Pfizer faces the Covid trough

On the day the Humira era formally ended Pfizer confirmed that the good times driven by Covid are coming to a close too. Sales of Comirnaty and Paxlovid were $37.8bn and $18.9bn respectively in 2022, but this year will fall 64% and 58%. This is partly behind 2023 group revenue guidance being set at $67-71bn, which – despite Pfizer talking down the numbers at JP Morgan – came in below sellside consensus of $72.9bn. The company expects compliance with Covid vaccinations to fall, but will crucially also move away from US sales under government contracts to a commercial model. In China, which Pfizer calls a “new but uncertain market opportunity”, temporary Paxlovid government reimbursement lasts only until March, after which private, self-pay sales take over. Analysts put on a brave face, calling 2023 a trough year before sales rise again. Is this possible? Much depends on a six-component mRNA Covid/flu combo vaccine – about which nothing is yet known clinically – and on what still looks like a lacklustre R&D pipeline. Could recent acquisitions save Pfizer? Nurtec ODT, which came through the $11.6bn Biohaven deal, sold only $211m in the fourth quarter, versus Evaluate Pharma’s consensus estimate of $325m.