After 'bad launch' remark by CEO, Pfizer's RSV vaccine gains traction in Q4. How will it fare in latest round of GSK showdown?

Earlier this month, at the J.P. Morgan Healthcare Conference, Pfizer CEO Albert Bourla said respiratory syncytial virus (RSV) vaccine Abrysvo was a “bad launch” for the company.

On a Tuesday conference call, as the drugmaker reported fourth-quarter Abrysvo sales of $515 million, Pfizer execs shared muted enthusiasm for the recent progress the company has made with its rollout.

When asked what market share Pfizer could achieve in 2024—versus its 35% showing in 2023—company officials dodged the question.

“We’re very focused going forward on retail contracting for the 2024-25 season,” said Amir Malik, Pfizer’s new U.S. commercial officer. “We’re going to also focus on new opportunities that we’re currently studying with Abrysvo—adults age 18 and older with underlying medical conditions.”

Pfizer's CEO Bourla added that the company is focused on increasing Abrysvo’s market share by establishing RSV vaccination as a year-round “discussion.”

Abrysvo’s sales were up from $375 million in the third quarter, but they're tracking behind sales of GSK’s Arexvy. That rival shot, which won FDA approval about a month before Pfizer's offering, generated 709 million pounds ($860 million) in the third quarter. The British company reports its fourth-quarter results tomorrow.

“The RSV market holds substantial promise, but Abrysvo faces tough competition from GSK’s Arexvy,” wrote Lee Brown, global sector lead for healthcare at Third Bridge, who termed Abrvsvo’s fourth-quarter performance as “positive.”

Before Pfizer reported its numbers, Zacks analysts predicted Abrysvo would generate $510 million for the period. 

Meanwhile, Pfizer is “encouraged” by early sales of Abrysvo as a maternal vaccine, Malik said. Women in weeks 32 through 36 of their pregnancies can protect their soon-to-be-born babies. Approval in that indication came in August.

“More than 65% of women prefer to get the maternal vaccine versus having their infant immunized by a monoclonal antibody, and we think that the label provides us the opportunity to grow that segment as well,” Malik said.

As Pfizer plots its strategy for 2024, it’s clear the company is focused on oncology. Of Pfizer's list of priorities (PDF, slide 6) for the year, “achieving world-class oncology leadership,” is placed first.

Pfizer’s recently completed $43 billion acquisition of antibody-drug conjugate specialist Seagen doubles the size of its pipeline, which has the potential to deliver “at least eight potential blockbuster products by 2030,” Pfizer said.

The company also expects to gin up sales of Seagen’s already approved products, pointing to its U.S. commercial infrastructure which is three times larger than that of the Seattle biotech. That effort begins with the launches of Seagen’s Padcev and Xtandi in new indications.

Another priority Pfizer mapped out for 2024 is to deliver a “next wave of pipeline innovation.” These include its fourth-generation pneumococcal vaccine and its development of COVID/flu and RSV vaccine combos.

Pfizer’s third priority is to maximize the “performance of our new products,” and there are many after a fruitful 2023 in which the company gained a record nine FDA approvals. In addition to a pair of age-group endorsements for Abrysvo, Pfizer won approvals for multiple myeloma drug Elrexfio, OPKO-partnered growth failure treatment Ngenla and first-in-class alopecia therapy Litfulo.

Also approved were ulcerative colitis drug Velsipity, which came by way of Pfizer’s 2022 acquisition of Arena Pharmaceuticals for $6.7 billion, and nasal spray migraine therapy Zavzpret, which arrived by way of Pfizer’s $11.6 billion buyout of Biohaven, which also brought soon-to-be blockbuster migraine drug Nurtec.

Another highlight from Pfizer’s earnings report was the better-than-expected sales of COVID vaccine Comirnaty, which came in at $5.36 billion for the quarter, helping the company reach $14.25 billion in revenue for the period and $58.5 billion for 2023.

On the downside, sales of pneumococcal vaccine Prevnar came in at $1.61 billion for the quarter, down 8% from the same period in 2022. The company blamed lower demand and “unfavorable timing of customer orders.”

As for 2024 guidance, Pfizer sees revenue reaching between $58.5 and $61.5 billion, including $8 billion from COVID product sales and $3.1 billion from products acquired in the Seagen deal.

After closure of the buyout on Dec. 14, fourth-quarter revenue included $120 million in Seagen product revenue, chief financial officer David Denton said.

“We believe Pfizer's growth will accelerate as the company is now more focused on innovative drugs and vaccines,” Edward Jones healthcare analyst John Boylan wrote. “The company has research and development expertise and strong product diversification. Profit from the COVID-19 vaccine should further strengthen the company's financial position and allow for investment in internal drug development and acquisitions.”