TRENTON, N.J. - Strong sales of blockbuster blood thinner Plavix helped Bristol-Myers Squibb Co. post a sizable fourth-quarter profit Tuesday, beating Wall Street's profit forecast and showing resilience amid the recession.

The drugmaker also said it expects to see some patients and payers cut back this year on drug spending because of the economic slowdown, but that it's less affected than some of its peers.

The New York-based maker of Abilify for bipolar disorder and Avapro for high blood pressure reported net income of $1.24 billion, or 63 cents per share, in the October-December quarter. A year ago, Bristol-Myers reported a net loss of $89 million, or 5 cents per share, due to large charges for restructuring and losses from investments in subprime securities.

Excluding a host of one-time items totaling a gain of 17 cents, or about $340 million, fourth-quarter profit would have been 46 cents per share. Those items included $260 million in payments to partner biotechnology company Exelixis Inc., $151 million for restructuring and an $870 million gain after expenses for selling Bristol's ImClone Systems Inc. stock after losing its bid to buy ImClone to rival Eli Lilly & Co.

Revenue totaled $5.25 billion, up 4 percent from $5.06 billion in 2007's fourth quarter. U.S. pharmaceutical sales rose 13 percent, but foreign sales fell 9 percent due to unfavorable currency exchange rates, which pulled down the overall revenue by 4 percent, the company said.

Analysts polled by Thomson Financial expected, on average, earnings per share of 41 cents and revenue slightly higher, at $5.43 billion.

Analyst Les Funtleyder of Miller Tabak & Co. said the company's business operations appear to be improving and cost controls are strong. Bristol-Myers plans to cut $2.5 billion out of its annual expenses and has already closed manufacturing plants and eliminated a significant number of jobs, although it will not specify how many.

Chief Executive Jim Cornelius told analysts during a conference call that the company's 2009 forecast reflects the fact that patients and government health agencies may have less money to spend on medicines this year because of the global recession.

"We should be less affected than others" in the industry, he said, because "we don't have lifestyle products" or secondary treatments for diseases.

"We are a little bit less negative about the short-term outlook than others," Cornelius added.

In trading Tuesday, Bristol-Myers shares rose 88 cents, or 4 percent, to $23.13.