CASE STUDY
They Were Still Prescribing. They'd Just Stopped Believing. How a 30-Day Sprint Rebuilt the Case for a Brand That Had Lost the Room With Its Most Important Physicians.
THE SITUATION
A top-5 pharma brand holding strong commercial coverage and growing revenue — but losing meaningful ground among its highest-volume, most commercially critical prescribers, where competitor preference had pulled even or ahead for the first time.
THE SPRINT
30-day engagement — fact-finding interviews with field and internal stakeholders, synthesis of market research and prescribing data, cross-industry ideation, and a full-day in-person workshop with 50+ participants followed by two virtual concept evaluation sessions.
THE OUTPUT
6 concepts spanning field engagement, HCP community building, messaging strategy, and category leadership — all 6 moved to next-steps planning.
A top-5 global pharmaceutical company managing a blockbuster oral therapy in a competitive neurological category — one with strong clinical differentiation, broad commercial coverage, and a loyal prescriber base across most of the market. The brand had crossed the billion-dollar threshold and was one of the company's named growth drivers. The challenge wasn't the product and it wasn't the category. It was a specific segment: the highest-volume, most clinically sophisticated prescribers in the space, whose preference had fractured in a way the rest of the market hadn't. This was the second Deliberate Sprint engagement for this brand team, following an earlier Sprint that had generated concepts around a separate commercial challenge — a track record that made the methodology the team's first call when this one surfaced.
01 — THE CHALLENGE
Every other prescriber segment favored the brand. This one didn't.
The top-prescribing segment — a relatively small group of physicians responsible for a majority of the brand's total prescription volume — had been slipping. Not dramatically, not all at once, but consistently quarter over quarter. What the data showed was unusual: across every other prescriber group, the brand held a clear head-to-head preference advantage over its main competitor. Among the top segment, there was no consensus. These physicians weren't leaving. They were splitting — writing for both brands at rates that reflected genuine uncertainty about which deserved the script, not a reasoned clinical preference in either direction.
The drivers weren't simple. Nearly half of these physicians had experienced a change in their sales representative relationship within the previous year. The brand's competitor had built a measurable advantage on category leadership perception — on the concept of being the definitive voice in the specialty — that the brand hadn't matched. And inside the commercial organization, marketing and sales held meaningfully different views of what was actually causing the problem, which had made it difficult to align on what to do about it.
OPPORTUNITY AREA 1
How might we reverse the decline in the top-prescribing segment so that we can restore and grow the business?
OPPORTUNITY AREA 1
02 — WHAT WAS IN THE WAY
Four different problems wearing the same label.
The first barrier was relationship continuity. A high proportion of the top-prescribing physicians had seen their primary commercial contact change, and for a segment that expected sophisticated, credible engagement — not standard detailing — that turnover had compounded into a credibility deficit. These physicians didn't just want scientific fluency; they expected it. A new rep, however capable, started without the accumulated trust that translated into prescription behavior.
The second was a positioning problem in the prevention indication. The competitor had built a coordinated portfolio strategy — separate, targeted solutions for acute and prevention — that gave their brand a sharper claim on each indication in the prescriber's mental model. The brand in question covered both indications in a single product, which should have been an advantage but had become a liability: physicians couldn't clearly articulate what it was the definitive choice for, which meant they didn't reach for it first.
The third was a presence gap at the category level. Across physician perception data, the competitor held a significant lead specifically on "migraine leadership" — not on clinical data, not on efficacy, but on the idea of who was driving the conversation about the disease. Pfizer had been less visible at key congresses and in the peer-to-peer channels where specialty opinion gets formed. That absence had accumulated over multiple years and wasn't going to close with a better detail.
The fourth was internal misalignment. Field leadership and marketing read the root cause differently — some saw it as a field execution problem, others as a messaging problem, others as a structural competitive problem — and that disagreement had prevented the team from committing to a single theory of the case and building around it.
03 — THE SPRINT
Thirty days. Fifty voices. One challenge that had been named but not solved.
The engagement opened with structured fact-finding — interviews with sales representatives, area business managers, commercial insights leaders, and marketing and field leadership — designed to map where internal perspectives diverged before any solution work began. That alignment session surfaced four distinct opportunity areas that shaped the entire engagement: reclaiming the prevention indication, deepening the quality of engagement with the top-prescribing segment, rebuilding the field's competitive mindset, and reigniting the brand's visible presence in the category.
Existing research was mined before anything new was commissioned. Market research, prescribing data, field observation notes, ATU tracking, and competitive analysis were synthesized to understand where the preference gap was most acute, what was driving it in each sub-group of the top-prescribing segment, and which interventions had and hadn't moved the needle in the past. That synthesis shaped twelve directional starter ideas, developed with cross-industry innovators and reviewed with the core commercial team before participants ever saw them.
The full-day workshop in New York City brought together more than 50 participants — field representatives, area business managers, commercial leadership, marketing, medical, and above-brand functions, including a virtual team participating remotely in real time. Six breakout teams worked simultaneously across four opportunity areas, building concepts from pre-constructed stimulus rather than starting from a blank page. Two virtual evaluation sessions in the following week allowed the full group to score, stress-test, and sharpen all six concepts against a defined set of criteria before any moved to execution planning.
The entire sequence — from fact-finding through final concept evaluation — ran in 30 days.
50
Participants across commercial, field, medical & above-brand functions
6
Concepts developed across four opportunity areas
6
Concepts moved to execution planning
04 — WHAT CAME OUT
Six concepts. Four opportunity areas. A complete picture of what it takes to win back a segment.
Concept 1 addressed the field credibility gap — the absence of a structured model for pairing acute and prevention expertise in a way that matched the clinical sophistication the top-prescribing segment expected from every commercial interaction.
Concept 2 addressed the execution consistency gap — the need for a clear, repeatable framework that gave field representatives a defined playbook for high-stakes conversations with the top segment, rather than relying on individual judgment.
Concept 3 addressed the NP/PA influence gap — the opportunity to engage the advanced practitioners embedded in high-prescribing practices as a distinct channel with distinct educational needs, not as a secondary audience to the physician.
Concept 4 addressed the category presence gap — the absence of a structured forum where the brand could rebuild its standing as a credible voice in shaping how the specialty thought about migraine care, not just how it thought about this product.
Concept 5 addressed the field intelligence gap — the mismatch between the segmentation data the commercial organization held and the actionable guidance field representatives actually had access to when building their approach to individual physicians.
Concept 6 addressed the messaging complexity gap — the accumulated weight of clinical storytelling that had made the brand's message harder to internalize and deploy than its competitive position warranted.
05 — WHAT MOVED
An execution problem turned out to be a presence and standing problem.
The commercial team entered the engagement with a largely shared belief that the problem was tactical: messaging had gotten complicated, field execution had gotten inconsistent, and the competitor had found a positioning angle that was working. All of that was true. None of it was the whole story.
What the Sprint surfaced was that the preference collapse in the top-prescribing segment wasn't primarily about what representatives were saying in the room. It was about whether the brand — and the company behind it — had earned the standing to be taken seriously as a category leader by the physicians who cared most about that distinction. These physicians tracked who showed up at congresses, who ran the peer-to-peer conversations, who was shaping how the specialty thought about disease management. On all of those dimensions, the competitor had built a meaningful lead that better field execution alone couldn't close.
The reframe: the team had been trying to win a detail when they needed to win a relationship, a presence, and a narrative. All six concepts moved to execution planning. The shift from "how do we improve what our reps are saying" to "how do we rebuild the standing that earns the conversation in the first place" was the change that made a coordinated response possible.