AbbVie’s Post-Humira Safety Net Has a Hole in It — and J&J Just Found It

Picture the scene inside AbbVie’s North Chicago commercial operation sometime in late 2025: the Skyrizi launch team is running its peak-sales models, and the numbers still look extraordinary. Risankizumab has already crossed $4 billion in annual revenue, its label now spanning plaque psoriasis, psoriatic arthritis, and Crohn’s disease, with ulcerative colitis approvals driving incremental volume. The team’s job — and it is a very good job right now — is to defend that castle. The Humira biosimilar erosion was brutal, faster than almost anyone modeled, but Skyrizi and Rinvoq together absorbed the shock better than the street expected. AbbVie CEO Rob Michael called the two drugs the “growth engine” for the next decade on the company’s Q4 2025 earnings call. The math, on paper, holds.

Then BNP Paribas publishes a research note flagging J&J’s oral tyrosine kinase 2 inhibitor — an investigational asset in Phase 3 development for moderate-to-severe plaque psoriasis — as a credible commercial threat to Skyrizi. The analyst community registers mild interest. The stock barely moves. And that muted reaction is precisely where the miscalculation lives.

Oral immunology is not a niche. It is the single most requested product attribute in patient and prescriber surveys across dermatology, and it has been for a decade. Every KOL conversation about psoriasis eventually circles back to the same friction point: the injection. Biologics deliver superior efficacy, but the needle is a compliance barrier, an access barrier for self-injection-averse patients, and a market segmentation problem for prescribers managing mild-to-moderate disease who hesitate to start a biologic conversation at all. An oral agent with competitive efficacy data does not need to beat Skyrizi in a head-to-head trial to take meaningful share. It just needs to be good enough to give payers a new negotiating chip and give physicians a pivot option for the patient who refused the pen.

The Oral Pivot Nobody Priced In

J&J’s TYK2 inhibitor program sits inside a competitive archetype that the market has seen before — but never quite respected in advance. Pfizer’s abrocitinib and Eli Lilly’s lebrikizumab both entered the atopic dermatitis market as alleged second-movers to Dupixent, and both carved out revenue that Sanofi and Regeneron’s consensus models underestimated at launch. The pattern is consistent: when a market is large enough — and the global psoriasis biologics market is tracking toward $30 billion annually by the late 2020s — there is almost always room for a well-differentiated entrant, particularly one that competes on delivery mechanism rather than mechanism of action alone.

TYK2 inhibition as a class already has a commercial proof of concept. Bristol Myers Squibb’s deucravacitinib, approved in 2022 under the brand name Sotyktu, became the first oral TYK2 inhibitor for plaque psoriasis and generated approximately $870 million in 2024 revenue — a number BMS described as exceeding internal forecasts in its Q3 2024 earnings call. That performance came despite Sotyktu’s PASI 75 response rates landing modestly below what IL-23 biologics like Skyrizi routinely demonstrate. The market absorbed that trade-off because the oral convenience story is real and the payer economics around small molecules are structurally different from biologics. J&J’s program, if it can demonstrate PASI 90 or PASI 100 data competitive with the IL-23 class, would enter the market with both the convenience narrative and the efficacy headline — a combination Sotyktu never had.

And here is the structural commercial reality that AbbVie’s model may be underweighting: Skyrizi’s psoriasis patent protection runs into the early 2030s, but peak-sales projections that assume only biologic-class competition are using the wrong denominator. The relevant competitive set by 2028 is not just IL-17s and IL-23s. It is every oral agent with a competitive label. AbbVie priced Skyrizi aggressively at launch, and its net price has moved with the market, but oral small molecules have historically forced biologic net price concessions at the formulary negotiation table — not because they are cheaper to manufacture, necessarily, but because payers use them as credible alternatives to extract rebates. The leverage is real even when the oral agent’s market share is modest.

What J&J’s BD Team Knows That the Headline Doesn’t Say

J&J is not stumbling into this category. The company’s immunology franchise generated approximately $14.8 billion in 2024 revenue, anchored by Stelara — which is now facing biosimilar entry — and the rapidly growing Tremfya, its own IL-23 inhibitor. Tremfya is the underappreciated asset in J&J’s derm portfolio: it posted 22% year-over-year growth in 2024 and has been expanding its label into inflammatory bowel disease, a strategic move that mirrors exactly what AbbVie did with Skyrizi to extend its commercial runway. J&J’s internal portfolio logic is coherent. Stelara revenues are eroding on biosimilar pressure from multiple entrants including Amgen’s Wezlana, and the company needs a next-generation oral asset to anchor its dermatology leadership into the 2030s. The TYK2 program is not a science project — it is a succession plan.

Which raises an uncomfortable question for AbbVie’s investor relations team: how much of Skyrizi’s $10-plus billion peak-sales consensus estimate was built assuming the oral competitive set remains as underpowered as it is today? Sotyktu at $870 million in 2024 is not a rounding error, but it has not fundamentally disrupted Skyrizi’s trajectory either. A J&J oral TYK2 candidate with J&J’s commercial infrastructure — global reach, formulary relationships, and a dermatology sales force that already calls on the same prescribers writing Tremfya — is a categorically different threat than a BMS asset with a narrower distribution footprint.

The BD angle compounds this. J&J has demonstrated through its $13.1 billion acquisition of Momenta Pharmaceuticals in 2020 and the $6.5 billion purchase of Proteologix in 2024 that it is willing to spend at scale to fortify its immunology position. An oral TYK2 asset that reaches strong Phase 3 PASI data would not stay in-house only — it would reset the licensing floor for every oral immunology asset currently in Phase 2 development across smaller biotechs. Arena Pharmaceuticals-era deals, Protagonist Therapeutics partnerships, the entire mid-cap oral immunology pipeline: all of it gets repriced the moment J&J publishes competitive efficacy data from a TYK2 program and backs it with a commercial launch.

AbbVie’s Real Exposure

The bearish case on AbbVie’s immunology business is well-rehearsed, and it is mostly about Humira’s legacy cliff and Rinvoq’s JAK inhibitor label restrictions from the FDA’s 2021 black box expansion — restrictions that constrained first-line use and handed Skyrizi a larger share of the biologic-naive market than originally projected. AbbVie navigated that transition with genuine skill. The bullish case, equally familiar, points to Skyrizi’s multi-indication runway and Rinvoq’s atopic dermatitis positioning, where label restrictions matter less because the patient population is often younger and lower cardiovascular risk. Both cases are largely correct.

What neither case adequately models is an oral competitive dynamic that compounds across three simultaneous vectors: payer leverage, prescriber behavior change, and patient-driven switching. Deucravacitinib demonstrated that the first vector is real — BMS has used Sotyktu’s existence to hold net price on its own biologic portfolio in certain formulary negotiations. A J&J oral TYK2 with superior efficacy data activates all three vectors simultaneously, and AbbVie’s commercial team would be managing that pressure while also defending Rinvoq’s JAK franchise in rheumatology against ongoing safety perception headwinds. Running two defensive plays at once, across the two biggest assets on the income statement, is not impossible — but it is exactly the kind of operational pressure that compresses margins and slows BD agility at precisely the moment when the pipeline needs fresh investment.

AbbVie has not been idle. Its acquisition of Cerevel Therapeutics for $8.7 billion in 2024 signals a portfolio pivot toward neuroscience, which is strategically coherent as a diversification move away from immunology concentration risk. But Cerevel’s lead asset emraclidine is in schizophrenia — a therapeutic area with brutal commercial history and payer resistance — and it does not offset immunology revenue exposure on any near-term timeline that matters to the 2027 or 2028 model.

Any BD team at a mid-cap biotech sitting on a Phase 2 oral immunology asset — TYK2, JAK, or otherwise — should be watching J&J’s Phase 3 readout timeline with the same attention they give their own data packages. If the efficacy signal lands above a PASI 90 threshold and J&J moves toward an NDA filing, the licensing conversation for every competing oral asset shifts from “interesting science” to “strategic necessity” overnight, and the companies paying for optionality will not be the ones who waited. The window between a competitor’s Phase 3 readout and the FDA review clock is shorter than most BD calendars allow for deliberation.

Back in that North Chicago conference room, the Skyrizi commercial model still pencils. The drug is genuinely excellent, its clinical profile is real, and AbbVie’s managed care relationships are among the strongest in the industry. But the model was built for a world where the main competitive threat arrives via syringe. J&J’s pill just changed the assumption set — and AbbVie’s next investor day will be the first real test of whether the company is ready to say so out loud.

References

1. Seeking Alpha Healthcare — “J&J’s new psoriasis pill to rival AbbVie’s Skyrizi: BNP Paribas” (March 2026)
2. AbbVie Q4 2025 Earnings Call Transcript — CEO Rob Michael commentary on Skyrizi and Rinvoq as growth drivers
3. Bristol Myers Squibb Q3 2024 Earnings Call Transcript — Sotyktu revenue commentary and deucravacitinib forecast update
4. FDA Drug Safety Communication — JAK inhibitor label updates and black box warning expansion (2021)
5. Johnson & Johnson press release — Acquisition of Momenta Pharmaceuticals for $6.5 billion (2020)
6. Bristol Myers Squibb — Sotyktu (deucravacitinib) Phase 3 POETYK PSO trial results, PASI 75 and PASI 90 data
7. Johnson & Johnson press release — Proteologix acquisition for $850 million (2024)