Pfizer turned in a better-than-expected fourth quarter, boosted by products outside the drugmaker's slumping COVID-19 vaccine and treatment.

The New York drugmaker also said Tuesday it's reaffirming its forecast for 2024, a month after surprising Wall Street with an initial outlook that missed consensus.

In the fourth quarter, Pfizer said it booked 8% operational revenue growth outside its market-leading COVID vaccine, Comirnaty, and treatment, Paxlovid. That excludes the impact of foreign exchanges.

Comirnaty sales tumbled 53% in the quarter to $5.4 billion, and Pfizer took a $3.1 billion hit from Paxlovid for a revenue reversal. That was tied to the return of unused treatment courses that had been purchased by the government.

The vaccine and treatment helped push Pfizer past $100 billion in sales for 2022. But a big sales drop was expected after the drugmaker switched last year to selling on the commercial market instead relying on bulk government contracts.

A Pfizer spokeswoman said the company expects to start recovering some of that revenue reversal from Paxlovid this year. Pfizer will contribute to a government stockpile of treatment courses and help establish a patient assistance program.

Overall, Pfizer lost $3.37 billion in the final quarter of 2023 after booking a nearly $5 billion profit in the same quarter the prior year. But earnings adjusted for one-time items came to 10 cents per share.

Analysts had expected a loss of 18 cents per share, according to the data firm FactSet.

Pfizer's total revenue fell 41% in the quarter to $14.25 billion. That missed the consensus expectation for $14.37 billion.

For the full year, Pfizer earned $2.1 billion on $58.5 billion in total revenue.

The drugmaker says it still expects 2024 adjusted earnings to range between $2.05 and $2.25 per share.

Analysts expect $2.27 per share this year. But Wall Street expectations also are dialed back now from previous consensus forecasts made last fall for earnings per share of $3.17 or more.

Pfizer debuted its 2024 forecast in December. It included sales expectations for its COVID-19 products that fell more than $5 billion short of expectations. The company said then that it was starting conservatively to avoid creating any more uncertainty.

The company had previously scaled back its sales expectations for 2023, which sent Pfizer shares plunging and contributed to a rough year for the stock.

Pfizer Inc. shares rose about 3% in early trading Tuesday.