Pfizer warns Comirnaty sales will plummet by nearly two-thirds in 2023. And Paxlovid won't fare much better

Despite a plan to jack up the price of Comirnaty to between $110 and $130 per dose when the United States goes to a commercial model this year for COVID-19 vaccines, Pfizer expects revenue from the shot to plummet by 64% in 2023.

Pfizer also expects a 58% decrease in revenue from COVID-19 oral antiviral Paxlovid. The company revealed its 2023 expectations in its fourth quarter and 2022 full-year earnings report on Tuesday.

With the decreases, Pfizer is guiding to a revenue window of $67 billion to $71 billion in 2023.

The projections—which fell short of analyst expectations—put a damper on what might have been a day of celebration as Pfizer reported $100.3 billion in revenue for 2022, after generating $81.3 billion in sales in 2021.

Pfizer expects sales of $13.5 billion for Comirnaty in 2023 after generating revenue of $36.8 billion in 2021 and $37.8 billion in 2022 from the vaccine. The analyst consensus projected 2023 sales at $14.4 billion.

As for Paxlovid, the company anticipates sales of $8 billion in 2023, which also fell short of analyst consensus projection of $10.3 billion. Pfizer reported sales of $18.9 billion for the post-infection treatment in 2022.

Complicating the guidance for COVID products in 2023, Pfizer explained, was that it's no longer derived from expected deliveries for signed contracts and now includes “anticipated sales through traditional commercial markets in the U.S.”

Pfizer expects 2023 to be a “transitional year,” for both Comirnaty and Paxlovid, CEO Albert Bourla explained. He said that the company expects both products to rebound beyond 2023.

In the U.S., the company expects 24% of the population to receive a COVID shot in 2023 as opposed to 31% in 2022. Pfizer expects the rate to increase to 30% and 40% in 2025 and 2026, assuming that a combined COVID/flu shot is developed.

As for Paxlovid, Pfizer sees symptomatic infections rising slightly each year through 2026. The company projects that it will retain roughly 90% of the oral antiviral market this year and next, with declines into the future as more treatments hit the market.

The company is still deciding what it will charge for Paxlovid once the U.S. goes to a commercial market, chief commercial officer Angela Hwang said.

If anything, Pfizer has been conservative with its previous projections for Comirnaty. At this time last year, it guided (PDF) to $32 billion in revenue from the shot, falling short by nearly $6 billion. On the flip side, it projected $22 billion for sales of Paxlovid at this stage last year, overshooting by more than $3 billion.

In response to the report, Pfizer’s shares dropped by 2.8% in pre-market trading.

Pfizer’s stock could well be undervalued, according to Greg Bassuk, CEO of AXS Investments.

“There are solid prospects for strong economic results from its other products, such as Eliquis, Prevnar and Vyndaqel, which are on pace for solid gains in market share,” Bassuk wrote.

Bristol Myers Squibb-shared Eliquis sales were up 14% in 2022, to $6.5 billion, while the Vyndaquel rare disease franchise produced revenue of $2.4 billion, which was a 29% increase from 2021. Excluding COVID products, Pfizer said it expects revenue to increase by between 7% and 9% in 2023.