Johnson & Johnson’s pipeline strategy: What does 2026 have in store for the big pharma?

As 2026 gets underway, Johnson & Johnson (J&J) is navigating an inflection point that involves balancing a maturing internal pipeline with evolving external pressures on pricing, policy, and dealmaking. After years of focused internal research and development (R&D) combined with selective external partnerships and acquisitions, the big pharma’s pipeline strategy this year could reflect a clearer prioritization of core therapeutic strengths – such as in the areas of oncology and immunology – tempered by pragmatic responses to the shifting market and regulatory dynamics. 

J&J has already set a positive outlook for the coming year. As its sales rose 9.1% in the fourth quarter to $24.6 billion, the company made its 2026 intentions extremely clear in a conference call on January 21, when it projected that its sales for the year would be in a range of between $100 billion and $101 billion – up from $94.2 billion last year, and above average analyst estimates.  

In this article, we explore J&J’s pipeline strategy for the coming year to understand whether it could potentially reach this $100 billion milestone, or whether its loss of exclusivity for top-selling drugs and its “most favored nation” (MFN) deal with the Trump administration will impact the company’s earnings.  

Oncology: J&J’s golden therapeutic area  

As its immunology business absorbs the impact of Stelara’s loss of exclusivity, J&J’s cancer portfolio is likely to be the company’s most credible source of near- and mid-term growth over the next year, anchored by a mix of established blockbusters and newer, high-value modalities.  

J&J’s chief executive officer (CEO), Joaquin Duato, reaffirmed during January’s conference call that the pharma’s goal “is to become the number one oncology company, reaching $50 billion by the end of the decade.” He added that the company is very confident in its pipeline progress in this area.  

Indeed, J&J has a sizeable oncology pipeline listed on its website, with many candidates in late-stage trials for different cancer types. Its strength is particularly rooted in its hematologic malignancies portfolio, as it describes itself as a “worldwide leader” in multiple myeloma therapies.  

The big pharma’s leadership in this role is anchored by the monoclonal antibody Darzalex. While Darzalex is, of course, no longer a “new” asset, its durability is central to J&J’s confidence that oncology revenues can offset immunology erosion. Much of the drug’s success is due to a green light in 2020 for Darzalex Faspro, a subcutaneous version of the treatment that allows patients to receive doses within minutes – far quicker than the intravenous administration, which can take hours. Just this week, Darzalex Faspro received a U.S. Food and Drug Administration (FDA) approval in combination with bortezomib, lenalidomide, and dexamethasone for adults with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant. 

Earlier this month, the company also shared positive topline results from its phase 3 study of its drug Tecvayli, showing a 71% reduction in the risk of disease progression or death and a 40% reduction in the risk of death in a multiple myeloma patient population that was predominantly refractory to anti-CD38 therapy and lenalidomide. The drug was approved in 2022 by the FDA as the first bispecific T-cell engager antibody for the treatment of patients with relapsed or refractory multiple myeloma. Additionally, when combined with Darzalex, Tecvayli reduced the risk of death by 54% over Darzalex and the steroid dexamethasone in J&J’s late-stage MajesTEC-3 study.  

Furthermore, the company has expanded its sales of cell therapy Carvykti – a product J&J picked up through a license and collaboration agreement with Legend Biotech in 2017 – by winning approval for the drug to treat adult patients with relapsed or refractory multiple myeloma who have received at least one prior line of therapy. This expanded indication in 2024 made Carvykti the first and only B-cell maturation antigen (BCMA)-targeted therapy approved for the treatment of patients with multiple myeloma as early as first relapse. 

In the fourth quarter of 2025, Carvykti sales soared 66% to $555 million, while Tecvayli’s sales rose 21% to $176 million. Meanwhile, Darzalex achieved sales of $14.4 billion in 2025, $3.9 billion of which came in the fourth quarter. The continued success of these therapies makes them extremely important assets for J&J.  

Beyond hematology, J&J has also been building depth in solid tumors, particularly lung cancer, where its ambitions are increasingly clear. The combination of Rybrevant with Lazcluze, approved by the FDA in 2024, has emerged as a cornerstone of this effort, with the potential to become a differentiated option in EGFR-mutated non-small cell lung cancer (NSCLC).  

J&J posted further phase 3 data for the combination therapy in December 2025 showing that Rybrevant plus Lazcluze led to a statistically significant and clinically meaningful improvement in overall survival benefit for Asian patients with EGFR-mutated NSCLC; according to J&J, this is the first and only chemotherapy-free combination in the first-line setting to demonstrate an overall survival benefit versus osimertinib among Asian patients. As clinical data mature and uptake broadens, this could provide J&J with a second oncology growth pillar.  

It is also worth mentioning that J&J acquired Halda Therapeutics last year for $3.05 billion, providing the big pharma with a Regulated Induced Proximity Targeting Chimera (RIPTAC) platform and a pipeline that includes a phase 1/2 candidate for prostate cancer, as well as several earlier candidates for breast, lung, and multiple other tumor types. 

And with other assets in J&J’s pipeline portfolio, like Inlexzo, which was approved last September as a “new, potentially practice-changing approach for treating patients with certain types of bladder cancer” after 82% of patients achieved a complete response without the need for reinduction, it is clear that the company’s oncology business will be its shining light throughout 2026.  

Immunology after Stelara: Is there another potential blockbuster in J&J pipeline? 

For J&J, 2026 is the first full year in which the loss of exclusivity for Stelara is no longer theoretical but fully embedded in the numbers. Once the backbone of the big pharma’s immunology franchise, Stelara’s exposure to biosimilar competition has created a clear revenue hole, and with it, skepticism about whether the company’s remaining immunology portfolio can realistically compensate. J&J’s response, however, has been less about directly replacing Stelara with another specific huge blockbuster and more about reshaping the franchise around several differentiated assets with longer runways. 

The most important of these is Tremfya, which has become the linchpin of J&J’s post-Stelara immunology strategy. Already well-established in plaque psoriasis, Tremfya’s expansion into inflammatory bowel disease (IBD) has expanded its growth potential. Its recent approvals for Crohn’s disease and ulcerative colitis made Tremfya the first IL-23 inhibitor to offer both under-the-skin injection and intravenous (IV) dosing options from the beginning of treatment through maintenance therapy for IBD patients. This positions the medicine ahead of other IL-23 inhibitors for IBD, such as AbbVie’s Skyrizi, Eli Lilly’s Omvoh, and even Stelara, as they require IV infusions, which can create barriers to starting treatment or be burdensome for some patients and clinicians.  

While Tremfya is unlikely to fully replicate Stelara’s peak sales, its label breadth and durability make it J&J’s most credible near-term immunology revenue stabilizer in 2026. 

Alongside Tremfya, J&J is placing a more strategic bet on next-generation immunology mechanisms. Nipocalimab, an FcRn inhibitor, is a good example of this. FcRn biology offers a different commercial dynamic: chronic use, high unmet need, and pricing power insulated from the biosimilar pressures facing older monoclonal antibodies. Speaking to its potential, the FDA approved the drug last year for the treatment of generalized myasthenia gravis, offering a new option in a proven class with the potential for lasting disease control in the broadest population of people living with the autoantibody disease. 

J&J has also diversified its immunology approach through oral therapies, most notably icotrokinra, an oral IL-23 receptor antagonist that J&J picked up through its license and collaboration agreement in 2017 with Protagonist Therapeutics, in which the two companies worked together to discover and develop next-generation compounds (ultimately leading to icotrokinra). J&J is now seeking approval for the drug for the treatment of plaque psoriasis. Its submission of a New Drug Application (NDA) to the FDA is based on an “unprecedented” data package that met all primary endpoints across four phase 3 studies, including head-to-head superiority comparisons versus deucravacitinib and evaluation of difficult-to-treat skin sites. If the drug receives approval, the ease of oral dosing could make it a real hit in the psoriasis/dermatology market. 

Taken together, these assets underscore how J&J is attempting to absorb Stelara’s decline within its immunology business unit.  

Opportunities beyond oncology and immunology: Neuroscience and other target areas 

While oncology and immunology dominate the near-term narrative for J&J, neuroscience represents one of the big pharma’s longer-term bets – and one that gained real weight with the $14.6 billion acquisition of Intra-Cellular Therapies in January 2025. The deal marked a rare example of J&J making a large move outside of its traditional strongholds, underscoring its growing confidence that neuroscience can deliver both clinical impact and commercial durability. 

The centerpiece of that acquisition was Caplyta, an oral therapy already approved for the treatment of schizophrenia and bipolar depression as a monotherapy and an adjunctive therapy with lithium or valproate. For J&J, Caplyta offered an on-market asset with clear revenue traction and expansion potential. The company just announced this month that a new analysis of phase 3 data found that Caplyta, in combination with an antidepressant, showed significantly greater remission rates in adults with major depressive disorder than placebo plus an antidepressant at six weeks, with continued benefits observed through six months in an open-label extension study. 

As J&J has integrated Intra-Cellular’s pipeline, which also includes ITI-1284, a promising phase 2 compound being studied in generalized anxiety disorder and Alzheimer’s disease-related psychosis and agitation, Caplyta is expected to become a meaningful contributor to growth in the latter half of the decade, helping diversify revenue away from immunology and oncology concentration. 

In the context of 2026, neuroscience is unlikely to offset near-term patent losses on its own. But, strategically, it plays an important supporting role, signaling that J&J is willing to deploy capital aggressively when a franchise meets its criteria. As oncology carries the immediate growth burden and immunology stabilizes itself post-Stelara, neuroscience stands out as a measured but meaningful pillar for the next cycle of expansion. 

In the January conference call, Duato also briefly referred to some of the company’s other key business units. He said: “It was a year that launched us into a new era of accelerated growth. Fueled by the strongest portfolio and pipeline in our history, Johnson & Johnson has a leading and expanding position in each of our six key businesses – oncology, immunology, neuroscience, cardiovascular, surgery, and vision.” 

“We are different from other companies,” he added. “We are not focused on one or two growth drivers.”  

Patent losses vs forecast growth: Can J&J really absorb the hit? 

Naturally, as is the case with other big pharmas, the central question hanging over J&J in 2026 is whether it can truly outgrow its patent losses, rather than simply manage them. The erosion of Stelara is real and material, and while J&J is not facing the steepest patent cliff in the sector, it is absorbing the decline of one of the most lucrative biologics of the past decade.  

Future growth now appears to rest on the idea that oncology momentum, a reshaped immunology franchise, and selective new growth pillars can collectively offset that drag – an assumption that will be tested quarter by quarter.  

However, there is a credible case that this is achievable. Oncology assets such as Darzalex, Carvykti, and Tecvayli are scaling, immunology is being rebuilt around Tremfya and next-generation medicines, and neuroscience now includes a revenue-generating anchor in Caplyta.  

And some more positive news came in earlier this week – Morgan Stanley upgraded J&J from equal weight to overweight, signaling some renewed optimism for the pharma giant. The firm’s analyst, Terence Flynn, bumped the price target from $200 to $262, implying a 17% upside from current levels. This move comes on the back of J&J’s robust new drug pipeline, which could drive stronger earnings growth than previously anticipated. 

Ultimately, 2026 could well prove lucrative for J&J. As the year progresses, we will all be watching closely to see whether the big pharma really can reach its milestone sales projection of between $100 billion and $101 billion.