A lazy writer would be spinning out a Viagra joke right about now.

Now, while I know I have more than a couple less-than-endearing traits, laziness is not among them. So I'll move past the easy jokes about flaccid earnings and get to the heart of the matter. Borrowing a term from the restaurant industry, Pfizer (NYSE:PFE) is still very much in the weeds.

For the third quarter, total revenue slid by 5% because decent performance in consumer health and animal health (up 8% and 6%, respectively) couldn't offset a 7% drop in the pharmaceutical business. With lower sales came a decline in gross margin, as well -- nearly three full percentage points. Looking at an adjusted operating income number (that is, adjusted for merger and restructuring charges and whatnot), income fell about 16% from last year. Some of that was recaptured, though, and adjusted earnings per share fell 7% for the quarter.

While the U.S. is generally the bonanza for health-care companies, Pfizer's U.S. performance was pitiful with drug sales down 15%. In contrast, sales overseas actually managed to rise about 6%. To some extent, that reflects a broader recent trend in the U.S. as a dearth of new blockbusters and greater competition from generics pushed the branded prescription drug market down about 3% in the third quarter.

Pfizer is managing to do even worse than that. A loss of exclusivity walloped Neurontin sales, and COX-2 inhibitor sales are down two-thirds, while Celebrex has yet to recover from the flap first started by Merck's (NYSE:MRK) Vioxx a year or so ago. Making matters worse, Pfizer isn't seeing much growth in its big-ticket drugs. Lipitor sales were up 6% overall but up just 1% in the United States. And given that Lipitor accounts for more than one-quarter of total sales, that's pretty significant.

Last and by no means least, Pfizer's guidance will likely trouble professional analysts and investors. Guidance for the fourth quarter is below the current average guess, and the company withdrew guidance altogether for 2006 and 2007. This is probably a smart move given the uncertain current financial performance and the unknown impact of future cost-cutting, but it's not going to go over well.

As I said a quarter ago, it took Pfizer a long time to get into this mess, and it will take the company a long time to get out of it. New drugs for cancer and infectious diseases will certainly help, as will the launch of inhaled insulin (once approved), but this big ship won't turn on a dime. This is likely a good time for long-termers to do their due diligence, since they'll probably have some time to get into the stock. Investors seeking a bit more short-term gratification should probably look to the likes of AstraZeneca (NYSE:AZN), Novartis (NYSE:NVS), or Schering-Plough (NYSE:SGP) in the meantime.

For more pharm-fresh Foolishness:

Pfizer is a Motley Fool Inside Value recommendation. Merck is a Motley Fool Income Investor recommendation. For a free 30-day trial, click here and here, respectively.

Fool contributor Stephen Simpson has no financial interest in any stocks mentioned (that means he's neither long nor short the shares).