Good afternoon, everybody. My name is Andrew "Cal" Callaway . I am responsible for healthcare investment banking here at Deutsche Bank. I am joined by my partner, John Guskin, who is responsible for our med tech effort. We are so pleased to have our good friend, Joe Wolk, here today. For those who do not know Joe, he is the Executive Vice President and CFO at Johnson & Johnson. So really excited to have this fireside with him. Today, we are going to start with some high-level questions, then we are going to jump into med tech. Then we will do a bit of a deep dive on pharma, and then we will close with some capital allocation questions. Let us jump in, Joe. You guys had a great Q2. You have been able to indicate that you are going to generate sales north of $100 billion this year, which is exciting.
Innovative medicines represents about two-thirds of that, and med tech, the remaining one-third. How do you see the balance potentially changing over time? Do you feel like you got the right balance between the two businesses, or do you think, as you look forward, that could change?
First off, thank you, Cal and John, for your interest, as well as all of you for your interest in Johnson & Johnson. It certainly is a pleasure to be here today. It is, I think, a really good story that we have to talk about at these conferences nowadays. I got to say, the board, the executive committee, we do not really wake up to a formula that says it has got to be two-thirds pharmaceuticals and one-third med tech. We want to make sure, and I think Joaquin has done an excellent job in this regard, in making sure we are playing in higher growth markets where we have a right to win. I think our business has got a better level of clarity now to investors like all of you with respect to where we think those areas that we can win are. In pharmaceuticals, oncology, immunology, neuroscience.
In med tech, it is surgery, where we have had a longstanding presence, vision, and then finally, it is cardiovascular, where we have beefed up our presence there. So I would say it does provide some advantages to think about our business where you have some overlap. When regulatory policy is being made and they think about a cancer patient, it is good to know that Johnson & Johnson can be there if that cancer patient needs a surgical procedure or a therapeutic, because Johnson & Johnson has expert voices in the room. Often an oncology patient does need that overlap. Cardiovascular, we have got a partnership with Bristol Myers for milvexian, a promising drug potentially to treat AFib. That complements our cardiovascular business very nicely. Those are just some examples, but I would not want anyone to leave here under the premise that Johnson & Johnson is about those convergences.
If those convergences happen, it is nice. But each business we hold accountable to competing against its peer set. It has to stand on its own and making sure we have got a right to win, either number one or number two in that respective marketplace. From a CFO perspective, I like the diversification it offers. As we approached a few years ago, the STELARA loss of exclusivity, even with an okay med tech business back then, we were still able to invest in our R&D pipeline on pharmaceuticals because we had that balance. I think it provides a lot of flexibility, not just for the company, but for how investors can look at us.
Thank you. Let us talk for a minute about growth. You guys announced a great Q2. Revenue was up 6.6%. You raised your outlook for 2026. You have talked about the ability to maintain a 5% to 7% growth rate over the long term. What gives you confidence that you are able to generate that durable growth as we look into the future?
Yeah. It has been a good year so far. I would say that 5% to 7% range is something that we committed to back at our Investor Day in 2023. We have, and hopefully many of you will be able to attend another Investor Day coming up on December 8th. You are going to see growth rates that are better than that. Okay?
That is exciting.
You've heard Joaquin, you've heard myself say publicly, we see double digits, clear line of sight to double digits for the enterprise over the next few years by the end of the decade. Let's get into that a little bit. 2027, you've got a weird dynamic in 2026 where we have an extra week of sales. Think about 1.5 to 2 points worth of growth. When you normalize for that, we'll be up next year over that, if you adjust for each period. After that, it's really unencumbered. What's amazing about next year is, let's say you're going to have equivalent reported growth, but actually operational growth a little bit better when you account for that 53rd week. There's about $4 billion to $4.5 billion of products that are losing exclusivity.
That's more than what we experienced STELARA's loss of exclusivity impact in year one of that biosimilar coming out. It truly is amazing. You think about XARELTO, loss of exclusivity, I don't think it's really appreciated. About $2 billion. The Pulmonary Arterial Hypertension franchise, about $1.5 billion. SIMPONI and STELARA combined, another $1 billion. Yet nobody's focusing on that, right? That's the amazing part of our portfolio. What gives me confidence? One, you've got largely a de-risked portfolio. Things that are on the market today or close to approval don't have a lot of risk left in them. We maybe have indication risk or things like that, but these are things that are pretty well known, markets that continue to grow, that are under-penetrated. You think about icotrokinra, which we just launched for psoriasis. Fantastic start. Maybe we'll talk about it a little bit later.
That's going to get likely indications in IBD somewhere down the road. You think about we're moving beyond multiple myeloma, where we've had a presence for probably the last decade, and prostate cancer, into different types of cancer like bladder cancer, lung cancer, head and neck, colorectal cancer, and then more therapies for multiple myeloma on the horizon. In med tech, we continue to have strong presence in wound closure and biosurgery, vision care. Contact lens is a good, steady business that's highly profitable within our portfolio, and now surgical vision is starting to emerge with some of their TECNIS platforms. OTTAVA was just recently approved.
We will go slow there to go fast later on, but that's an exciting new development that won't really have any material financial contribution for the balance of this decade relative to the scope of Johnson & Johnson, but really promises to be something big to support the next decade. So we're thinking 2031 and beyond at this point, placing those bets to make sure that's solidified. But we feel very comfortable with not just 5% to 7% growth, but as you've heard us say publicly, we've got line of sight to double-digit growth over the next few years. The one thing I think, we've always thought about how do we replenish the portfolio when you have these loss of exclusivity events, right? A number of our peers are facing that now in the pharmaceutical industry. It's nothing new to have that skill set.
Matter of fact, there has been one other company that has been able to grow through a period where they have had a significant biosimilar enter the market or a significant loss of exclusivity. That other company was Johnson & Johnson back in 2018 with REMICADE. We have done it now with STELARA. We are going to do it again whenever the next big LOE hits, and we think about it that way. We probably need to get a little bit more forthcoming with how we are positioned for that so investors can appreciate that. But there is a really good stable that John Reed and his team are working on that promise well for a good long time. But we feel really good about the balance of this decade.
How do you think about the relative growth between the pharma and the med tech businesses? If you want to drill down a little bit further into that, thinking about pricing, market share gains, potential acquisitions going forward.
Yeah. That is a great question, John. I think the markets, if I look at it, a top-tier pharmaceutical market growing in its heyday is going to have a higher growth profile than what you will see for a top-tier med tech company. But what I can say really with a lot of confidence is both our med tech segment and our innovative medicine segment are positioned to have higher growth rates than where they are today. That growth rate is not going to come from price. We just simply do not play in markets that allow for price. Matter of fact, the growth in pharmaceuticals for us has probably overcome 3% to 4% price erosion on an annual basis for at least the last seven to eight years.
Sure.
Okay? Med tech has never really had a lot of price flexibility. Maybe you see a little bit of that in contact lenses, more of a consumer-facing product, but that is even few and far between in terms of the years that that occurs. Our estimates are not really bolstered by or assuming any acquisitions. We will continue to do acquisitions to fortify the portfolio, but we are making these comments based on the portfolio or the pipeline that is in place today. So it would be additive. The good news is that should something go wrong, we have got the firepower to be able to do a smart acquisition. But it has got to make strategic sense. It has got to make financial sense.
Great. In terms of just the geographic split of the business today, do you see any shifts to be more U.S.-focused, OUS-focused?
For as long as I have been with the company, I think it has always kind of been a 50/50 split, 48/52. It is a little ambiguous now with some of the MFN deals in pharmaceuticals and how that may play out. We certainly do need to see, particularly Europe, I think, step into reimbursing for, quite frankly, innovations that are highly valued that extend and improve lives significantly. So it is hard to say that, but I would not see a dramatic shift from the roughly 50/50 split that exists today.
That is great. Thank you. We have got an ever-shifting U.S. healthcare policy landscape right now, whether that is Medicare drug price negotiations, shifting insurance coverage, payer mix, evolving tariffs, an ever-evolving FDA environment. What do you see as the net impact of more of the macro situation you see here in the U.S.?
Yeah. That is a good question. The way I think I would like to answer that question, there is a lot of topics in there, is that Johnson & Johnson, as well as the industry, has been at the forefront of having constructive dialogue with the administration for better business here in the U.S. What does that mean? Well, with respect to pricing, we did step into MFN, certainly participated in IRA. Matter of fact, one of the things that commentators on news broadcasts often comment, too, is the only thing that has not been inflationary is drug pricing. I think we need to refocus the discussion. If you think about healthcare costs overall, right? In the U.S., it is about 19% of GDP, $5 trillion. Pharmaceutical spending is only about 9% of that. So the savings that we are talking about are already where there has been cost containment.
The savings are to be had in other parts of the healthcare system. I think we need to take a focus on that. Matter of fact, on prescription drugs, 90% of them, not in terms of dollar value, but in terms of quantity, are actually generic prescriptions. The system kind of works, and if you think what therapeutics do, they keep people out of the more highly costly hospital stays. You think about, boy, I am old enough to remember when Magic Johnson declared he had HIV, and we thought, "Boy, that is a death sentence." Here he is 40 years later thriving. The same is happening in cancer. When we started her journey with multiple myeloma about seven or eight years ago, it was one to two year life expectancy. Now we have people who started on that original therapy of DARZALEX still living today.
Not just living and getting by, but living healthy, high quality living. I think there needs to be that focus. The other thing is from a U.S. perspective is, it provides really good jobs to the economy. China is closing the gap pretty quickly, where probably 15 years ago, they had maybe 9% of investments in the R&D pipeline globally. It is up to 30% now. U.S. is number one. We have got a sizable lead. We want to maintain that lead, one for the economic benefits, some for national security, but because that is where cutting-edge innovation occurs. That is why we were so pleased to advocate for and then see the passage of the tax bill.
Because it provides some permanency where we were able to make a declaration that, beginning about a year and a half ago, we were going to invest $55 billion in U.S. capabilities over the next four years. We are well on our way to doing that because we now have a tax system we can rely on, tap into the venture capital nature of the U.S., the ecosystem, whether that be just innovation, workforce, or the university system, which we think really leads to some of the things that we are seeing today in terms of not just treating people, but potentially curing them.
It was exciting to hear you say earlier that you think you can do better than the 5% to 7% over the course of the near to medium term. If you think about it from an investor perspective, what two or three KPIs should they be focused on that would indicate you are able to deliver that growth and continue to generate phenomenal shareholder returns?
Yeah, I don't think it's anything that's going to be groundbreaking here. I would want investors to make sure that we're meeting the success of these new product launches. Whether it's icotrokinra, whether it's TREMFYA in inflammatory bowel disease that received indications early last year, that's just getting started. Here's a product that's been on the market for about five years and maybe six, and we had 80% growth in the second quarter. These are big markets. OTTAVA, while the early days, are we getting good feedback from physicians? We've seen some of our peers that if you have a failed launch, those are hard to recover from. We're going to do this, like I said, we're going to go slow to go fast.
That means white glove service, getting feedback from the operating rooms to make sure we've got a high-quality product that people can rely upon. I would say if we have that growth, and again, I am confident we will have that growth, investors should expect some margin improvement along the way. We're going through a pretty deep exercise right now with the separation of our orthopedics unit to really look at our company and making sure the infrastructure is appropriate. We've got the benefit maybe of technology and AI. We'll see how all that plays out. We did the same thing when we separated our consumer health business.
Let's take not just stranded costs not being part of the conversation, but something that improves margin, which could help EPS growth, but then also be redeployed in R&D to really fund the future, because when a $100 billion company becomes $125 billion company, you're going to need to place more bets along the way. We're well-positioned to do that. I would say, as the CFO, cash conversion is pretty important. This year, I think we've targeted and are on track to hit $21 billion, which would be a high water mark. I expect that to grow substantially, and we'll have some more information at our Investor Day on December 8th in the coming years. It'll be meaningful, which will provide us even more flexibility to deploy capital in a number of areas.
Maybe one more question before we bounce to med tech. You mentioned the consumer separation in 2023. You mentioned the orthopedic separation that's ongoing. In both cases, you elected, as you've said publicly, to get out of those businesses to move into higher growth, higher margin areas. Do you think the work is done now? Or do you expect to continue to monitor the portfolio and cleave those types of assets on the go forward?
Yeah. That is a good question, Cal. I will say this right up front, that we love our portfolio. We love the six areas that we are in today. Make no mistake about that. I may even repeat that in this answer just so there is no ambiguity. But part of our remit as an executive committee is to continually look at our portfolio. Are we in those areas that are making a difference for patients, elevating the standard of care? Is there innovation to be had? Are we the right stewards to make sure that that innovation gets done? If you think about oncology, immunology, neuroscience, surgery, vision, and cardiovascular, we believe we have got the right portfolio now to make that work.
You never say never, but I think part of the remit of any management team is to continue to look at those areas where you are going to be really good at, and it is important to know what you are good in, right? We did an acquisition back in 2017, Actelion. It was a good business. It was a value-creating acquisition, put us in Pulmonary Arterial Hypertension. But here we are, the products are losing exclusivity, and there is really no carry through, right? It was good to do at the time. REMICADE was an unknown in terms of how that was going to react to a biosimilar competitor. So it made a ton of sense. But it was not an area we knew particularly well.
We will often get asked, "Hey, are you going to get into GLP-1s?" Well, you got really good companies that know that space pretty well, and they are ahead of us. Let us go make a difference where we can actually make a difference for patients, and that usually translates into a pretty good business model. Again, we love our portfolio as where it stands today.
That is great. Why don't we spend some time on med tech before we switch back to the pharma side of things? I really want to start around the acquisition strategy. If you look back a few years ago, you did some really sizable transactions with Abiomed and Shockwave Medical . It has been relatively quiet over the last 18 months on that front. Any commentary around new areas you want to go into in med tech or areas you want to beef up?
We're always looking for, again, those areas that we think we know well, that we've got some expertise, that will include adjacencies. I don't have a list to pull out of my pocket and say, "These are the companies we're interested in," even though that's probably the list everybody wants. What I would say is, it doesn't matter that valuations are depressed. When we did those deals, the M&A markets were kind of quiet, yet J&J moved ahead and did things. It's going to be situational. Again, when we talk to our board, 75% to 80% of the discussion is, what is that strategic fit? What's the scientific expertise? What's the commercial capability? Maybe sometimes it's global reach that Johnson & Johnson brings to the table that's going to make that asset more valuable in our hands than where it currently resides.
The other 20% of the conversation is about, okay, how does it compare to other investment alternatives? Does it make financial sense for Johnson & Johnson? That's really the discussion. It's not overly sophisticated, and if you can answer that first 80%, you're well on your way to doing something that's going to be instrumental in the portfolio and not just for the near term. It is a luxury that I believe I have as a CFO in that because of our broad-based portfolio, I never feel like I've got to plug a one or two-year gap, right? I never have to go out and do a bad deal just to plug a gap. It truly is a luxury that I have in my position that we don't have that pressure.
Great. I want to spend some time on some specific products and end markets that are in the portfolio, starting first with pulsed field ablation.
There's been a lot of commentary from some of the competitors in the market, whether that's Boston Scientific or Medtronic with their products, and the growth rates that they're seeing in those end markets. Any commentary you could provide around VARIPULSE both here in the U.S. and then VARIPULSE Pro in Europe?
Yep
and plans to ultimately bring that to the U.S.?
Yeah. So listen, EP is certainly a market we know well, we helped build with the RF technology. PFA has come out, and it's really translated into EP becoming one of the most, I'd say, fastest growing markets within med tech, but also one of the most competitive, right? We've got a nice install base with our CARTO mapping system. I think there's 6,300 systems that we're in because of that. It is advantaged versus the competitors. And we also have the benefit, I'd say, of integration with our CAS, or our clinical account specialists, who are often there during the procedure guiding the physicians and the relationship that's been built there, that there's stickiness to that. VARIPULSE has treated now more than 100,000 patients worldwide. The feedback in terms of usability, workflow, safety is getting stronger and stronger.
VARIPULSE Pro, which was launched in Europe, we hope to launch soon here in the United States, has received really good feedback. You got faster ablation times. They are complementary of the workflow, so we think that bodes well when we bring that to the U.S. market. The team is focused on innovation. If you're going to compete here, you're going to have to continually innovate, making the systems, the catheters better. The team's committed to, I believe it's a new therapeutic invention per year over the next three years being introduced to the market. OMNYPULSE, ISOPULSE. We'll continue to make upgrades to our CARTO mapping system, which is already, I think, the premier mapping system out there. So we should be well-positioned. And we'll continue to look into how do we support that business with maybe inventions that aren't part of Johnson & Johnson's portfolio right now.
We'll have the capability to do that.
Great. Moving to the IVL market, you've got Boston Scientific's launching their SEISMIQ products here in 2027. Any notes that you could say around potential market share changes or impacts on the broader market because of that launch?
Yeah, listen, I think competition is a sign of a good market, right? We always expect it when we acquired Shockwave, that there would be competition. Here, too, you've got physician familiarity, we've got physician relationships. We've got a generator that's distinguished. That team is on their fifth generation. It's probably, in all my visits across the company, one of the management teams that's mostly what they talk about. How are they going to continue to innovate, go into new areas? So in terms of circulatory restoration, it's been a great acquisition. We feel really good, despite competition coming in, that we will have the preeminent leadership position in that space going forward.
Great. Something I think everyone's been really focused on, and you spoke at length about, and mentioned earlier in this chat, is around the robotics-
Yes
-And OTTAVA. Obviously, everyone's really excited to see what that looks like in the years to come. Any commentary around the acceleration and the commercial launch as that's been obviously brought to market, and how you view that relative to the rest of the med tech portfolio in terms of, is that where the growth for the broader for products you have is going to come from?
Yeah. It's not primarily the growth. When you have, again, a company that has 28 platforms that generate more than $1 billion in revenue, a lot of those growing double digits. The good news is we don't have to hang our hat on just one. But we are extremely excited about what this could mean for hospital systems and for patients overall. There's about 300 million surgical procedures today, 50 million here in the U.S. Depending on what source you use, anywhere from 15% to 25% are subject to some post-op complication. There's room for improvement. There's room to elevate the standard of care. We're not misguided in terms of we know there's a very strong competitor out there. But we think our offering is differentiated. It's got integrated architecture. That helps with workflow. There's no booms.
It allows for a better workflow amongst the participants in the operating room. We've got digital twin, so the patient doesn't need to be re-docked. You don't have to delay procedures. You've got Ethicon instruments. Even today, without our robotic system, a high percentage of procedures are using our sealing and stapling capabilities. Then you've got what we're calling an open network or Polyphonic, which allows the operating room to almost have a suite of surgeons in the presence of that surgical procedure, as well as building a database to make that surgery inform the next for a better outcome. So we think these are all different. Again, we're going to go slow. We're not reliant. This is the luxury of maybe the position of where our portfolio is today. We're not reliant on this being successful for success in 2028 or 2029.
This is really about a next decade play. But getting these first couple launches, first 10, 20, 30 launches exactly right, that means a white glove service around those, is really what we're focused on. We were pleased to announce the first account sign on, Memorial Hermann down in Texas. We think there's going to be a number of other announcements in the coming months, and so we feel really good about where that positions, and we think it is differentiated. But by no means do we don't think the competition is just going to lay down for us. We've got to prove our value case, and we think we're in position to do that.
Yeah, we're all really excited to see how that evolves over time. Just going back to the big picture for MedTech. Historically, the margin profile for that part of the business has been lower than what you've seen from pharma. How do you see those margins evolving over time, and do you think there's an opportunity to get that up to the level where the rest of the business has historically performed?
Yeah. I would say that investors are right to acknowledge there is a different profile in the margins on those businesses. Again, when I look at it, when the management team and Joaquin look at it, how we compare to our peers within the MedTech space, we have got work to do. There are some businesses that are very good. Surgery is a very good business in terms of margin performance. Vision, another one that is very good, particularly on the contact lens side. We have made improvements on the surgical side in recent years. Even though surgery is good, we continue to make improvements there in rationalizing the portfolio, making sure the footprint is right for manufacturing. Cardiovascular, both Abiomed and Shockwave acquisitions with pretty good margins to begin with. So living into Joaquin's stated goal when he assumed the role back in 2022 is, higher growth, higher margins.
But I do not think people should expect us to be at pharmaceutical level margins. But to improve where we are today? Absolutely. Particularly when the growth on the top line is a little bit more healthy.
Yeah. Thank you. You mentioned Abiomed there.
Sure
In that business of late, we have seen some field actions as well as some recent studies on physician utilization patterns. Any commentary on resolving some of those issues and seeing the business continue to outperform and take market share?
Yeah. So, thank you for the question, John. I think there has been some headwinds in that particular business. I think we've had some field actions. We are working actively with the FDA to make sure those are resolved, and patient safety remains a priority. This is a highly under-penetrated market. There is no competition currently that exists. So we feel good about the long-term prospects of this business. We are relying on it going forward. In terms of utilization, you had a study that was done in the U.K. based on about 300 patients. That is kind of getting a little bit more press than what we think over a decade of data set suggests. We are thrilled that we will be able to come out with what is known as the PROTECT IV study , which will have four times the number of patients, sometime next year, which we think will fortify the use case.
But it is about patient selection. I think when you look at the U.K. study, was the right patient selected? Are some of the questions we have. But we are going to let the data speak, and making sure that patient safety remains a priority. But we think this is still a good acquisition despite this little pause period here. But we think that this time next year, we are in a much better position back to those double-digit growth rates that we were experiencing prior to that report.
Great. I want to make sure we save some time for pharma. So Cal, do you want to jump in?
Sure. Let us start with oncology. You have been very clear that Johnson & Johnson’s goal is to be number one overall in oncology, which translates to about $50 billion of sales as a target.
Pretty lofty goal, given that you are just shy of $30 billion today. What gives you confidence that you can deliver on this goal, and is M&A going to be a part of that solution?
Let me answer the last question first. M&A is not part of that $50 billion target that we have. If we happen to do something there, great, but that would be additive to what you can expect from us. Let us start with multiple myeloma, where I think it is over 85% of the patients who are suffering from multiple myeloma are on a Johnson & Johnson drug. We are now, DARZALEX, the CAR- T Therapy. We have TALVEY. These are now starting to be combined for even better efficacy. These are early in their life cycle, I would say. The DARZALEX FASPRO designation made it very easy to administer for patients. You went from a three to four hour infusion time, sometimes as long as five, to about 15 minutes, and that includes making your next appointment, right?
These are the kind of innovations that Johnson & Johnson is focused on. Again, you go back to when we got into the market with DARZALEX, there was not a very healthy outlook for patients who were diagnosed with it. Here they are living longer, healthier lives. We have other things that are in place. Ramantamig is a trispecific that could actually turn this conversation from treating multiple myeloma to curing multiple myeloma, right? Very exciting stuff. Prostate cancer, it is really where we kind of had our entry into oncology back with the acquisition of, I believe it was called Cougar Biotechnology back then, ZYTIGA. We continue to build on that. We are currently enjoying ERLEADA, but there are other new modalities coming up.
There are studies in ERLEADA to go earlier with localized prostate cancer, but you have some acquisitions we recently did that are going after the KLK2 antigen. There is the Halda platform, which not only attacks the protein causing the cancer, but addresses the protein that helps cell preservation, which could really negate what we see in terms of drug resistance or therapeutic resistance. We continue to innovate there. What is really exciting is we are moving out of those areas that we have been pretty good at for better than a decade and now moving into new areas. We have RYBREVANT, lazertinib combination, which is out there for lung cancer right now. That is being studied in both head and neck and colorectal cancer. We are in bladder cancer now with BALVERSA, a very small population.
Maybe about 10% of the population is what is currently indicated, but we look to expand that out further. Right now, the treatments that are available for people who suffer from bladder cancer trying to save their bladder are pretty egregious on the patient. It is not a very comfortable process. This is a very easy, in partnership with our surgery team, insertion of a catheter into the bladder, releasing of a drug, really limits, I would say, side effect profile. Where else are we going? So that has potential to go in other parts and other cancers, too. We continue to make really good strides on the oncology portfolio. Here, too, I would say $50 billion, that should be the floor for us. We think bigger than that, and we will see what we have to say on our investor day later this year.
Amazing. Let us switch to I&I for a second. It looks like you have a mega blockbuster in ICOTYDE, which you mentioned earlier, approved so far in psoriasis, but you are going after-
Yeah
-Bunch IBD indications as well. Given the impressive launch to date, it looks to us like perhaps this could be far bigger than perhaps the analysts project today. Is that the right read from our seats?
Yeah, I will say that with some certainty on December 8th. But I would say that is a really good take. That is my take-
Yeah
-If that helps you at all. It has been on the market for five months. There are 17,000 patients. We have got coverage by all the big three providers now. What is interesting about this is a couple things. I just had a review yesterday with the team. We are seeing a lot of naive systemic. What does that mean? That means we are actually expanding the market. The psoriasis market is still, I would probably say, 50% penetrated. We are able to expand the market because folks had, for one reason or another, an aversion to getting stuck with a needle, right? The once daily pill option is something that appeals to folks. The other thing that is pretty neat of a dynamic here is who is prescribing this. Clearly you would expect dermatologists, but we are also seeing prescriptions from general practitioners as well as advanced practitioners. So nurse practitioners, physician assistants.
This has broad appeal, and the fact that we now have coverage out there. CVS, I believe, started two days ago. That was the last one to bring in. We are in a good position, and I would think that where the analysts are, we should see a number more to that. We will give you more details on December 8th. I will let the team comment.
Sounds like we should all be there on December 8th.
I think that is a good idea.
Investors are really focused on some of your large high growth commercial assets, whether it's DARZALEX or TREMFYA or CARVYKTI. What should investors be thinking about? What are you thinking about as we look forward to 2030? Give us a sense as to some of the pipeline assets that are coming down the pike that could really continue to be that next gen.
Yep. I would say one that doesn't get a lot of play, but it has the potential to be big, is IMAAVY, nipocalimab. It currently has approval for myasthenia gravis, as well as it just recently received approval for warm autoimmune hemolytic anemia. Had to pause. I'm an accountant, not a scientist, right? But it has even larger potential in Sjögren's disease as well as lupus. So that's an exciting one. I would say the ramantamig, one that I spoke about earlier, trispecific, that would be off the shelf, easier to use for multiple myeloma, has a lot of promise. I would say pasrodimab in prostate cancer, as well as the RIPTAC technology that we acquired with Halda. Those all provide platforms within areas we know well and other areas. So those are some of the things that I think would be pretty interesting.
There's a combination, I think it's JNJ-4804, which is looking at refractory IBD that holds a lot of promise. There's a lot of cults in the stable to take over in 2030 and beyond.
Exciting. You mentioned obesity earlier. It's an area that you guys have been very public about not intending to enter, despite being an enormous TAM that certainly is playing out as many had projected. Do you see this potentially changing? If so, what could alter your decision to sit still in this market?
It comes back to what I said earlier, Cal. It is really about the scientific expertise we do or we do not have, right? When you go up against competition, you want to make sure that you are in a position to win. The companies that are out there right now, to their credit, are very respectable. They are steep, they are studying things, to be fourth or fifth to market probably is not very good for our business, but it also really does not advance anything for patients. From that perspective, it does not make a ton of sense given that we do not have maybe an acute insight that would prevent some of the things that maybe GLP-1s are trying to correct for now. You never say never. We never know what is going to come across our desk.
But right now, again, the areas that we are in, there is a lot of disease that still needs to be tackled in those spaces. You just asked me about what to look forward to. Atopic dermatitis. We have purchased some assets. We have got some early-stage assets. That is, I think, four times the market than psoriasis is. So we are playing in there. It is a nice adjacency. We do not have anything there yet on the market. But we are positioned to do there, and we think we can do something there because of our expertise in immunology.
Maybe one last question, then we will go to capital allocation. It strikes us that valuations in biotech have gotten a little frothy at the moment. Do you agree? If so, does that change your appetite for M&A?
I think we do ourselves a disservice when we characterize something as frothy or not frothy. It has to be, at least in my experience, the right opportunity at the right time at the right value. We do not get overly hung up. John stated earlier we did some acquisitions in a time where the M&A market was dead, but we had the flexibility, the power, and the strategic purpose to do it. I do think maybe valuations are a tad high simply because you do have some of our competitors in the pharmaceutical space that are facing significant LOEs.
They do not quite have the stockpile of assets in their pipeline to make up for that in short order. There is maybe a twinge of that, but it does not mean we cannot find value out there.
Right. Why do we spend a few minutes, our last few minutes, on capital allocation. Johnson & Johnson will generate roughly $20 billion of free cash flow in 2026. How do you think about the trade-off between the capital allocation with that kind of cash flow between the existing business, investing, M&A, buybacks, dividends? What is some general commentary you could provide-
Yeah
-In terms of how you think about those pursuits?
Yeah. Hopefully, what all of you see is that we are disciplined in our capital allocation, and you kind of know who we are at this point. The dividend, we have got dividend king status. I do not think Joaquin nor I want to be the one to break that streak, to be quite frank. But we have got investors who invest in Johnson & Johnson for that reason. But that will not prevent us from doing smart acquisitions that go into our portfolio that provide value for the long term. One of the areas maybe we get a little bit knocked around for is we want a lot more share repurchase. But I would point shareholders back to 2023, when we did not only the largest share repurchase in our history, but by three times fold with the consumer health separation and how we separated that business.
It was a $33 billion share repurchase, right? We are not averse to share repurchases, but if we can put our capital to work that fortifies 2030 through 2040, that seems like a smarter play for us, and it seems to be working. The good news is, though, as I said earlier, I like the fact that we are going to potentially hit a high water mark, and we are on track to hit that high water mark this year with $21 billion free cash flow. And I see that number going up substantially over the next few years.
That is great. A final question as it relates to the talc settlement. Any further financial uncertainty around that situation going forward once the settlement is finalized?
No. I think it kind of ties into your earlier question about capital allocation. We have been dealing with this for better than a decade now, this matter, and it has not stopped us from doing what we think are important for the long-term health of this business. Right? Continuing to pay dividends, continuing to add to our portfolio where it makes sense. The $5.5 billion settlement is far below what the bankruptcy settlement was, so we thought that was smart. But we did, in a very profound way, I think, and this is good for American businesses, kind of uncover some of the tactics that are used by plaintiff's attorneys in these class action lawsuits. We have had witnesses discredited because they lied on the stand. We saw photoshopped evidence that was brought in and accepted. So once you get to jury trials, it gets a little bit squirrely.
It is maybe a blemish on an otherwise really solid legal system. But I do think it is a threat to American business, and the fact that the lead plaintiff attorney was actually disqualified for actions of misconduct on and being unethical, I think is also noteworthy. Other businesses are starting to figure this out and join us in this fight. People on Capitol Hill are starting to recognize this with some legislation. So I think that is a win. It is a shame we had to go through it, but we think this is behind us now, and that just portends, again, for us to use cash where it matters most for not only our business results, but for society.
Well, Joe, on behalf of everybody here at DB, thank you so much for coming. Congrats on all the success. We are certainly looking forward to December 8th and what you are going to unveil there. But thanks again.
Thank you, Cal. Thanks, everyone.