Johnson and Johnson said pricing pressure from payers was the reason sales for its blood thinner Xarelto and diabetes treatment Invokana were lower in the first three months of the year compared to the same quarter a year ago.

J&J CFO Dominic Caruso told investors that heavy competition in cardiovascular and metabolic categories has given payers more leverage and, as a result, forced the drugmaker to offer higher rebates to maintain competitive positioning on formularies.

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“In certain parts of the portfolio, cardiovascular and metabolic in particular, that’s a little more crowded. And that’s where the payer community has more influence over rebates and the like,” he said.

J&J’s SGLT2 inhibitor, Invokana, saw U.S. sales slip for the third-straight quarter and was down 17%, to $247 million, in the first quarter of 2017, compared to the same three-month period last year. Sales in the U.S. for Xarelto dropped 10%, compared to the first quarter of 2016, to $513 million.

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Separately, Caruso noted that the drugmaker’s rheumatoid-arthritis drug Remicade has not felt “much of an impact” from Inflectra, Pfizer’s new biosimilar version of the drug, which went on sale in November.

J&J’s pharma business saw sales grow by 1.4% to $8.2 billion in the first quarter of 2017. That increase was driven by higher revenue from four drugs: Darzalex, Imbruvica, Stelara, and Invega Sustenna.