⚠ The Price Is Now Set ElsewhereHigh threat
Johnson & Johnson (JNJ) — threat to the moat
J&J now grows by selling more medicine at lower prices: price took 3.1 points off its growth in 2025.
For most of its history J&J grew partly by raising prices. In 2025 price subtracted 3.1 points from its sales growth while volume added 8.4; in 2024 price contributed nothing1. The company is growing by selling more at lower prices.
Several forces push the same way. Biosimilars cut the price of Stelara and Remicade. The Inflation Reduction Act's redesign of Medicare Part D shifts a greater portion of costs to manufacturers within certain coverage phases2. The Medicare Part D redesign appears in the 2025 explanations for Erleada, Imbruvica, Invega, Opsumit, Uptravi and Stelara3. The Inflation Reduction Act sets government prices for selected drugs from 2026, and its provisions also impose rebates if certain prices rise faster than inflation4. In January 2026 J&J agreed to provide Medicaid access at prices comparable to other developed countries5.
The rebate figures show the scale. Innovative Medicine accrued $56,819 million of rebates in 2025 against $47,523 million in 2023, while net sales grew from $54,759 million to $60,401 million67. Rebates grew about twice as fast as sales8.
The risk is that the replacement machine depends on high prices for new medicines to fund research. If governments and payers compress prices on new products as well as old ones, each replacement earns less than the product it replaces, and the margin that funds the next one shrinks.
J&J's defence is volume and mix: oncology grew 22.1% in 20259, largely on medicines that are not yet exposed to price-setting.
The agreement with the administration shows how pricing now works. J&J will participate in TrumpRx.gov, enable American patients to access medicines at comparable prices to other developed countries, and provide Medicaid access at comparable prices10, while the specific terms, including revised prices and covered medicines, were not disclosed11. A company that cannot disclose its own price concessions has lost some control of the variable that matters most.
Pricing has shifted from a tailwind to a steady headwind. The price line in J&J's annual sales bridge will show it; a decline of more than 3.1 points in 2026 would mean the headwind is strengthening faster than new products can offset.
Price is now a headwind; a larger negative in 2026 would mean it is strengthening faster than new products offset.
Source: Johnson & Johnson Form 10-K, FY2025 ↗- ReportedIn 2025 price subtracted 3.1 points from its sales growth while volume added 8.4; in 2024 price contributed nothing.Johnson & Johnson Form 10-K for fiscal 2025 (year ended 28 December 2025) - Item 7 MD&A: consolidated sales, volume and price, geography, the three wholesalers, rebate accruals, costs, R&D and liquidity. — FY2025 · publ. 11 February 2026 · source ↗
- ReportedThe Inflation Reduction Act's redesign of Medicare Part D shifts a greater portion of costs to manufacturers within certain coverage phases.Johnson & Johnson Form 10-K for fiscal 2025 (year ended 28 December 2025) - Item 1A risk factors, Note 19 legal proceedings (talc, Innovative Health, Auris, Tracleer) and the Inflation Reduction Act. — FY2025 · publ. 11 February 2026 · source ↗
- ReportedThe Medicare Part D redesign appears in the 2025 explanations for Erleada, Imbruvica, Invega, Opsumit, Uptravi and Stelara.Johnson & Johnson Form 10-K for fiscal 2025 (year ended 28 December 2025) - Item 7 MD&A: Innovative Medicine segment, therapeutic-area and product sales analysis. — FY2025 · publ. 11 February 2026 · source ↗
- ReportedThe Inflation Reduction Act sets government prices for selected drugs from 2026, and its provisions also impose rebates if certain prices rise faster than inflation.Johnson & Johnson Form 10-K for fiscal 2025 (year ended 28 December 2025) - Item 1A risk factors, Note 19 legal proceedings (talc, Innovative Health, Auris, Tracleer) and the Inflation Reduction Act. — FY2025 · publ. 11 February 2026 · source ↗
- ReportedIn January 2026 J&J agreed to provide Medicaid access at prices comparable to other developed countries.Johnson & Johnson press release: agreement with the United States government on drug prices, Medicaid access, TrumpRx and a tariff exemption. — January 2026 · publ. 8 January 2026 · source ↗
- ReportedInnovative Medicine accrued $56,819 million of rebates in 2025 against $47,523 million in 2023, while net sales grew from $54,759 million to $60,401 million.Johnson & Johnson Form 10-K for fiscal 2025 (year ended 28 December 2025) - Item 7 MD&A: rebate accrual tables, research and development, cost of products sold, debt and liquidity. — FY2025 · publ. 11 February 2026 · source ↗
- ReportedInnovative Medicine accrued $56,819 million of rebates in 2025 against $47,523 million in 2023, while net sales grew from $54,759 million to $60,401 million.Johnson & Johnson Form 10-K for fiscal 2024 - segment sales, the three wholesalers in 2023 and 2024, rebate accruals for 2023 and segment income for 2022. — FY2024 · publ. February 2025 · source ↗
- Moat Explorer calcRebates grew about twice as fast as sales.Moat Explorer calculation from Johnson & Johnson's reported figures ($ millions unless stated). Darzalex royalty: 2,400 / 14,351 = 16.7%. Stelara 2023-2025: 10,858 - 6,078 = 4,780 lost; Tremfya 5,155 - 3,147 = 2,008 gained, 2,008 / 4,780 = 42%. Growth 2023-2025: Darzalex 14,351 - 9,744 = 4,607; Carvykti 1,887 - 500 = 1,387; Erleada 3,574 - 2,387 = 1,187; Spravato 1,696 - 689 = 1,007; five products 4,607 + 2,008 + 1,387 + 1,187 + 1,007 = 10,196. Myeloma medicines Q2 2026: 4,207 + 657 + 260 + 174 = 5,298; 5,298 / 25,310 = 20.9%. Simponi and Opsumit 2025: 2,668 + 2,325 = 4,993. Abiomed: 3,700 / 1,751 = 2.1 times; 1,751 x 1.171^5 = 3,850 by 2030. Shockwave: 12,600 / 1,146 = 11.0 times. Caplyta: 361 x 4 = 1,444 a year; 14,500 / 1,444 = 10.0 times. Acquisitions: 15,146 + 17,541 = 32,687. Goodwill and intangibles: 48,772 + 50,403 = 99,175; 99,175 / 199,210 = 49.8%. Free cash flow 2025: 24,530 - 4,832 = 19,698. Cash uses 2025: 12,381 + 5,953 + 17,541 = 35,875. Capex 4,832 / 94,193 = 5.1%. Surgery: 10,137 / 10,037 - 1 = 1.0%. Electrophysiology: 5,634 / 33,792 = 16.7%. MedTech share of sales: 33,792 / 94,193 = 35.9%; Innovative Medicine 60,401 / 94,193 = 64.1%. Segment income 2025: 22,266 + 4,113 = 26,379; Innovative Medicine 22,266 / 26,379 = 84.4%; MedTech 4,113 / 26,379 = 15.6%. Gross margin 63,937 / 94,193 = 67.9%. MedTech rebates: 6,446 / 33,792 = 19.1%; 5,955 / 31,857 = 18.7%. Return on identifiable assets: Innovative Medicine 22,266 / 78,057 = 28.5%; MedTech 4,113 / 86,482 = 4.8%. Cost of products sold / segment sales 2025: Innovative Medicine 15,646 / 60,401 = 25.9%; MedTech 14,549 / 33,792 = 43.1%. Q2 2026 segment margins: Innovative Medicine 6,249 / 16,384 = 38.1%; MedTech 1,177 / 8,926 = 13.2%. Growth 2023-2025: sales 94,193 / 85,159 - 1 = 10.6%; operating cash flow 24,530 / 22,791 - 1 = 7.6%; dividends 12,381 / 11,770 - 1 = 5.2%. Dividends per share 5.14 / 2.95 - 1 = 74%. Payout 2025: 12,381 / 26,804 = 46%; 12,381 / 26,215 = 47%; 12,381 / 19,698 = 63%. Diluted shares 2,429.4 / 2,812.9 - 1 = -13.6%; Kenvue exchange 190.96 / 2,674.0 = 7.1%. Firefly and Sail initial payments: 1,000 + 785 = 1,785. Consumer sales 2015-2022: (14,953 / 13,507)^(1/7) - 1 = 1.5% a year. Wholesalers: 21.8 + 15.5 + 11.1 = 48.4 (2025); 20.5 + 15.6 + 12.3 = 48.4 (2024); 18.2 + 15.1 + 14.2 = 47.5 (2023); largest 21.8 - 18.2 = 3.6 points. Innovative Medicine rebates: 56,819 / 60,401 = 94.1% (2025); 47,523 / 54,759 = 86.8% (2023); 56,819 / 47,523 - 1 = 19.6%; net sales 60,401 / 54,759 - 1 = 10.3%. Top three products: 15.0 + 6.5 + 5.5 = 27.0% of revenue. United States share: 53,752 / 94,193 = 57.1% (2025); 14,533 / 25,310 = 57.4% (Q2 2026). MedTech excluding orthopaedics: (33,792 - 9,258) / (31,857 - 9,158) - 1 = 8.1%. Talc: 5,500 / 76,000 claims = about $72,000 per claim; 5.5 - 3.7 = 1.8 billion. Valuation: 348.19 / 24.242 = 14.4 times (end-2024 market value over 2024 adjusted net earnings); 652.05 / 348.19 - 1 = 87%; 270.57 / 11.04 = 24.5 times; 11.04 / 10.79 - 1 = 2.3%; 277.91 / 270.57 - 1 = 2.7%. Innovative Medicine history: (60,401 / 31,430)^(1/10) - 1 = 6.8% a year; Pharmaceutical pre-tax margins 11,734 / 31,430 = 37.3% (2015), 12,827 / 33,464 = 38.3% (2016), 8,816 / 42,198 = 20.9% (2019); restated growth 52,563 / 51,680 - 1 = 1.7% (2022), 54,759 / 52,563 - 1 = 4.2% (2023), 56,964 / 54,759 - 1 = 4.0% (2024). Additional: 2015 mix 31,430 / 70,074 = 45%; dividend 5.36 / 11.04 = 49%; buybacks 4,253 / 5,953 = 71%; vision 5,468 / 33,792 = 16%; Innovative Medicine international 60,401 - 36,344 = 24,057 against 54,759 - 31,169 = 23,590 (2.0%); United States 36,344 / 31,169 - 1 = 16.6%; myeloma four-product growth 2023-2025 4,607 + 1,387 + (670 - 395) + (463 - 63) = 6,669 of oncology growth 25,380 - 17,661 = 7,719, 86%; Darzalex international 1,772 / 4,207 = 42%; equity gap 99,175 - 81,544 = 17,631; Abiomed 440 x 4 = 1,760; amortisation MedTech 0.5 / 1.3 = 38%; MedTech H1 2026 segment income 2,416 / 2,625 - 1 = -8.0%, SM&A 5,975 / 5,518 - 1 = 8.3%, R&D 1,492 / 1,324 - 1 = 12.7%, cost of products sold 7,438 / 6,964 - 1 = 6.8%, margins 2,416 / 17,562 = 13.8% and 2,625 / 16,561 = 15.9%; Innovative Medicine H1 2026 11,566 / 10,762 - 1 = 7.5%, 11,566 / 31,810 = 36.4%; dividends / operating cash flow 12,381 / 24,530 = 50%; receivables 17,178 - 14,842 = 2,336, inventories 14,191 - 12,444 = 1,747; Q2 2026 dividend 3,227 x 4 = 12,908, one cent x 4 x 2,408M shares = $96M; diluted shares 2,663.9 / 2,812.9 - 1 = -5.3%; MedTech United States 17,408 / 33,792 = 52%; international sales 94,193 - 53,752 = 40,441; oncology share of Innovative Medicine 25,380 / 60,401 = 42.0%; Darzalex sales increase 14,351 - 11,670 = 2,681, royalty increase 2,400 - 2,000 = 400, 400 / 2,681 = 15%; newer myeloma medicines Q2 2026 657 + 260 + 174 = 1,091, 1,091 / 4,207 = 26%; Shockwave international 67 / 335 = 20%; amortisation 2,492 x 2 = 4,984 a year, 4,984 / 26,215 = 19%; US long-lived assets 89,392 - 70,670 = 18,722; surgery international Q2 2026 1,559 / 2,653 = 59%; net interest 1,056 - 971 = 85; dividends per share 5.14 / 4.70 - 1 = 9.4%; MedTech rebates 6,446 / 5,955 - 1 = 8.2%; trailing sales 94,193 - 45,636 + 49,372 = 97,929; net earnings 26,804 - 16,536 + 10,769 = 21,037. MedTech history: (33,792 / 25,137)^(1/10) - 1 = 3.0% a year; Medical Devices 6,826 / 25,137 = 27.2% (2015), 5,392 / 26,592 = 20.3% (2017); restated 4,208 / 27,060 = 15.6% (2021), 4,447 / 27,427 = 16.2% (2022); growth 27,427 / 27,060 - 1 = 1.4% (2022), 30,400 / 27,427 - 1 = 10.8% (2023), 31,857 / 30,400 - 1 = 4.8% (2024) - product and franchise growth. — 2015-2026 · publ. September 2026 · source ↗Method: Arithmetic on figures reported in J&J's Forms 10-K, 10-Q, results releases and market data; operands shown in the source line.
- ReportedJ&J's defence is volume and mix: oncology grew 22.1% in 2025, largely on medicines that are not yet exposed to price-setting.Johnson & Johnson Form 10-K for fiscal 2025 (year ended 28 December 2025) - Item 7 MD&A: Innovative Medicine segment, therapeutic-area and product sales analysis. — FY2025 · publ. 11 February 2026 · source ↗
- ReportedJ&J will participate in TrumpRx.gov, enable American patients to access medicines at comparable prices to other developed countries, and provide Medicaid access at comparable prices, while the specific terms, including revised prices and covered medicines, were not disclosed.Johnson & Johnson press release: agreement with the United States government on drug prices, Medicaid access, TrumpRx and a tariff exemption. — January 2026 · publ. 8 January 2026 · source ↗
- ReportedJ&J will participate in TrumpRx.gov, enable American patients to access medicines at comparable prices to other developed countries, and provide Medicaid access at comparable prices, while the specific terms, including revised prices and covered medicines, were not disclosed.CNBC, J&J strikes deal with U.S. government to cut drug prices, gain tariff exemptions. — January 2026 · publ. 9 January 2026 · source ↗