Operator
Operator
Good morning. Welcome to Johnson & Johnson’s First Quarter 2020 Earnings Conference Call. [Operator Instructions] I would now like to turn the conference call over to Johnson & Johnson. You may begin.
Johnson & Johnson (JNJ)
Q1 2020 Earnings Call· Tue, Apr 14, 2020
$227.41
+0.92%
Same-Day
+1.12%
1 Week
+2.50%
1 Month
+1.10%
vs S&P
+0.69%
Operator
Operator
Good morning. Welcome to Johnson & Johnson’s First Quarter 2020 Earnings Conference Call. [Operator Instructions] I would now like to turn the conference call over to Johnson & Johnson. You may begin.
Chris DelOrefice
Analyst
Good morning. This is Chris DelOrefice, Vice President of Investor Relations for Johnson & Johnson. Welcome to our company’s review of business results for the first quarter of 2020. I hope everyone is healthy and remaining safe during these times. With safety in mind, we are utilizing a more virtual approach in exercising social distancing while conducting this call. Joining me on call today to address Johnson & Johnson’s response to the coronavirus global pandemic along with our first quarter results are Alex Gorsky, Chairman of the Board of Directors and Chief Executive Officer; Dr. Paul Stoffels, Vice Chairman of the Executive Committee and Chief Scientific Officer; and Joe Wolk, Executive Vice President, Chief Financial Officer. During the Q&A portion of the call, Joaquin Duato, Vice Chairman of the Executive Committee, will also join Alex, Paul, Joe and myself. A few logistics before we get into the details. This review is being made available via webcast accessible through the Investor Relations section of the Johnson & Johnson website at investor.jnj.com where you can also find additional materials, including today’s presentation and associated schedules. We would like to draw your attention to the fact that there are slight changes to the sales reporting of the medical devices and pharmaceutical businesses which I will comment to as I review the segment commentary. Additionally, those changes are noted and reconciliations are available on the website. We appreciate you joining us on the call today. In order for us to provide insights related to the COVID-19 pandemic and to allow for ample time for Q&A, the call will last around 90 minutes. Please note that today’s presentation includes forward-looking statements. We encourage you to review the cautionary statement included in today’s presentation, which identifies certain factors that may cause the company’s actual results to…
Alex Gorsky
Analyst
Thank you, Chris and thanks to all of you for joining us today. I also want to thank Joaquin Duato and Dr. Paul Stoffels for joining our first quarter webcast. As the Vice Chairs of Johnson & Johnson and given the leadership role they are playing as we mobilize our efforts and resources across the company to address COVID-19, I thought it would be helpful to have both of them available to answer potential questions and convey key information. Paul will also share more detailed perspective in his prepared commentary which will follow my remarks. Clearly, COVID-19 is at the forefront of everyone’s mind, which is why we plan to spend a fair amount of time during the earnings webcast discussing this unprecedented global pandemic, the profound impact it is having on global public health, and our unwavering commitment to create and deliver value to all of our stakeholders. Johnson & Johnson was built for times like this and our strong first quarter results are just one reflection of our sustainable business model. Our Johnson & Johnson colleagues remain focused on delivering on the commitments and responsibilities to our patients, doctors, nurses, employees, parents, children, communities and shareholders as defined in our Credo. As we announced this morning, we increased our quarterly dividend by 6.3% to $1.01 which is another reflection of our stability and further underscores our commitment to delivering value to our shareholders. This marks the 58th consecutive year of dividend increases for Johnson & Johnson and we believe that taking this action is the right thing to do for our shareholders at this time and importantly a strong example of the confidence we have in our business now and in the future. Given Chris and Joe will discuss our first quarter performance and outlook in greater detail,…
Paul Stoffels
Analyst
Thank you, Alex. I’m pleased to provide an update on a multi-pronged approach to addressing COVID-19 including developing a vaccine and screening of compound libraries to identify potential new treatments to address this pandemic. In addition, we are exploring immunomodulators to protect against Acute Respiratory Distress Syndrome or ARDS in COVID-19. While we focus today on finding potential new treatments, ultimately a vaccine is key to eradicating the ongoing threat of the pandemic. Since 2011, Johnson & Johnson has invested heavily to build state-of-the-art vaccine capabilities which we used to develop and manufacture our Ebola, Zika, RSV and HIV vaccine candidates. We are bringing to bear those same capabilities to rapidly accelerate our efforts towards the potential COVID-19 vaccine. We are pleased to see that there are many approaches to vaccines for COVID-19 which show the importance of ongoing research in industry over the past several decades. Our COVID-19 vaccine program leverages Janssen Adeno vector and PER. C6 technologies that provide the ability to rapidly develop new vaccine candidates and upscale production of the optimal vaccine candidate. Based on the WHO criteria for key attributes for prioritizing vaccine platforms, here on the right, the attributes of our platform put us in a leadership position. First, our Adeno26 viral vector platform induces potent and long lasting humoral and cellular immune responses in humans. Further this approach has very low to no risk on the respiratory disease enhancement based on the immune responses observed across our programs. This is in line with the observation that targeted preclinical models used in context of the RSV vaccine development have shown that this platform is not associated with enhanced respiratory disease. Our platform has a proven safety profile. More than 50,000 people have been vaccinated and we have demonstrated that it’s well tolerated. Our PER.C6…
Chris DelOrefice
Analyst
Thank you, Paul. Now, I will provide our Q1 results. Worldwide sales were $20.7 billion for the first quarter of 2020, an increase of 3.3% versus the first quarter of 2019. Operational sales growth, which excludes the effect of translational currency, increased 4.8% as currency had a negative impact of 1.5 points. In the U.S., sales increased 5.6%. In regions outside the U.S., our reported growth was 1%. However, operational sales growth outside the U.S. was 4%, with currency negatively impacting our reported o-U.S. results by 3 points. Excluding the net impact of acquisitions and divestitures, adjusted operational sales growth was 5.6% worldwide, 6.7% in the U.S., and 4.5% outside the U.S. These global sales results include an estimated net impact of COVID-19 which negatively impacted worldwide sales by about 80 basis points. This includes a negative impact to our medical device business segment across all regions with Asia-Pacific and the U.S. regions seeing the most prominent impact. Partially offsetting this was a net positive sales lift in our consumer health and pharmaceutical business segments as communities prepare to ensure they have the necessary access to healthcare products and medicines. Turning now to earnings, for the quarter net earnings were $5.8 billion and diluted earnings per share, was $2.17 versus diluted earnings per share of $1.39 a year ago. Excluding after-tax intangible asset amortization expense and special items for both periods, adjusted net earnings for the quarter were $6.2 billion and adjusted diluted earnings per share was $2.30, representing increases of 8.7% and 9.5% respectively compared to the first quarter of 2019. On an operational basis, adjusted diluted earnings per share grew 10.5%. Beginning with consumer health, I will now comment on business segment sales performance for the first quarter, highlighting items that build upon the slides you have in…
Joe Wolk
Analyst
Thank you, Chris and good morning everyone. We appreciate that you decided to join the call today unlike others on this call who spoke before me, I hope you and those close to you are safe and healthy. Let me state right upfront, the fundamentals of Johnson & Johnson’s business are strong and our expectations of where the business is heading have not changed combating the current crisis is anything but usual. However, many aspects of Johnson & Johnson continued to operate with a business as usual focus such as advancing breakthrough innovation, fostering consumer and patient access and being financially disciplined. We are motivated by never stopping when it comes to taking care of you, our stakeholders and we can have a profound positive impact, because we are built to lead, built to last and quite frankly, built for times like this. My central focus in today’s prepared remarks is twofold. First, I will share with you our ongoing business continuity plans. It is important particularly in times of challenge that you understand the steps we have put in place recently and over a number of years to ensure reliable supply of the important products we provide. Second, I will outline how we are thinking about the impact of the COVID-19 crisis and what that will have on our near-term financial performance in the context of changes from the guidance we issued in January. I trust at the end of the my remarks and at the end of this call, the obvious conclusion is that Johnson & Johnson is strong in a financial position to meet its obligation to all stakeholders and poised for many years of success. The fundamentals of our business are intact. As Alex mentioned earlier, as the most broadly based global company in the healthcare…
Chris DelOrefice
Analyst
Thank you, Joe. We will now move to the Q&A portion of the webcast. Operator, can you please provide instructions for those on the line wishing to ask a question?
Operator
Operator
Yes, thank you. [Operator Instructions] Your first question comes from David Lewis, Morgan Stanley.
David Lewis
Analyst
Good morning and thanks for all the significant work you are doing on behalf of patients in the system as well as the very significant guidance that Joe just provided. Just a couple of quick questions for me. The first for Paul just you talked extensively about the vaccine program and I know your goal is to produce 1 billion doses and you are ramping [production] [ph] throughout the year. So just first question is by the first quarter of ‘21, where do you think production capacity will be and how could that scale through 2021 relative to that 1 billion doses? And I had a quick follow-up for Joe.
Paul Stoffels
Analyst
Yes, production capacity would be ready to go at 600 million to 900 million in the first quarter going up to 1 billion in the course of the year, north of 1 billion by the end of the year. So – and that’s on an annual basis. So we will have 4 manufacturing sites going on one by one bringing the whole capacity up to 1 billion in the course of the year.
David Lewis
Analyst
Okay. Very helpful, Paul. And then Joe just your detailed guidance on medical devices is very much appreciated. On consumer and pharma, obviously we saw in the first quarter some hoarding benefit in consumer and the OTC franchises and probably some stocking benefit in pharma. So those businesses for the year I appreciate are stable. Can you give us any help first to second quarter how we should be thinking about the relative trends of those businesses? Should we expect them to be below trend in second quarter versus first and then pop back up in the third quarter just based on the stocking and hoarding benefits? Thanks so much.
Joe Wolk
Analyst
Great. Sure, David. Thanks for the questions. I would say you could probably expect that in our consumer unit, you saw significant stocking across the globe probably as Chris referenced was about 7 points of additional growth for the consumer franchise. We were off to a good start, but then you saw the benefit of pantry loading. I would say in pharm remains to be seen. As you know, we don’t give quarterly guidance. It was only worth about 1 point of growth in the quarter as some PBMs moved from 30-day refill cycles to 90 days. I would imagine that activity will still continue, but we have to see how that plays out a little bit further into the second quarter here when you have stay-at-home protocols.
David Lewis
Analyst
Thanks so much.
Chris DelOrefice
Analyst
Thanks, David. Appreciate the questions. Rob, next question please.
Operator
Operator
Our next question is from Chris Schott with JPMorgan.
Chris Schott
Analyst
Great. Thanks very much and again appreciate all the color on the COVID dynamics, very helpful given all the uncertainty out there. So just my two questions here was one, can you just elaborate on the sensitivity of your business to elevated unemployment levels as we look past some of the near-term shutdowns. I guess we are in an environment where we have double-digit unemployment in the near-term and maybe still rates are elevated as we look out into 2021, what does that do to the business as we think about things starting to normalize? My second question was a question about China and just share a little bit about what you are seeing with the business as the economy begins to reopen there and are there any learnings we have found from China that could be helpful as we think about recoveries elsewhere in the world from what you have seen today? Thanks so much.
Chris DelOrefice
Analyst
So, Chris let me take the first question with respect to how we factored unemployment into our modeling specifically around the Medical Device business and maybe I will turn it over to Alex to provide some commentary around what our team is telling us with respect to getting back to things in China. With respect to unemployment, we look back at the financial crisis of 2008 and 2009 tried to draw inferences from GDP growth and what that meant relative to elective procedures and procedures in general. So we will have to see how that kind of plays out relative to the 2008, 2009 financial crisis. The team has done a nice job relying on many of the reports and surveys that you in the sell side have conducted to make some assessments, but we will really have to see how it plays out. And that’s why we have widened our range much more than we have traditionally. I think at the outset of the year we had about an $800 million range on our overall enterprise sales guidance. Here you can see it’s about $3 billion of a range and it’s exclusively tied to medical devices. So more to come on that front, but we believe we have got at least a fairly sizable element of that already baked in. Alex, can I turn it over to you for some thoughts on China?
Alex Gorsky
Analyst
Sure, Chris. Thank you very much for the message. And look maybe before I answer that, I just want to make a couple of comments. First of all, once again acknowledging the tremendous impact that this is having on citizens around the world let alone patients and consumers, this is likely one of the most significant events that any of us have ever experienced in a very personal way. And I think making sure that throughout this particularly as the world’s largest healthcare products company that we remain just incredibly focused on serving them is our number one priority. I think secondly, it’s really acknowledging healthcare workers. I am privileged to have a number of family members frankly who are out there on the frontline making a difference everyday. And when you see what they are doing and literally going into battle and preparing for the worst hoping for the best, working 24/7, without them, I couldn’t imagine the situation we would be in. And then last but not least is the work of our employees. I am incredibly inspired you’ve heard earlier the great progress, the strong progress that we have made on our vaccine program. And while Paul reviewed that perhaps in 10 minutes which is I think really important to keep into perspective is that the work that he is talking about accomplishing literally in 6 to 12 months would usually take between 5 and 7 years. And to do that in a way where there is a relentless focus on safety, on efficacy, on affordability, but also while accelerating those timelines to do everything we can to be touching as you heard in those numbers up to 1 billion people with vaccines in the course of 2021 is it’s a huge undertaking and we have got…
Chris DelOrefice
Analyst
Thanks, Chris. Appreciate the question. Rob, next question please.
Operator
Operator
Your next question is from Larry Biegelsen with Wells Fargo.
Larry Biegelsen
Analyst
Good morning. Thanks for taking the question. Thanks for all the very helpful color. One question on Medical Devices and the recovery there and one on the vaccine, first on devices, Joe, could you share with us your preliminary thoughts on believe it or not 2021 just the postponed procedures, I heard your comments about the capacity and little catch up assumed for Q4. Just qualitatively, should we think about a lower base in 2020 and normalized growth in 2021 or how should we think about those postponed procedures potentially coming back next year? I had one follow-up.
Joe Wolk
Analyst
Sure, Larry. Thanks for the question. As you might imagine, while we hope 2021 looks a lot like we thought it was going to look like maybe 3 months ago. We really have to let that play out. We did see and put into our modeling anywhere from normal level of procedures in the fourth quarter to a recoupment if you will of plus 15%. But it’s really going to depend on the pandemic itself what’s the health priorities, how are patients and consumers feeling about going to the hospital for these procedures. So I believe from what we have heard from hospital CEOs that they would like to get back into business of elective surgeries. Many of you saw recent announcements, Mayo Clinic most recently with respect to just only 25% utilization in their elective suites. That is putting financial strain on major hospital systems and we want to make sure that when we return to normal that there is good quality healthcare still in place. So I will defer I think it would be a little bit irresponsible for me at this point in time to comment on 2021. The hope and the optimism is for whenever the pandemic abates, we will be at or above expectations that we have all once had.
Larry Biegelsen
Analyst
Great.
Alex Gorsky
Analyst
Larry, Larry?
Larry Biegelsen
Analyst
Yes, Alex.
Alex Gorsky
Analyst
Larry, just one other comment on that that I think might be some important perspective is you know as Joe said and as I am sure you can appreciate over the past several weeks we have done our best to be in very close touch with hospital CEOs, with physicians who are working in systems around the country. And what we are currently saying I think is a – this was consistent with what you have seen in some recent press articles where look there are clearly areas where it has been just a relentless pace of patient care in areas like New York, areas like Northern New Jersey, other hotspots such as New Orleans, Detroit, and there are also other areas in the Midwest where you might say there are hot zones. Outside of that, however and very consistent with Joe’s comments what you see in many cases are hospitals that are well under 50% of their capacity that have also increased some of their investments to the threefold sometimes more and appropriately so preparing for the absolute worst case in a pandemic. But at the same time, they have lost a very significant portion of their income, seeing a cost increase putting potential financial stress on them. And so – and we are also hearing a consistent theme of making sure that as they think about returning ensuring that we can get consumer and patient confidence back up to the right kind of testing programs, the right kind of protocols in the hospital in place to make sure that we can get healthcare professionals that is physicians, nurses, the kind of assurance that they are going to need to get back to a more normal state of working as well as in some cases given the amount of work they have been doing make sure that they have got the kind of backup resources in place to be able to do that is going to be very, very important as the healthcare systems work with governors and frankly even with Congress making sure the Cares 3 and Cares 4 are accounting for this significant strain on hospitals around the country. So I hope that’s helpful.
Larry Biegelsen
Analyst
That’s super helpful. Chris, if I can just get one in on the vaccine for Paul, my understanding is Moderna is targeting 4x of base immunity. Paul, what’s your understanding of the base immunity in effective COVID-19 patients? What level do you think you need for an effective vaccine, what are you targeting? Thank you for taking the questions.
Paul Stoffels
Analyst
Well, I can’t definitely give a scientific answer of that, because I don’t think that’s tested yet, but what we learned in from Zika, from Ebola and from other vaccines is that we get a strong humeral, but also a cellular immunity with one injection, especially in Zika we saw that. So we think that we can get to very high level of protection with one single vaccine and that it will give us an ability to then protect for longer term, so eventually boosting 1 year later and we think would be sufficient, but we are going to study that in large scale studies in Phase 1 and that will start early September.
Chris DelOrefice
Analyst
Thanks, Larry. Appreciate the questions. Rob, next question please.
Operator
Operator
Your next question is from Joanne Wuensch with Citi.
Joanne Wuensch
Analyst
Good morning and thank you for all the work that you are doing during this time and for all the information for modeling. It’s really appreciated. I have two questions. The first one has to do with as we think about procedures coming back in Medical Devices in your conversation with hospitals and physicians and also experienced during other economic downturns, which types of procedures generally come back first and recognizing this is a different lay of the land, but also I just want to think about ortho versus vision care versus surgical or anything that you can add there? And I will say my second question now which is in your conversation with the FDA, what are you seeing or expecting to see in terms of clinical trial enrollment and FDA product approvals? Thank you.
Alex Gorsky
Analyst
Okay. Hey, Joanne, this is Alex. Thank you for the first one. Look, what we are seeing in the first case and again referring to my earlier comments is I think that there is a keen sense among hospital executives and physicians of the need to try to return to a more normal state of surgery as we see our system be able to work their way through this curve and the virus. And that’s being driven by the way for also a broad recognition that many of the procedures that are currently being delayed will have a healthcare impact on these patients. And we also know for example that the more of a significant hit the economy takes will likely lead to greater rates under insurance and those studies would demonstrate that in a poor economy, healthcare outcomes are poor. So these are not only economic issues, but these are actually healthcare issues driving their desire to get back to work. Also similar to Joe’s point I think every system is trying to decide what does that pace look like as they have to return their operating suites, even some of their ambulatory surgery centers back to more elective procedures. That’s not going to happen overnight. That’s going to take some time for them to reestablish the system. I think there is clear recognition of that. And then regarding the specific procedures, look, we would expect obvious areas such as oncology in general surgery to come back sooner. We would expect there to be also certain areas in orthopedics, while elective, that can have a significant impact on mobility and overall standard of living to come back in next. And then look we think the longer term procedures perhaps cataract surgery in areas of like that, could be what I’d call a third tier. We also believe that the EP, the electrophysiology business would be one that we would also see at faster return too. I mean, there is some concerning data actually regarding the cardiovascular effects of COVID-19 and how that could manifest itself in some of these conditions, but at a high level, I think that’s the way we are thinking about it today. Paul or Joaquin, did you want to discuss the impact on clinical timelines?
Joaquin Duato
Analyst
Yes. Thank you, Alex.
Joe Wolk
Analyst
Go ahead, Paul. Why don’t you go?
Paul Stoffels
Analyst
Yes. On – first on the regulatory, there are not, at the moment, – we have not got any information from regulatory authorities that the current reviews on review timelines on our current submissions have changed. So that’s going like planned. For our anticipated filings in 2020, we progress as planned and at the moment, for the submissions that are fully recruited, our deal stay unchanged. And then maybe for the submissions that are continuing to recruit patients, we will evaluate in the next few weeks. Clinical trials, we do our best – utmost best to keep going with minimal delays as we are changing sides and to less impacted areas as well as have different ways of reaching patients and working with the investigators. Alex?
Alex Gorsky
Analyst
And, Joanne, another - just one comment that I would like to make more at a global level here too is to acknowledge the great work that the FDA, and frankly, European authorities and others are making in partnering in an appropriate way to this pandemic our sense is that they have been extremely collaborative in helping to ensure that our ongoing clinical trials that patient care is not interrupted, they’re working with us on how can we make, again, appropriate adjustments along the way. So we’ve been really pleased by the partnering that we’ve been able to have with them, and I just think it’s really important to acknowledge, given all the other dynamics that are taking place right now that they’re making that a priority. Joaquin?
Joaquin Duato
Analyst
Yes. I would also add that this is going to be a particularly strong year for the Pharmaceutical Group in terms of approvals and submissions. In terms of approvals, in the second half of the year, we are expecting four key line extension approvals, one being DARZALEX subcu that we expect in the second quarter, very important for us and very important driver for DARZALEX. We also are expecting TREMFYA in psoriatic arthritis. it’s going to give us the opportunity to be the only IL-23 with both psoriasis and psoriatic arthritis. We are expecting SPRAVATO in major depressive disorder with suicidal intent and finally we are also expecting IMBRUVICA in frontline CLL in combo with Rituximab, so four major line extension approvals in the second half of the year. Additionally, this is going to be a very strong year for Johnson & Johnson in submissions. We submitted in the first quarter, Ponesimod, a new NME for multiple sclerosis. And we plan to have three additional submissions also during the second half of the year. One is our BCMA CAR-T in relapsed or refractory multiple myeloma that has breakthrough designation. The other one, niraparib in metastatic castration-resistant prostate cancer, that also has breakthrough designation. And finally, our latest one is our bispecific EGFR-cMET in non-small cell lung cancer that will be also submitted at the end of this year. That also has breakthrough designation. So, very strong year from a filing and approvals perspective for the pharmaceutical group.
Chris DelOrefice
Analyst
Great. Thanks, Joanne. Appreciate the question. Operator, we have time for two more questions. I would ask folks to keep their questions to just one.
Operator
Operator
Thank you. Our next question is from Terence Flynn with Goldman Sachs.
Terence Flynn
Analyst
Hi, good morning. Thanks for taking the question and thanks for all the work the company is doing on the COVID front. Would you be able to share any high-level perspective on what a framework for reopening the country looks like and maybe what are the leading indicators that you’re watching here to understand if you will need to potentially adjust your guidance again? Thank you.
Alex Gorsky
Analyst
Yes, Terence, thank you very much and, look, I would also like to acknowledge the great work that I think our teams have done in trying to provide you with a very thoughtful balance and fact-based projection on what we’re seeing in each of our markets. And again it’s been extremely rigorous using a number of quantitative as well as qualitative sources to – and hopefully the kind of transparency that you are hearing and you’re seeing on this call is indicative of the way we are trying to proceed to ensure that you have got as much information as possible to help understand what we are dealing with. It’s difficult to predict, overall, but I would tell you that there are many efforts here in the United States, certainly, with organizations like the business roundtable there others taking place on a global basis and obviously I think everyone believes that they should start with the science and the data on what we’re seeing in terms of disease progression, particularly in some of the hot spots and what you’re seeing in Italy and Spain, let alone watching the ongoing issue in China with an emphasis on what could happen in a round two or round three, as well as what we’re seeing here in the United States, be it in New York City, Northern New Jersey, but also relative to other places. Frankly, we’re seeing some quite encouraging signs such as California and other areas. So understanding the data in terms of what is the rate of new patient infections versus the rate, for example, of discharges or deaths that are taking place, we think is an important factor. Next, it’s also the availability of some of the testing kits that are available, both at the front end with antigen…
Chris DelOrefice
Analyst
Joe, did you want to comment on leading indicators related to guidance?
Joe Wolk
Analyst
Yes, I would think it really dovetails to what Alex outlined there in terms of returning to work, opening up the economy. We’re going to look for those same telltale signs, how safe is the environment at large with respect to people’s comfort level to going back, being in social settings, going to hospitals to get procedures that they would – might otherwise defer during a time like this. So we’ll continue to watch those on each weekly basis and the volume that comes through our major markets.
Chris DelOrefice
Analyst
Great. Thanks, Terence. Appreciate the question. Rob, last question please.
Operator
Operator
The last question is from Louise Chen with Cantor.
Louise Chen
Analyst
Hi, thanks for taking my questions here. So first question I have for you is could you provide more color on your variable cost structure and what’s in that $2.3 billion decline in spend for this year? And then secondly, how should we think about cash flow for 2020 and 2021 in light of your new guidance? Thank you.
Joe Wolk
Analyst
Thanks for the questions, Louise. So with respect to what’s in the $2.3 billion that I referenced in my prepared remarks. Those are expenses that we expect to naturally fall out as a result of the social distancing or stay-at-home measures, the work-from-home measures that have been instituted across the globe. So think of those in categories such as travel, company meetings. There will be some project delays naturally when people aren’t on site to execute them. I want to be very clear though, we are not rushing to judgment and cutting valuable scientific programs, valuable initiatives within our commercial capabilities or programs that benefit our employees to manage our P&L in the short term. As you heard me say, we think we are very well-positioned for the long term. You heard from Paul, Alex and Joaquin that our clinical trials for our major submissions this year continue to be on track. We are not looking to disrupt this. So we talk to investors regularly. They want us managing for two, five, 10 years out with a long term perspective. And so that’s what we’re living into. We think that’s appropriate given with the guidance we provided today and should the need arise, we will look to of course correct as appropriate. With respect to our cash flow, clearly, we will have a little bit of a hit to our original projections. But as a reminder, we are a strong generator of cash flow. Last year, we had an all-time high of about $20 billion in cash flow. We were still up very well into the teens this year in all of our projections. We will see how it plays out relative to this guidance. But we are very well-positioned with $18 billion of cash and access to credit markets, should we need them on a short term basis. But we feel very comfortable with the position, not just for getting through 2020, but then being very strong into 2021.
Chris DelOrefice
Analyst
Great. Thanks, Louise. Appreciate the question. Thanks to everyone for your questions and your continued interest in our company. Apologies, I know we weren’t able to get to a lot of you, but certainly the Investor Relations team is happy to engage with you in more detailed discussions and we appreciate your time on the call today. We hope you find this information valuable and I will now turn the call over to Alex just for some final comments.
Alex Gorsky
Analyst
Hey, thank you, once again, everybody, for your time and the work that you’re doing and I want to end where we started by once again acknowledging the significant impact this is having on citizens, on patients, on consumers around the world. We also believe that this demonstrates the importance of healthcare in everyone’s lives, the impact that it has in a very personal way on people, on families, but also the impact that it has on countries, on economies, on almost every aspect of our lives. And what I can absolutely commit to you is that when we say that at Johnson & Johnson, we are built for time like this, it’s out of humility, knowing the important role that we play and ensuring healthcare is available and accessible in a way where we can truly make a difference for billions of people around the world. So thank you very much. And we will look forward to our upcoming discussions and updates in the coming weeks and months. Bye everybody stay safe and stay healthy.
Operator
Operator
Thank you. This concludes today’s Johnson & Johnson’s first quarter 2020 earnings conference call. You may now disconnect.