At the top, Pfizer ceded the No. 1 slot as its revenue tumbled 41% from an industry record $100.3 billion in 2022 to $58.5 billion last year. The difference was directly attributable to declining sales of COVID vaccine Comirnaty and COVID antiviral Paxlovid. After the duo combined for sales of $56.7 billion in 2022, they fell (PDF) all the way to a combined $12.5 billion last year.

The drugmaker expects another decline in sales of its COVID products to a combined $8 billion this year. But it also is projecting a small increase in overall revenue to between $58.5 billion and $61.5 billion thanks to its overall healthy portfolio, which turned in a 7% sales increase in 2023 when excluding contributions from the COVID products.