 employees. They bring their commitment to patients with them to work every day. It's a commitment enshrined in our Credo. I have cited many statistics today, but there is one number that makes me the most proud.
93% of our employees say they are willing to go the extra mile to help Johnson & Johnson meet its goals and improve patients' lives. As Chairman and CEO and a 36-year veteran of the company, I find this inspiring. Together, we are transforming health for humanity. Thank you all. I will turn the meeting back over 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 84% 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 shareholders' meeting. As described beginning on page 13 of the proxy statement, there are 11 nominees for the Board of Directors: Darius Adamczyk, Mary Beckerle, Jennifer Doudna, Joaquin Duato, Marillyn Hewson, Paula Johnson, Hubert Joly, Mark McClellan, 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 52 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 the ratification of the appointment of PricewaterhouseCoopers LLP as the independent registered public accounting firm for Johnson & Johnson for fiscal year 2025, as described in the proxy statement beginning on page 121. The board recommends a vote for this management proposal. The final items of business are two proposals submitted by shareholders. The first shareholder proposal and its supporting statement appear on page 124 of the proxy statement and was submitted by John Chevedden. Ms. Cam Franklin will introduce the proposal and will have two minutes.
Good morning. Can you hear me okay?
Yes.
Okay. Proposal for shareholder approval requirement for excessive golden parachute, sponsored by John Chevedden. Shareholders request that the board seek shareholder approval for any senior manager's new or renewed pay package that provides for severance or termination payments with an estimated value exceeding 2.99x the sum of the executive's base salary plus target short-term bonus. This proposal only applies to the named executive officers. This provision shall at least be included in the governance guidelines of the company or similar document and be accessible on the company website. The board shall retain the option to seek shareholder approval after material terms are agreed upon. This proposal has already been somewhat successful in triggering the board to adopt a bare-bones version of this proposal. Without this proposal, the board would not have even taken that limited action.
Unfortunately, some companies only limit cash golden parachutes to the 2.99 figure, which means that there is no limit on the non-cash golden parachutes. This proposal is relevant even if there are current golden parachute limits. A limit on golden parachutes is like a speed limit. A speed limit by itself does not guarantee that the speed limit will never be exceeded. Like this proposal, the rules associated with a speed limit provide consequences if the limit is exceeded. With this proposal, the consequences are a non-binding shareholder vote is required for unreasonably rich golden parachutes. This proposal places no limit on long-term equity pay or any other type pay. This proposal thus has no impact on the ability to attract executive talent and does not discourage the use of long-term equity pay because it places no limit on golden parachutes.
It simply requires that overly rich golden parachutes be subject to a non-binding shareholder vote at a shareholder meeting already scheduled for other matters. This proposal is relevant because the annual say on executive pay vote does not have a separate section for approving or rejecting golden parachutes. This proposal topic received between 51% and 65% support at FedEx, Spirit AeroSystems, Alaska Air, and Pfizer. Please vote yes. Shareholder approval requirement for excessive golden parachute, proposal four. Thank you.
Thank you, Ms. Franklin. The second and final shareholder proposal and its supporting statement appear on page 126 of the proxy statement and was submitted by Mercy Investment Services. Lydia Kuykendal will introduce the proposal on behalf of the proponent and will have two minutes.
Good morning. My name is Lydia Kuykendal. I am here on behalf of Mercy Investment Services and co-filers to present proposal five, request for a human rights impact assessment. The right to health is enshrined in international human rights principles. The World Health Organization's constitution states, "The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic, or social condition." The UNGPs explicitly state that companies must conduct human rights due diligence to identify and address adverse salient risks and adverse impacts connected with their products and services, particularly if the scale and scope of the impacts are likely to be large. Human rights impact assessments provide the best available evidence that such impacts are subject to structured and ongoing reviews.
Such an approach should certainly be applied to the company's most important business consideration, that of pricing and access to medicines. In fact, several direct industry peers have better due diligence and assessment models in place. While not perfect, Sanofi, Novartis, and Novo Nordisk all disclose processes that describe their commitment not just to a robust human rights policy, but diligence and assessment of that policy. The company states that they have a long-standing commitment to respecting human rights. Their Credo, their human rights position statement, and others all point to a consideration of human rights, which is a good place to start. What is noticeably missing from any public reporting is due diligence or assessment of those policies, Credos, and position statements.
The company states that it recognizes that respecting human rights and related due diligence is a process of continuous improvement, but then provides no disclosures around any process that would demonstrate that sentiment to be true. While the commitments are laudable, they ring hollow when the company doesn't lean into this very commitment to examine the core of its business, which is getting its products to patients. We believe that to fulfill their human rights commitment, the company must assess and disclose the results of that assessment, the human rights impacts of its operations, activities, business relationships, and products related to access to medicines. For these reasons, we ask you to vote for proposal five.
Thank you, Ms. Kuykendal, and thank you to each of our shareholder proponents 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 top priority 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 proposals presented today for reasons more fully described in the proxy statement. In summary, the proposals request board action on topics that are already well managed by the company and overseen by the board. The Compensation and Benefits Committee has already implemented a new policy that expressly requires shareholder approval for payment of the nature described in Mr. Chevedden's proposal.
Further, the company's robust human rights program and focus on access to and affordability of medicines demonstrate its long-standing commitment and leadership in areas relating to the proposals submitted by Mercy Investment Services. It is therefore recommended that shareholders vote against the two proposals presented today. The polls will now remain open for a few minutes. We will report on the voting results for each item of business shortly 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 video with you that articulates how Johnson & Johnson is giving healthcare real meaning, advancing life-changing innovation, and connecting the best of health and care.
Healthcare. It's more than a system. It's fundamental to our collective well-being. Healthcare has become disconnected. At Johnson & Johnson, we want to give healthcare real meaning again. The answer is right in front of us in those two simple words, health and care. Connecting the best of both to bring life-changing innovation to patients. Leading technology solutions that help people through recovery with greater ease. Advanced treatments for today and potential cures of tomorrow. Let's connect the best of health and care for every provider and every patient 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 11 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 proposals 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 seriously evaluate the voting results as we always do. Final voting results will be published within four business days of this meeting in a 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 you 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. Several of your questions were 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. We have received questions from Frank H., Mark C., William M., Steven K., and other shareholders regarding Johnson & Johnson's approach to diversity, equity, and inclusion going forward. Can you please provide an update?
Thank you for the question. Our Credo, which is over 80 years old, uniquely positions Johnson & Johnson to remain dedicated to our deeply held beliefs and core priorities: delivering for patients, doctors, and nurses, our employees, the communities we serve, and our shareholders. Our Credo directs that we foster an inclusive work environment where each person is considered an individual and calls on us to respect the diversity and dignity of all J&J colleagues and recognize their merit. We are doing exactly that. It is also imperative that we comply with all applicable laws, and we always will. This principle is foundational to our ability to serve patients. As a federal contractor, executive orders recently issued by the U.S. federal government have changed the legal landscape.
As a result of these developments, we have conducted an analysis and will continue to review our activities for legal compliance. The result of this work may lead to changes to our practices as necessary. Nevertheless, our commitment to our Credo and the values it represents remains constant.
We received questions from Gail B. and other shareholders regarding Johnson & Johnson's contributions to political parties. Can you explain?
At Johnson & Johnson, we have a long history of balanced giving to elected officials of both major political parties as well as bipartisan and nonpartisan organizations. Our political engagement plays a vital role in shaping the healthcare innovation environment in which we operate and allows us to advocate for public policies at the state and federal levels that promote our healthcare priorities. In the interest of transparency for our shareholders and other stakeholders, we voluntarily share on our website lists of Johnson & Johnson PAC and corporate political and ballot measure contributions.
We received questions from Steve H., Walter V., and other shareholders regarding how Johnson & Johnson will continue to be a leader in healthcare innovation while addressing evolving market dynamics and geopolitical uncertainties.
Thank you for the question. We remain confident in our ability to navigate the regulatory and geopolitical environment. Our recent Q1 performance reflects the power and resiliency of Johnson & Johnson's uniquely diversified business. We are not just a pharmaceutical company or a MedTech company. We are a healthcare company innovating across the full spectrum of disease, and we are investing for the future. It includes approximately $50 billion invested in research and development and inorganic innovation since January 2024. This industry-leading level of investment, plus our strong balance sheet, positions us for sustained differentiated growth through the end of the decade and beyond. Regulation and governments around the world play an important role in the life cycle of a product from its inception to commercialization. They also make a difference with respect to patients and healthcare providers having access to innovative lifesaving medicines and medical technologies.
We take any policy changes that would impact patients very seriously. This is why we work to engage and educate government leaders, policymakers, and other stakeholders on the importance of sustaining the health innovation ecosystem while at the same time ensuring equitable access for patients everywhere.
Thank you. Our last question for today, we received from Cameron A. regarding how Johnson & Johnson is using artificial intelligence to drive the business.
From discovery to diagnosis, from treatment to delivery, we live in a time of extraordinary opportunity. We have scientific platforms today that were unimaginable 10 years ago, and we have technologies like AI that are transforming the speed and delivery of innovation. At J&J, we are deploying AI in multiple ways. For example, in our Innovative Medicine business, we are using AI to identify promising drug candidates, assess safety, and optimize the design of our clinical trials. In MedTech, we are starting to embed AI directly into our devices and software, for example, with our CARTO mapping system in electrophysiology. We are also using AI to advance our support of healthcare providers. Our MedTech teams, for example, are training AI algorithms to create highlight reels of surgical videos just minutes after surgery, allowing surgeons to rewatch their procedures essentially in real time.
These are just a few examples of how AI is implementing better innovation. Ultimately, that's what AI in healthcare is all about: better serving patients.
Thank you. That completes our question and answer session today.
Thank you, Marc. As you have heard, Johnson & Johnson has an unrivaled portfolio and pipeline with the financial muscle, global reach, and disease expertise to deliver the sustained pace of innovation and growth that is our hallmark. Your confidence and investment in Johnson & Johnson is important to our success, and I thank you for your continued support. I look forward to sharing with you all that we accomplish in the year ahead.