Those following the headlines about Pfizer (PFE -0.43%) last year may have thought 2020 was all about developing a vaccine for COVID-19. For society at large, it was. For the company, though, 2020 was about transformation. Management is hoping to reestablish Pfizer as a scientific trailblazer after shedding slow-growth businesses. By this time next year, we should know whether the move is paying off or whether competition will stunt the 172-year-old pharmaceutical giant's attempt to ignite growth.

The new Pfizer

Over the last decade, the company has been converting itself into what it calls a pure-play science and innovation-focused company. After the August 2019 deal with GlaxoSmithKline to create a joint venture of consumer health assets, and the November 2020 deal to combine its off-patent arm, Upjohn, with Mylan to form Viatris, management is finally able to devote all of its energy to the biopharmaceuticals business. The unit is surprisingly well-diversified, with no single segment comprising more than roughly a quarter of sales, as the recently reported full-year 2020 results demonstrate.

Segment 2020 Revenue Percent of Revenue YOY Growth
Internal medicine $9 billion 22% 3%
Oncology $10.9 billion 26% 21%
Hospital $8 billion 19% 3%
Vaccines $6.6 billion 16% 2%
Inflammation & immunology $4.6 billion 11% (3%)
Rare disease $2.9 billion 7% 29%
Total $41.9 billion 100%  8%

Data source: Pfizer. YOY = year over year. 

As the largest segment, oncology is the most important growth driver for the company. Breast cancer drug Ibrance is the best seller there, and its sales were up 9% year over year in 2020. The $5.4 billion in revenue made it the company's second best-selling drug overall. Other smaller contributors in the segment included Xtandi and Inlyta, drugs for prostate and kidney cancer, respectively. Beyond oncology, blockbuster drugs for arthritis, heart failure, and blood clots all grew at least as fast as Ibrance.

That is impressive diversification across a portfolio of drugs for many different diseases. Of course, the greatest success of 2020 was the development and rollout of Comirnaty, the COVID-19 vaccine developed with partner BioNTech (BNTX -4.08%).

A pharmaceutical pill manufacturing line.

Image source: Getty Images.

A bevy of competition

To maintain this kind of growth, Pfizer will have to fight off competition on nearly every front. So far, the company has shared the stage with Moderna in the fight against COVID-19. However, with Johnson & Johnson's single-dose vaccine now authorized for emergency use, that may change fast. And there's another contender not far behind; this one, from Novavax, requires two shots but doesn't use a genetic delivery mechanism and has no special storage requirements. The company could see its market share shrink fast as these alternative options emerge.

In oncology, a clinical trial studying the ability of Ibrance to prevent recurrence in women after treatment for early stage breast cancer did not meet its goal. That opens the door for Eli Lilly's (LLY -0.55%) competing drug, Verzenio, which did reduce the risk of recurrence in its own study. 

In inflammation and immunology, patients taking arthritis drug Xeljanz were shown to be at greater risk of heart complications and cancer than if they were taking other anti-inflammatory drugs. The issue may not be with the drug itself. Instead, the entire class of JAK inhibitors -- drugs that block an enzyme that regulates immune response -- has come under scrutiny. That should give investors concern about the durability of the $2.4 billion Xeljanz produced last year. Competing drugs like Abbvie's (ABBV 1.22%) Humira, which generated nearly $20 billion in sales last year, and Amgen's (AMGN 0.04%) Enbrel, which produced $1.3 billion, take a different approach to treating inflammatory diseases.

Pfizer's best-selling drug is pneumococcal vaccine Prevnar, bringing in $5.85 billion last year. It was the highest-grossing vaccine in the world before COVID-19, and it could also be under threat. Pfizer and Merck (MRK 0.09%) both have improved pneumococcal vaccines for adults slated for a decision from the U.S. Food and Drug Administration this summer. However, adults only account for 20% of Prevnar sales -- and Merck's new candidate is expected to have results on its effects in children by November, a year earlier than Pfizer's. That head start could eat into sales of Prevnar for at least a year, or even longer if doctors stick with the Merck treatment once they start using it.

This time next year

A year from now, investors will have a lot more information about the growth prospects for Pfizer. Prevnar sales could be under assault, COVID-19 vaccine sales could be limited to boosters, and some of the company's blockbuster drugs could have been replaced. Management has guided for $59.4 billion to $61.4 billion in revenue this year thanks to $15 billion from COVID-19 vaccine sales, but these risks could undermine the minimum 6% annual revenue growth CEO Albert Bourla has promised beyond this year.

That said, Pfizer is mounting a defense. The company is currently investigating a third vaccine shot in the hopes that it will extend protection, in addition to developing a version of the vaccine to target the South African variant. Also, the recent launches of biosimilars should bolster the oncology segment and fill some of the gap left by the inability of Ibrance to expand beyond metastatic breast cancer. These biosimilar drugs generated $866 million in revenue last year, up 203% year over year. 

2021 will be the first year of Pfizer operating in its new form. Despite the risks, the company has a broad portfolio of drugs and well-performing new products in the key oncology segment. Investors seeking stability may want to add shares to their portfolio. So far, the company is managing risks despite some setbacks, and the next 12 months should provide a lot of clarity about the long-term outlook.