In the private dining room of a San Francisco steakhouse, Albert Bourla exuded confidence. The Pfizer chief executive joked with reporters as he fielded questions about his company and the state of the pharmaceutical industry at the gathering in January.
Bourla had good reason to be in a jovial mood. Last October, he outmanoeuvred his competitors to be the first pharmaceutical boss to strike a drug pricing agreement with President Donald Trump.
The following month, Bourla triumphed over Novo Nordisk to acquire a weight-loss biotech start-up in one of the most dramatic boardroom battles of 2025.
Bourla’s confidence belied the reality facing Pfizer. Fewer people have been getting Covid-19 shots, denting revenues. In an earnings report this week, Pfizer said revenues from its conventional Covid vaccine and jab for high-risk patients were down 34 per cent and 95 per cent respectively from a year ago.
Pfizer raised its overall 2026 revenue estimate by $500mn, but said revenues from Covid shots would now be $1bn lower at $4bn.
Amid declining vaccine sales, Pfizer stock has dipped in recent months with the company now worth $152.5bn — considerably less than biotech rivals Amgen ($222bn) and Gilead ($165bn). Pfizer’s shares are up 7.5 per cent this year, compared with gains of 25.5 per cent and 8.5 per cent for Amgen and Gilead.
Bourla, 64, has run Pfizer since 2019 and been praised by world leaders, including Joe Biden, for rushing a Covid-19 vaccine to the world. Investors, however, are increasingly anxious about its trajectory.
Pfizer is now the most heavily shorted pharmaceutical company with a market value above $50bn, according to data from S3.
“The market is really not giving you a vote of confidence with the share price,” said Kevin Gade, a portfolio manager at Bahl & Gaynor, an Ohio-based value fund. The firm owns pharmaceutical stocks but has not held Pfizer since 2019.
“Give them their flowers for the Covid-19 vaccine, but beyond that there’s just not a lot to really pinpoint a successful R&D franchise,” he said.
Another investor in pharmaceutical companies put the situation more bluntly: “They are in a world of hurt.”
Pfizer declined to comment beyond their public statements.
In its latest quarterly report the company said it was also shouldering $60.5bn of total outstanding debt — the second-highest figure among big pharmaceutical companies, according to the most recent financial statements.
Given its debt load, investors are quietly questioning Pfizer’s dividend payments. Some investors think it could cut the dividend, arguing the extra cash could allow the company to buy small biotechs and replenish its drug pipeline.
After a $10bn deal for Metsera in 2025, Pfizer has sat on the sidelines despite a boom in biotech M&A this year. The company has said it has about $6bn to spend on acquisitions.
Daniel Lyons, a portfolio manager at Janus Henderson, said a dividend cut “definitely would help to give them more flexibility”, adding: “Maybe for the right deal, they could justify a dividend cut, but you have to do that pretty carefully.”
Asked about the dividend on a call with analysts on Tuesday, Bourla said that even in “the most stretched” financial scenarios, “we will be able to maintain our dividend”.
Acquisitions are essential for Pfizer and its global rivals, which inevitably lose their lucrative drugs to patent expirations.
Pfizer’s recent acquisitions have been controversial. The Metsera deal left investors worried it might have overpaid for a weight-loss drug. After the bidding war with Novo Nordisk, Pfizer paid as much as $2.7bn more for the biotech than its initial offer.
Metsera’s drug is estimated to reduce a similar amount of weight as Eli Lilly’s weight-loss drug. However, Pfizer’s treatment is not expected to launch until 2028, when it will compete with Lilly and Novo’s well-established rival products as well as other potential competitors.
Bourla has consistently defended the Metsera deal, arguing the drug is a monthly shot that will be more convenient for people to take and has better tolerability than rivals.
“Monthly is ideal,” Bourla said in January. In June, Pfizer reported positive results from testing for the monthly weight-loss shot, but analysts have questioned whether it can rival existing treatments.
Some of its other recent acquisitions have not aged well. In 2024, Pfizer withdrew a drug targeting sickle cell disease. The drug was part of Pfizer’s $5bn deal in 2022 for biotech Global Blood Therapeutics and it remains in late-stage development, the company has said.
In 2023, Pfizer bought Seagen for $43bn in one of the largest pharmaceutical deals, bolstering the oncology portfolio with dozens of additional cancer medicines.
This year, one of Seagen’s cancer drugs failed a final phase 3 trial in what Goldman Sachs described last month as a “notable pipeline setback”.
While it has not made acquisitions this year, Pfizer has been one of the most active dealmakers in China. In May, Pfizer said it would pay $650mn to Chinese drugmaker Innovent for access to 12 early-stage drugs.
Innovent could receive up to $10bn if certain regulatory and commercial targets are hit as the drugs advance. Pfizer’s upfront $650mn payment was the largest by a US drugmaker to a Chinese pharmaceutical company in the first half of the year.
Pfizer is “trying to get rights to drugs for cheaper prices, and a lot of that involves going to China”, said Karen Andersen, an analyst with Morningstar. “They are trying to bulk up their pipeline with some products that could work well alone or in combination, but doing it at a price that’s not hefty upfront.”
Amid the pressure on Pfizer to invigorate its share price, she said the stock had been “overly punished” by investors. The company has a diverse portfolio of drugs, fortifying its revenues despite some trouble in its drug development plans.
“It’s very hard to put really significant pressure on their top line,” she said.
While Bourla successfully fought off activist investor Starboard in 2024, Pfizer’s prolonged underperformance could invite questions about his future as chief executive, Gade said. “Maybe he is not the right guy to lead the company going forward.”
