It would appear to this Fool that middle ground is pretty rare real estate in the pharmaceutical world these days. Companies are either doing well (or at least notably better), like Novartis (NYSE:NVS) or Wyeth (NYSE:WYE), or they're struggling like Pfizer (NYSE:PFE) and Merck (NYSE:MRK). Count Bristol-Myers Squibb (NYSE:BMY) in that latter group.

Revenue was up just 3% this quarter, and gross margins worsened -- though they were already among the worst in the big-cap pharma sector. And when you look at earnings from continuing operations, stripped of charges and gains, you see about a 5% decline from last year.

Overall pharmaceutical performance was a mix of good news and bad news. Bristol-Myers Squibb's total pharmaceutical sales were up 3%, and that's not so good. Better, though, was the news that Plavix revenue was up 21%, Avapro/Avalide revenue was up 19%, and Abilify revenue was up 51%. On the other hand, Pravachol (and its $536 million in sales this quarter) is now no longer covered by patents, and generics are going to chew away at that lucrative franchise.

Likewise, the future is a mix of possibility and trial by ordeal. Bristol-Myers Squibb launched Orencia in February (good), but into an already crowded market for arthritis (not so good). The company also earlier announced a settlement among itself, partner Sanofi-Aventis (NYSE:SNY), and a potential patent challenger of Plavix (good), but there's still the chance that regulatory authorities will scotch the deal (bad). And if Plavix goes bye-bye, that's roughly one-quarter of revenue walking out the door earlier than hoped (really bad).

Bristol-Myers Squibb management likes its pipeline, but only time will tell. After all, Pargluva was going to help save the day . until the Food and Drug Administration nixed it. And let's not forget that the company is behind Merck and Novartis (and alongside GlaxoSmithKline (NYSE:GSK) and Eli Lilly) in the increasingly crowded market for next-generation diabetes drugs. Can a pipeline with some interesting cancer drugs surmount that? We'll see.

If these shares were back near their lows, I'd have a mild level of interest. At today's prices, though, there are just too many other better ideas to go after.

For more Foolishness from the medicine cabinet:

Merck, GlaxoSmithKline, and Lilly are Motley Fool Income Investor recommendations. Pfizer is an Inside Value recommendation. The Fool has a newsletter for almost every style of investing.

Fool contributor Stephen Simpson owns shares of Sanofi-Aventis, but has no financial interest in any other stocks mentioned (that means he's neither long nor short the shares).