Pfizer (NYSE:PFE) is overhauling its cardiometabolic pipeline and weighing acquisitions after an oral weight-loss candidate stumbled, even as its Q1 results delivered a mixed bag of beats and misses.

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The New Yorkbased drugmaker reported $13.7 billion in first-quarter revenue, roughly $400 million shy of analysts' $14.09 billion consensus, but topped bottom-line forecasts and confirmed its 2025 earnings outlook.

Revenue slid about 8% year-over-year, driven largely by a steep drop in Paxlovid sales to $491 million versus a $902 million forecast. That decline was only partly offset by Comirnaty, Pfizer's COVID vaccine co-developed with BioNTech, which generated $565 million and outpaced the $325.5 million estimate.

Sales of flagship drug Eliquis fell 4% operationally amid ongoing pricing pressures, while oncology and immunology franchises held near prior-year levels. Adjusted EPS beat the Street, buoyed by operational efficiency and one-time gains, and management maintained its full-year guidance for upper-end adjusted diluted EPS despite the top-line shortfall.

CEO Albert Bourla said discontinuing the oral GLP-1 agonist danuglipron was the right decision for the company after a patient in a dose-optimization study developed liver injury.

He added that Pfizer would build our cardiometabolic pipeline, including in obesity, by advancing internal programs such as our GIPR antagonist and pursuing external opportunities that could include partnerships or acquisitions. That strategic pivot comes as shares slipped in mid-April following the trial setback, underscoring investor appetite for growth beyond COVID-era products.

To bolster margins and fund new R&D bets, Pfizer also announced an extra $1.2 billion in cost savings through 2027, on top of $4.5 billion targeted by the end of 2025. The combined $5.7 billion program will focus on streamlining operations and cutting non-core expenses, management said, freeing up cash for potential dealmaking and pipeline expansion.

Investors will be watching closely whether external partnerships or acquisitions can fill the obesity-drug void and sustain revenue growth as pandemic tailwinds wane. With Q2 results due late July and a 2025 Investor Day on the horizon, Pfizer's ability to translate its strategic reset into concrete pipeline and financial gains will be critical for its next act.