You mentioned this asset a couple of times in your remarks. pharmaceutical margins improved by 340 basis points to 46.4% primarily driven by favorable product mix, and selling and marketing expense leveraging. So we're looking at MRIs for joint and spine surgeries. Can you offer any thoughts on that? This slide acknowledges those relationships. In Q3, we continued the very successful launch of Darzalex FASPRO which is our subcutaneous formulation of Darzalex to treat multiple myeloma. Moving now to immunology. Let me now give you a brief update on our COVID-19 vaccine. Our OTC business is growing above the market, gaining 0.7 points of share on a year-to-date basis. So it wouldn't be beyond our expectation to think that Jennifer and her team could do even better in 2021. Erleada continued its strong growth momentum, contributing just over $200 million in the quarter, with sales more than doubling versus prior year, with strong share growth especially in the metastatic indication. Clearly, a big chunk of that is Medicare, and then the smaller amount is Medicaid and about 40% private. Rob, next question please. Seven of our key brands grew at double-digit rates including our oncology brands, Erleada, Darzalex and Imbruvica; our immunology brands, Stelara and Tremfya; and our pulmonary hypertension brands Opsumit and Uptravi. What we're paying attention to is really the diagnosis, Danielle, to say -- let me give you an example, colorectal surgery. And I think you can look forward to many types of different campaigns to enroll, all of the appropriate folks at the appropriate time once we have greater line of sight into when these products will actually be able to reach the market. Pharma has accelerated the entire year on both a reported underlying basis. Is there a realistic time frame for us to learn if the adverse event was in the treatment or placebo arm? U.S. growth of 4.2% for the quarter reflects COVID-19-related procedural recovery as well as continued strength of our newer products, such as the Femoral Neck Systems and cannulated compression screws. Cumulative Growth of a $10,000 Investment in Stock Advisor, Johnson & Johnson (JNJ) Q3 2020 Earnings Call Transcript @themotleyfool #stocks $JNJ, Got $500? So we don't know treatment arm, vaccine arm. Moving on to operational sales, our guidance is $82 billion to $82.8 billion or flat to growth of 1% versus 2019. I encourage you to review our 10-Q for further details on specific tax matters. However, the state of procedure recovery has varied by market due to factors such as the structure of different healthcare systems and localized decisions regarding COVID-19 restrictions. We continue to advance our contact lens pipeline with the world's first and only drug-releasing contact lens for patients with allergic eye itch having received approval from Health Canada for ACUVUE Theravision. Thank you, Chris. We've seen a recent speed of complete response letters, not sure if that's just a timing issue or if they've truly changed your thinking there. Great. We are particularly excited by the lead asset, nipocalimab, a potentially best-in-class anti-FcRn antibody. Advanced Surgery showed significant improvement versus Q2, but still declined by 1.2% due to the impact of COVID-19.
Mathai Mammen will provide a few words on the COVID-19 vaccine candidate at the conclusion of my remarks. And then it's Jennifer. Our operating margin for 2019 was 31.3%. Additionally, we received approval from the U.S. FDA for a THERMOCOOL SMARTTOUCH SF ablation catheter for the treatment of persistent atrial fibrillation, making it the only radio frequency catheter on the U.S. market with this indication. Cost of products sold remained flat versus 2019 as a percent of sales as COVID-19-related fixed cost deleveraging in the medical devices business was offset by favorable mix in the pharmaceutical and consumer businesses. It's unique to us. Good morning, and welcome to Johnson & Johnson's third-quarter 2020 earnings conference call. Worldwide pharmaceutical sales of $11.4 billion grew 4.6%, enabled by growth across all regions. Last year's supply disruption impacted biosurgery growth by about 400 basis points in the quarter. Our vaccine was shown to elicit a robust immune response in humans as demonstrated by the presence of neutralizing antibodies in T cells. Year-to-date, immunology growth is 5.7%. Thank you, Jennifer. Thank you so much. So listen, for 2021, we do anticipate, as I mentioned, double-digit growth versus 2020.
Those colorectal surgeries in the United States are down about 10% to 12% from a procedure point of view versus pre-COVID baseline. However, as a company that always puts safety first, we take each and every case seriously. As such, we expect to continue delivering solid volume-driven above-market growth in 2021. But that's how we will begin, but our eyes are on the larger EGFR mutation market and patients in non-small cell lung cancer. Also, we continue to advance the Darzalex innovation pipeline with the U.S. filing for amyloidosis. And between everything that the R&D teams and manufacturing teams are doing around the clock to help bring forward new vaccines and new treatments, as well as what the commercial teams are doing to be prepared to both be able to supply these products in the marketplace, but also make sure that there's going to be a receptive audience and demand, people actually wanting to get these vaccines once they get to market. Taking the qualitative factors related to each of our segments into account, and based on recent developments, we are making the following adjustments to our 2020 guidance. We are tightening the range of net interest expense, now expected to be net interest expense of $100 million to $150 million. So in terms of the vaccine overall, like as soon as we overcome this temporary pause, our plan is to continue the 50,000-person study that we're on route to.
We've risen to this challenge in rethinking how we engage with our customers. Thank you, Terence. But of course, based on the Phase 1/2a data, we're very bullish on that or better efficacy. So knowing what we know today with the impact of COVID and what it's had on 2020, I expect that we're going to deliver robust double-digit operational growth in 2021. Surgical vision declined 16.4% globally due to the continued impact of COVID-19 on procedures and competitive pressures in the U.S. We have not encountered any undue pressure, and we will maintain the rigorous requirements of research, development and manufacturing to bring a safe and effective COVID-19 vaccine to the public as we do for all our products. To name a couple of examples, we partnered with an education partner, Advances in Surgery, where we virtually trained over 1 million surgeons in 150 different countries on COVID-19 protocols as well as ways to safely stand back up medical procedures. Have you any change in their appetite for risk? As you know, we've got 11 indications now for Imbruvica. And so I think it really demonstrates to us that they have really learned how to manage both patient populations quite well. And we do anticipate growth in 2021 relative to where we exited 2019. And it will be a few days at minimum for the right set of information to be gathered and evaluated. The upcoming earnings date is derived from an algorithm based on a company's historical reporting dates.
While improving from a Q2 decline of 55.3%, Q3 OUS sales decline of 26.4% reflects slower market recovery, especially in revision procedures where we have higher penetration than primary. We don't know whether -- they haven't informed us their -- they have the right to unblind. The vision business declined 9.5% globally. Next question is from Terence Flynn with Goldman Sachs.
Our overall plans are to complete recruitment of the 50,000 subjects in two or three months, and that's -- that remains on track. I'd like to start by acknowledging all those who have been and continue to be impacted by COVID-19. And I guess I'm curious, you gave a lot of color, I appreciate that. Well, thank you Joe, and good morning everyone. Is the Coronavirus Vaccine Market Oversaturated? Mathai, maybe I'll start with you just as we finished with you. There was some variability by platform and across markets, but overall, we saw more stable results in total across each month this quarter, with September declining in line with the total quarter decline of 3.3%. A further description of these risks, uncertainties and other factors can be found in our SEC filings including our 2019 Form 10-K and subsequent Form 10-Qs, along with a reconciliation of the non-GAAP financial measures utilized for today's discussion to the most comparable GAAP measures are also available at investor.jnj.com. And things that we're considering, I do think that we're confident in how hospitals are managing through the surges.
Hi, Chris. And as I think about 21 margins, would you characterize those as normalized margins for J&J or are these still margins that are going to be depressed as we're facing some COVID disruptions? And in terms of our working with the agency, we've had a really good track record over the past few months, really during the height of COVID, and continuing to submit files, have them accepted and really, importantly, get approvals, not only on time but actually ahead of time. Thank you, Chris, and thank you again everyone, for joining today's call to discuss our third-quarter results and your very thoughtful questions. Louise Chen -- Cantor Fitzgerald -- Analyst. Regarding taxes in the quarter, our effective tax rate increased from a 6.4% benefit in the third quarter of 2019 to 19.2% in the third quarter of 2020.
However, this was mostly offset by some sales related true-ups in Latin America. And in working with our local industry associations, be they bio or pharma in the U.S., be it IFPMA, ex U.S., there's a lot of work that's under way to help develop and build vaccine confidence across the board by different types of audiences. Appreciate it.
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