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Pfizer reported a surprise quarterly profit on Tuesday, helped by cost cuts and fewer returns of its COVID treatment Paxlovid by the U.S. government than it had expected, but sales of some high profile products fell short of Wall Street estimates.

The New York-based drugmaker earned 10 cents per share on an adjusted basis for the fourth quarter. Analysts on average had expected a loss of 22 cents per share, according to LSEG data.

Pfizer shares were down 1.3% in morning trade after opening more than 2% higher.

Revenue in the quarter of $14.25 billion was shy of Wall Street estimates of $14.42 billion.

Investors fled Pfizer last year as pandemic worries declined and billions of dollars in COVID-19 vaccine and treatment sales disappeared. The company has responded with a recent purchase of cancer drugmaker Seagen, a $4 billion cost-cutting program, and internal restructuring.

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Jeff Jonas, portfolio manager at Gabelli Funds, said he was concerned about the company’s non-COVID performance, after revenue for products like breast cancer treatment Ibrance and the Prevnar pneumonia vaccine were lighter than expected.

“Historically I thought they had one of the best sales forces in the industry and they’ve been able to at least sell and execute on drugs pretty well, even if their R&D maybe wasn’t always the best. But there have been some challenges there recently,” Jonas said.

Pfizer CEO Albert Bourla said the company was looking to leverage a “more focused, efficient structure” to drive growth of new drugs. Bourla previously expressed disappointment over the launch of the new RSV vaccine Abrysvo, which has significantly trailed a rival shot from GSK

Ibrance, which is facing intense competition from rival treatments, saw sales fall 12.6% to $1.12 billion in the quarter, below analysts’ forecasts for $1.23 billion.

Prevnar brought in sales of $1.61 billion, below estimates of $2 billion. The company cited lower demand and “unfavourable timing of customer orders” for the shortfall.

Revenue from COVID products, the Paxlovid antiviral treatment and vaccine Comirnaty, came in at $12.5 billion for 2023, meeting the company’s own targets for the year, but a far cry from the $57 billion peak racked up in 2022.

Pfizer in October renegotiated a contract, allowing the U.S. government to return unused Paxlovid inventory. The company recorded a smaller-than expected $3.5 billion revenue reversal in the quarter as the U.S. returned about 6.5 million treatment courses. It had previously forecast a $4.2 billion revenue reversal based on the expected return of around 7.9 million courses.

A Pfizer spokesperson said there had been more use of the two-drug treatment than it had forecast. Still, the window for U.S. government Paxlovid returns remains open, and the company could take another financial adjustment in the current quarter.

The company maintained its 2024 adjusted profit and sales forecasts of $2.05 to $2.25 per share earnings, and revenue of $58.5 billion to $61.5 billion.

That includes a $3.1 billion contribution from cancer drugmaker Seagen and $8 billion in sales from Paxlovid and COVID-19 vaccine Comirnaty, which it makes with German partner BioNTech.

The company has been slashing research and development spending as part of its cost cut program. R&D expenses were down 22% in the quarter to $2.82 billion, driven by lower compensation spending, as well as reductions in its vaccine and rare disease programs.

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