How Pfizer won the pandemic, reaping outsize profit, influence

The grinding two-plus years of the pandemic have yielded outsize benefits for one company — Pfizer — making it both highly influential and hugely profitable as covid-19 continues to infect tens of thousands of people and kill hundreds each day.

Its success in developing covid medicines has given the drugmaker unusual weight in determining U.S. health policy. Based on internal research, the company’s executives have frequently announced the next stage in the fight against the pandemic before government officials have had time to study the issue, annoying many experts in the medical field and leaving some patients unsure whom to trust.

Pfizer’s 2021 revenue was $81.3 billion, roughly double its revenue in 2020, when its top sellers were a pneumonia vaccine, the cancer drug Ibrance, and the fibromyalgia treatment Lyrica, which had gone off-patent.

Now its mRNA vaccine holds 70% of the U.S. and European markets. And its antiviral Paxlovid is the pill of choice to treat early symptoms of covid. This year, the company expects to rake in more than $50 billion in global revenue from the two medications alone.

Paxlovid’s value to vaccinated patients isn’t yet clear, and Pfizer’s covid vaccine doesn’t entirely prevent infections, although each booster temporarily restores some protection. Yet, while patients may recoil at the need for repeated injections — two boosters are now recommended for people 50 and older — the requirement is gold for investors.

“Hopefully, we could be giving it annually and maybe for some groups that are high-risk more often,” CEO Albert Bourla told investors this year. “Then you have the treatment (Paxlovid) that will, let’s say, resolve the issues of those that are getting the disease.”

Just last week, the Biden administration agreed to buy another 105 million doses of Pfizer’s covid vaccine for the fall booster campaign, paying $3.2 billion. At $30.47 a dose, it’s a significant premium over the $19.50-adose rate the government paid for the first 100 million. The vaccine is being modified to target early omicron variants, but newer variants are gaining dominance.

Because the virus keeps mutating and will be around for a long time, the market for Pfizer’s products won’t go away. In wealthier countries, the public is likely to keep coming back for more, like diners at an all-you-can-eat restaurant, sated but never entirely satisfied.

The reliance on Pfizer products at each stage of the pandemic has steered the U.S. response, including critical public health decisions.

When last year Bourla suggested that a booster shot would soon be needed, U.S. public health officials later followed, giving the impression that Pfizer was calling the tune.

Some public health experts and scientists worry these decisions were hasty, noting, for example, that although boosters with the mRNA shots produced by Moderna and Pfizer-BioNTech improve antibody protection initially, it generally doesn’t last.

Since January, Bourla has been saying that U.S. adults will probably all need annual booster shots, and senior FDA officials have indicated since April that they agree.

At a June 28 meeting of FDA advisers considering a potential fall vaccination campaign, Pfizer presented studies involving about 3,500 people showing that tweaks to its covid vaccine allowed it to elicit more antibodies against the omicron variant that began circulating last December.

But most of the advisers said the FDA should require the next vaccine to target an even newer omicron variant, known as BA.5.

That would mean more work and expense for Pfizer, which called on the FDA to enable it to make future changes to the covid vaccine without human trials — similar to how annual influenza vaccines are approved. “If such a process were implemented, responses to future waves could be substantially accelerated,” said Kena Swanson, Pfizer’s vice president for viral vaccines.

FDA officials at the meeting did not immediately respond to the suggestion.