Pfizer raises its revenue range on a flat quarter, carried by Eliquis in the U.S.

Pfizer lifted its revenue guidance for 2026 on 3 November to between $62.0 billion and $64.0 billion, having already nudged it up in August. The quarter behind the new range was flat. Revenue in the September 2026 quarter came to $16.6 billion, $71 million less than a year earlier.

Two things cancel out inside that flat number. Sales of the COVID vaccine and the COVID pill keep shrinking, and the rest of the business grew 7% at constant exchange rates, the measure the company uses. Almost half of that growth came from one drug. Eliquis, the blood thinner Pfizer sells in an alliance with Bristol Myers Squibb, brought in $508 million more than a year earlier. Take it out and revenue fell about 4% last quarter, calculated from the reported figures. Over the first nine months of the year Eliquis added more revenue than the whole company did, so everything else, COVID included, was slightly smaller than a year ago.

The gain was American. Eliquis sales in the U.S. rose 39.9% on the year, while sales elsewhere slipped, which the company put down to generic copies and lower prices in certain international markets.

Why the U.S. number jumped matters more than its size. In its results, Pfizer said Eliquis grew mainly on a higher net price in the U.S., meaning lower rebates and a more favourable mix of sales channels, with higher demand around the world listed after that. On the call, the new chief financial officer, Cecile Guegan, was asked about U.S. net pricing across the company and said "there is not really any very material change into our gross to net dynamics during the third quarter". Gross to net is the gap between a drug's list price and what the company keeps after rebates and discounts. She credited most of the performance to market growth and volume.

The two statements need not conflict. One describes a single drug and the other the company's whole U.S. book, and the transcript is hard to read at that point in her answer. Ms Guegan said the quarter was "really a reflection of the strong execution rather than dynamics around gross to net that would not continue"; the written results, though, still put U.S. net price first for Eliquis.

Eliquis is not the only support. Pfizer's newer and acquired medicines, led by the bladder-cancer drug Padcev, grew 32% at constant exchange rates, while the Prevnar pneumonia vaccines fell. Since February the company has also cut its estimate of revenue lost to generic competition this year to about $1.1 billion, from about $1.5 billion.

Next year brings fresh patent losses. Asked about 2027, Ms Guegan named the loss of patent protection for the prostate-cancer drug Xtandi in the U.S. and for Eliquis outside it, along with pricing changes, against growth from the newer medicines. Pfizer does not expect to buy back shares this year, and she tied the return of buybacks to the period after those patent losses. The company said it will give its 2027 guidance around the middle of December, which will show how much of this year's higher base it expects to keep once those changes take effect.