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A sign outside Pfizer's commercial headquarters, in Walton Oaks, Britain, on Feb. 1, 2021.MATTHEW CHILDS/Reuters

Pfizer Inc PFE-N said on Tuesday it expects 2022 sales of its COVID-19 vaccine and antiviral pill to top $54-billion, but that fell short of lofty Wall Street estimates and its shares were off about 3 per cent.

Still, Chief Executive Albert Bourla said final sales for its oral COVID-19 antiviral, Paxlovid, could be “way bigger” than what Pfizer has forecast since its current outlook only included contracts that have been or are close to being signed.

Pfizer currently expects $22-billion in 2022 sales of the treatment, compared with Wall Street estimates of $22.88-billion.

“Clearly, this is only a fraction of the 120 million treatments that we are right now preparing to manufacture” this year, Bourla told analysts on a conference call.

The company is selling 20 million courses of Paxlovid to the United States at around $530 a course, but Bourla said that was a special price because of the size of the order.

The price for most high income countries, he said, would be more or less in line with the price of Merck & Co’s rival treatment molnupiravir, which the U.S. government bought for around $700 a course.

Pfizer executives said the company is in active discussions with over 100 countries about Paxlovid, and has the capacity to top 120 million courses if needed.

For the COVID-19 vaccine Pfizer developed with Germany’s BioNTech SE BNTX-Q, the U.S. drugmaker cautioned that final sales for the year may not top its current forecast of $32-billion, a 13 per cent decline from 2021 levels.

Last year, the company increased its COVID vaccine sales forecast several times as it signed more supply deals around the world.

Analysts have forecast sales of $33.79-billion for the vaccine in 2022, according to Refinitiv data.

Overall, Pfizer expects 2022 sales of $98-billion to $102-billion, also below estimates of $105.48-billion.

“Looking forward is not as good as looking back for Pfizer now and that is why (the stock price) is down on a somewhat decent report,” said Dennis Dick, a proprietary trader at Bright Trading LLC.

Going forward, “acquisitions are obviously very much in the cards,” said Aamir Malik, Pfizer’s chief business innovation Officer.

Some investors have been looking for Pfizer to use its huge cash infusion from COVID products on deals to drive future growth.

Pfizer said it had begun working on a next-generation version of Paxlovid, which is authorized to treat high-risk COVID-19 patients shortly after onset of symptoms.

Paxlovid performed significantly better in its clinical trials than Merck’s rival pill with about 90 per cent efficacy versus 30 per cent.

But Pfizer may still need an improved version of Paxlovid, according to Davinderpreet Mangat, senior analyst at Informa Pharma Intelligence.

“The door is slightly open, still, for COVID antivirals,” Mangat said. “Drugs from other companies may be able to surpass Paxlovid, similar to how Paxlovid surpassed Merck’s drug.”

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