By Financial Times / In a private room at a San Francisco steakhouse, Albert Bourla exuded confidence. The Pfizer chief executive joked with reporters as he answered questions about the company and the state of the pharmaceutical industry during a meeting in January.
Bourla had reason to be in good spirits. Last October, he beat out his competitors by becoming the first pharmaceutical company executive to reach a drug pricing agreement with President Donald Trump.
The following month, Bourla triumphed over Novo Nordisk to acquire a biotech startup that develops weight-loss drugs, in one of the most dramatic boardroom clashes of 2025.
But Bourla's confidence did not reflect the reality that Pfizer was facing.
Fewer and fewer people are getting vaccinated against Covid-19, hitting the company's revenue. In a financial report released this week, Pfizer said revenue from its regular Covid vaccine and its vaccine for high-risk patients had fallen by 34 percent and 95 percent, respectively, compared with a year earlier.
Pfizer raised its overall revenue forecast for 2026 by $500 million, but said revenue from Covid vaccines is now expected to be $1 billion lower, to about $4 billion.
Amid declining vaccine sales, Pfizer's shares have weakened in recent months, and the company is now valued at $152.5 billion — significantly less than its biotech rivals Amgen, at $222 billion, and Gilead, at $165 billion.
Pfizer shares have risen 7.5 percent this year, compared with gains of 25.5 percent for Amgen and 8.5 percent for Gilead.
Bourla, 64, has led Pfizer since 2019 and has been praised by world leaders, including Joe Biden, for accelerating the development and distribution of a Covid-19 vaccine worldwide.
But investors are increasingly concerned about the direction the company is taking.
According to S3 data, Pfizer is now the pharmaceutical company with the highest level of short positions among pharmaceutical companies with a market value of over $50 billion.
“The market is not really giving you a vote of confidence through the stock price,” said Kevin Gade, portfolio manager at Bahl & Gaynor, an Ohio-based investment fund. The firm invests in pharmaceutical stocks, but has not held Pfizer shares since 2019.
"Let's give them credit for the Covid-19 vaccine, but beyond that there's not much that can point to a successful research and development sector," he said.
Another investor in pharmaceutical companies described the situation even more directly: "They are in a world of trouble."
Pfizer declined to comment beyond its public statements.
In its latest quarterly report, the company also said it had total debt of $60.5 billion — the second-highest figure among major pharmaceutical companies, according to its most recent financial statements.
Due to the debt level, investors are also quietly questioning Pfizer's dividend payments.
Some investors think the company could cut its dividend, arguing that the money saved would allow Pfizer to acquire smaller biotech companies and replenish its pipeline of drugs.
After a $10 billion deal for Metsera in 2025, Pfizer has stayed out of the market, despite a boom in mergers and acquisitions in the biotech sector this year.
The company has stated that it has about $6 billion available for new acquisitions.
Daniel Lyons, portfolio manager at Janus Henderson, said a dividend cut “would definitely give them more flexibility,” adding:
"Maybe for the right deal they could justify a dividend cut, but they should do so very carefully."
Asked about the dividend during a call with analysts on Tuesday, Bourla said that even in the “most strained” financial scenarios, “we will be able to maintain our dividend.”
Acquisitions are crucial for Pfizer and its global rivals, as pharmaceutical companies inevitably lose profitable drugs when their patents expire.
Recent purchases raise questions
Pfizer's recent acquisitions have been controversial.
The deal for Metsera has worried investors, who fear the company may have overpaid for a weight-loss drug.
After a bidding war with Novo Nordisk, Pfizer paid up to $2.7 billion more for the biotech company than its initial offer.
Metsera's drug is estimated to cause a similar level of weight loss as Eli Lilly's drug. However, Pfizer's treatment is not expected to hit the market until 2028, when it will face already established products from Eli Lilly and Novo Nordisk, as well as other potential competitors.
Bourla has consistently defended the Metsera deal, arguing that the drug is a monthly injection, which will be more convenient for patients and have better tolerability than rival products.
"Once a month is ideal," Bourla said in January.
In June, Pfizer reported positive results from trials of its monthly weight-loss injection, but analysts have raised questions about whether it can compete with existing treatments.
Some of the company's other recent acquisitions haven't fared so well.
In 2024, Pfizer withdrew a drug targeted at treating sickle cell anemia. The drug was part of a $5 billion deal that Pfizer had struck in 2022 to acquire biotechnology company Global Blood Therapeutics. The company said the drug is still in advanced development.
In 2023, Pfizer acquired Seagen for $43 billion, in one of the pharmaceutical sector's largest deals, strengthening its oncology portfolio with dozens of other cancer drugs.
This year, one of Seagen's cancer drugs failed a final phase 3 trial, in what Goldman Sachs described last month as a "significant blow to its pipeline of emerging drugs."
Pfizer seeks opportunities in China
Although it has not made any major acquisitions this year, Pfizer has been among the most active companies in pharmaceutical deals in China.
In May, Pfizer announced it would pay $650 million to Chinese drug company Innovent to secure access to 12 drugs in early stages of development.
Innovent could benefit from up to $10 billion if certain regulatory and commercial targets are met as the drugs advance to market.
Pfizer's initial $650 million payment was the largest payment made by a U.S. pharmaceutical company to a Chinese drugmaker during the first half of this year.