A Moderna vaccine production facility in Massachusetts.
Credit: Maddie Malhotra/The Wall Street Journal

Healthcare companies that came up with effective Covid-19 vaccines, treatments and tests are seeing a huge financial payoff and are starting to spend their cash, while grappling with questions about whether the growth is sustainable.

Companies including Pfizer Inc. and Moderna Inc. so far have reported at least $79 billion in combined global sales of Covid-19 vaccines and treatments for 2021, according to a Wall Street Journal review of recent earnings reports. Diagnostic sales also have been strong for companies including Abbott Laboratories, which had $7.7 billion in Covid-19 test sales last year.

It’s a market that didn’t exist prior to the pandemic. Many companies attempted to find pandemic countermeasures during 2020 but only some were successful.

Sales from the resulting products kicked into high gear in 2021, strengthening profits while adding to cash reserves.

Some companies are investing the windfalls in employee bonuses, share repurchases, internal research efforts to develop new drugs and vaccines, or pursuing acquisitions of other companies to bolster research and development pipelines.

But sales are already 

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