Pfizer (PFE) Q3 2026 Earnings: U.S. Eliquis Up 40%, Guidance Raised

Pfizer's Q3 2026 earnings showed U.S. Eliquis revenue up 40% and margins holding as R&D rose, and Pfizer raised its full-year guidance. The company reported results for the third quarter on November 3, 2026, through an earnings release, a Form 10-Q and an earnings call [1][2]. Four questions framed the quarter: whether U.S. Eliquis could hold its second-quarter level in the first year of Medicare's negotiated price, whether Vyndaqel could sustain its recovery after price cuts, whether adjusted earnings per share could stay within the guided range while R&D rose, and whether COVID-19 products could deliver about $4 billion for the year. The first three were confirmed; COVID-19 revenue recovered but is running behind pace. Overall, growth outside COVID-19 and a better product mix improved profit, but how much of the U.S. Eliquis net price gain will last is still unquantified.

Pfizer researches, manufactures and sells prescription medicines and vaccines, and nearly all of its revenue comes from its Biopharma business [3]. In the U.S. it sells drugs mainly to wholesalers and records revenue at net prices after rebates and allowances; Pfizer and Bristol Myers Squibb share profits and losses on the blood thinner Eliquis in most markets [4].

U.S. Eliquis revenue rises to $1.808 billion

U.S. Eliquis kept climbing in the first year of the negotiated Medicare price. Third-quarter U.S. revenue was $1.808 billion, up 40% year over year and above $1.651 billion in the second quarter [1][5]. Global revenue was $2.523 billion, up 25% at constant exchange rates; international revenue was $715 million, roughly flat [1].

Pfizer attributed the growth to a higher U.S. net price and higher global demand. The 10-Q states that the higher net price came from lower rebates and favorable channel mix [2]. On the call, the new CFO said that, apart from one expected price adjustment, company-wide gross-to-net discounts did not change materially and performance came mostly from volume [6]. The two statements stress different drivers, and Pfizer did not disclose how much came from rebates or channel mix, so the lasting share of the gain cannot yet be confirmed.

This growth was the largest support for revenue in the quarter. U.S. Eliquis revenue rose by about $516 million year over year, roughly half of the decline in the two COVID-19 products [1]. The constraints sit mainly in 2027: management said international Eliquis loses exclusivity at the end of 2026 [6], and a 340B pilot program the U.S. government plans to start in January 2027 is expected to include Eliquis, though the pilot is subject to litigation [2].

Vyndaqel U.S. revenue grows 14%

The recovery of Vyndaqel, Pfizer's heart-disease drug for ATTR cardiomyopathy, continued. Third-quarter global revenue was $1.773 billion, up 12% at constant exchange rates, after 4% in the first quarter and 8% in the second [1][7]. U.S. revenue was $1.086 billion, up 14% and above $1.064 billion in the second quarter; international revenue grew 9% [1].

Pfizer attributed the quarter's growth to market expansion in the U.S. and to more diagnosed patients and improved access abroad [2]. Lower U.S. net prices from new payer contracts appear only in the year-to-date explanation, and Pfizer does not disclose patient counts or net price. On patents, no generic has launched in Europe, but in September one company filed a U.S. application for generic tafamidis tablets, and Pfizer has sued [2].

Cost control keeps profit above the guided range

Profit held up while R&D increased. Third-quarter adjusted EPS was $0.87, including about $0.10 of one-time acquired in-process R&D expense from a licensing deal [1]. The adjusted gross margin was about 77%, which the CFO attributed to favorable product mix and cost management [6]. Adjusted selling, informational and administrative expenses were $3.221 billion, up 2%, while adjusted R&D expenses grew 18% [1].

Adjusted EPS was flat with last year, mainly because the effective tax rate on adjusted income rose from 7.9% to 14.0% [1]. Pfizer raised its full-year adjusted EPS guidance from $2.80-$3.00 to $2.95-$3.05 and its full-year revenue guidance to $62.0-$64.0 billion [1][8]. Operating cash flow for the first nine months was $8.825 billion, up from $6.356 billion a year earlier [2].

COVID-19 products still have to deliver in the fourth quarter. Third-quarter COVID-19 revenue was $1.257 billion, higher than in the second quarter but below the roughly $1.3 billion pace implied by the full-year target [1]. Pfizer reaffirmed about $4 billion for the year [6], which requires about $2 billion in the fourth quarter, relying mainly on international vaccine contract deliveries.

Conclusion

This report strengthens the case for Pfizer's growth and profit conversion. Revenue excluding COVID-19 products grew 7% [1], growth in Eliquis and Vyndaqel lifted both revenue and gross margin, and cash flow was clearly better than last year. The main uncertainties are whether the U.S. Eliquis net price gain lasts, whether fourth-quarter COVID-19 revenue arrives, and how the loss of international Eliquis exclusivity and the next round of cost savings play out in 2027. Based on full-year guidance, fourth-quarter adjusted EPS works out to about $0.56 to $0.66, and that result will test this quarter's conclusions.

Sources

• [1] PFE Q3 2026 earnings release 2026-11-03 · 8-K Exhibit 99
• [2] PFE 10-Q filed 2026-11-03 · Q3 2026
• [3] PFE 10-K filed 2026-02-26 · commercial operations and segments
• [4] PFE 10-K filed 2026-02-26 · Eliquis alliance economics
• [5] PFE 10-Q filed 2026-08-04 · Q2 2026 Eliquis discussion
• [6] PFE Q3 2026 earnings call 2026-11-03 · transcript
• [7] PFE 10-Q filed 2026-08-04 · Q2 2026 Vyndaqel discussion
• [8] PFE Q2 2026 earnings call 2026-08-04 · revenue and EPS guidance