Pfizer has cut its way to stability, but growth after Eliquis still rests on phase 3 bets

The technology

Pfizer is one of the world's largest drugmakers and has a lot of revenue to replace. It guided to $60.5 billion to $62.5 billion in 2026 revenue, and Eliquis, its biggest product, is nearing the end of its patent life. Its answer rests on two platforms it bought: antibody-drug conjugates from the $43 billion Seagen deal, and obesity drugs from Metsera.

The ADC record is split. Padcev is a clear win. It gained approval in all muscle-invasive bladder cancer in July after EV-304 cut the risk of recurrence, progression or death by 47%, and sales grew 23% to $667 million in the second quarter. But sigvotatug vedotin, the next ADC in line, missed its phase 3 survival goal and drew a $3.8 billion impairment, BNN Bloomberg reported.

In obesity, Pfizer bet on monthly dosing. Berobenatide showed up to 12.3% placebo-adjusted weight loss at 28 weeks in a monthly maintenance study, and Pfizer plans 10 phase 3 trials in 2026.

The odds

For berobenatide, the GLP-1 mechanism is proven, so the question is less whether it works and more whether monthly dosing holds weight off as well as weekly drugs. Industry data put the odds of a phase 3 drug reaching a filing at 57.8%.

In oncology, Pfizer has near-term regulatory events with good odds. Talzenna plus Xtandi in prostate cancer has an FDA decision due in the fourth quarter of 2026 under priority review, after TALAPRO-3 cut the risk of progression or death by 52%. Filed drugs reach approval 90.6% of the time. The PD-1 and VEGF bispecific PF-08634404 is in registrational trials in three tumor types, a riskier and larger bet.

The 12-program Innovent deal sits at the other end. Only 7.9% of drugs entering phase 1 reach approval.

The money

Pfizer is profitable but carries heavy debt. At June 28 it held $976 million in cash and $10.72 billion in short-term investments against about $63.2 billion of debt. It paid $4.9 billion in dividends in the first half and has made no buybacks in 2026.

The cost program is the main lever. Pfizer added $2.5 billion of savings for 2027 to 2029, bringing the three-year total above $10 billion, with a one-time cost of about $4 billion. BNN Bloomberg reported about $6 billion of remaining deal capacity, which limits Pfizer to bolt-on deals.

The risks

The main risk is the patent cliff hitting before obesity and new oncology drugs scale. Pharmaphorum wrote that growth should pick up from 2028, which leaves a gap. COVID revenue keeps shrinking: Pfizer cut that forecast to about $4 billion from about $5 billion.

Execution risk sits in obesity. Ten phase 3 trials are costly, and Pfizer will launch after established weekly drugs. The finance team is also changing, with CFO Dave Denton leaving in August and an interim CFO named.

Our read

Pfizer has stabilized. Non-COVID products are growing, Padcev is expanding into curative-intent treatment, and the cost cuts protect margins. The case for growth beyond 2028 depends on berobenatide's phase 3 program and the PD-1 and VEGF bispecific, and neither has late-stage data yet. The sigvotatug vedotin miss shows the Seagen pipeline beyond Padcev is weaker than Pfizer hoped, though Pfizer still has fetrastobart vedotin in phase 3 in lung cancer and is pairing its ADCs with the bispecific. The next checkpoints are ESMO, October 23 to 27, and third-quarter results on November 3.