J&J Beats Q4 Estimates, Raises 2026 Guidance to $100B
Johnson & Johnson posts 9% revenue growth in Q4 and forecasts first $100 billion year as Darzalex and MedTech drive expansion.
Johnson & Johnson just crossed a major milestone.
The healthcare giant reported fourth-quarter revenue of $24.6 billion Wednesday morning, up 9.1% year-over-year, with adjusted earnings of $2.46 per share—comfortably ahead of the $2.49 consensus. More importantly, management guided to roughly $100 billion in revenue for 2026, which would mark a new high for the 138-year-old company.
Shares dipped 2.7% in premarket trading despite the beat. The stock gained 43% in 2025, so some profit-taking isn't surprising.
The Numbers
Q4 operational growth of 7.1% reflects strength across both business segments. The Innovative Medicine division posted $15.8 billion in quarterly sales, while MedTech contributed $8.8 billion.
For full-year 2025, J&J delivered $94.2 billion in revenue—6% growth—with adjusted EPS of $10.79. Net earnings hit $26.8 billion, nearly doubling from the prior year as litigation costs normalized.
The 2026 outlook calls for $99.5 billion to $100.5 billion in sales, representing roughly 6.7% growth at the midpoint. Adjusted EPS guidance of $11.43 to $11.63 implies 7% earnings growth, slightly ahead of analyst estimates.
What's Working
The oncology portfolio carried the quarter.
Darzalex, J&J's multiple myeloma blockbuster, grew 23% to $4.2 billion in Q4 sales. Full-year revenue of $14.4 billion makes it one of the best-selling cancer drugs globally. The trajectory continues to accelerate as new treatment combinations gain approval.
CARVYKTI, the CAR-T cell therapy acquired through the Legend Biotech partnership, nearly doubled year-over-year to $645 million quarterly. Manufacturing capacity has been the bottleneck—J&J invested heavily in 2025 to expand production, and volumes are now catching up to demand.
Tremfya, the psoriasis and inflammatory bowel disease treatment, jumped 40% to $1.5 billion in Q4. The ulcerative colitis indication approved last year opened a significant new patient population.
On the negative side, Stelara revenue fell 41% to $1.4 billion as biosimilar competition intensified. The decline was expected—J&J has known the patent cliff was coming—but the magnitude shows how quickly biosimilars can erode branded drug sales.
MedTech Momentum
The device business contributed 6.1% operational growth for the year.
Electrophysiology products led the way, with ablation catheters and mapping systems gaining share against Medtronic and Abbott. The Abiomed heart pump franchise, acquired in 2023, continues integrating well and expanding into new clinical settings.
Surgery robotics remains a work in progress. J&J's Ottava platform hasn't launched yet, while Intuitive Surgical's da Vinci systems dominate the market. Management acknowledged the competitive gap but maintained the 2027 launch timeline.
The Litigation Overhang
J&J settled the bulk of its talc powder lawsuits in 2025 through a controversial bankruptcy maneuver that limited future exposure. The $8.9 billion deal ended years of legal uncertainty, though some plaintiffs continue appealing.
The resolution allowed J&J to redirect capital toward business development. Since the settlement, the company has announced three acquisitions totaling $15 billion, including Halda Therapeutics for radiopharmaceutical oncology assets.
CFO Joe Wolk noted on the call that the balance sheet remains "well-positioned" for additional M&A. J&J ended 2025 with $35 billion in cash and investments against $28 billion in long-term debt.
What Wall Street Is Saying
Analysts are generally positive but note limited upside at current valuations.
Leerink Partners maintained outperform, calling the quarter "solid across the board" and highlighting the Darzalex trajectory. They see the $100 billion revenue target as conservative given pipeline momentum.
Bernstein kept market perform, pointing to the Stelara decline as a reminder that even diversified pharma companies face patent cliffs. Their model shows J&J needing two to three significant acquisitions to maintain growth beyond 2027.
The stock trades at 15 times forward earnings—reasonable for pharma but not cheap. J&J's 2.8% dividend yield provides some downside support, though it's no longer the high-yield name it once was after the Kenvue spinoff.
For investors, J&J offers stability without excitement. The company will likely hit $100 billion in revenue, but the path to $120 billion requires execution on late-stage pipeline assets and successful integration of recent deals.
Earnings results follow strong prints from regional banks and continue a trend of beats this reporting season. The real test comes later this week when megacap tech reports.