Pfizer’s chief executive, Albert Bourla, has embarked on an ambitious redirection for the pharmaceutical giant, channeling the company’s significant pandemic-era earnings into a concentrated effort to reshape cancer treatment. This strategic pivot, following the successful development of a COVID-19 vaccine, signals a profound shift in priorities, backed by a substantial $23 billion investment in 2023 aimed at new business development. Bourla, reflecting on the challenging period of 2023, characterized it as a year of immense difficulty, yet maintained a perspective rooted in resilience, stating that “winners always stand up again.”
The impetus behind this aggressive strategic shift is not solely altruistic; it is also a response to stark financial realities. While the COVID-19 pandemic propelled Pfizer to unprecedented heights, with sales reaching $100 billion and COVID-related revenues hitting $56 billion in 2022, the subsequent decline was sharp. By the following year, COVID-related revenues had plummeted to approximately $12 billion, a drop that significantly impacted the company’s stock performance. Adding to this pressure is a looming “patent cliff” set to begin in 2026, when several of Pfizer’s highly profitable drugs will lose their exclusivity. Bourla’s strategy, initiated even before the pandemic, prioritizes scientific innovation over consumer healthcare to navigate these impending challenges.
At the core of this strategy lies oncology, which now accounts for over 40% of Pfizer’s annual research and development expenditure. The objective extends beyond merely treating cancer; it aims for a dramatic improvement in patient outcomes. Bourla highlighted recent advancements, noting three or four studies in the past two years that demonstrated a doubling of survival rates in significant cancers such as bladder and prostate, alongside progress in colorectal cancer. He acknowledges that unlike the singular breakthrough of a vaccine, success in oncology will be a cumulative process, marked by incremental improvements rather than a sudden, definitive cure. The vision is to transform many cancers into manageable chronic conditions, akin to diabetes today. 
To accelerate these ambitious goals, Pfizer is adopting the “time is life” philosophy that proved instrumental during its pandemic response. Bourla observed a cultural transformation within the company, where employees shifted from outlining obstacles to actively seeking solutions. He recounted how, when faced with challenging requests, individuals initially tend to articulate reasons for impossibility. However, once the seriousness of the request is understood, this energy redirects towards finding pathways to achieve the seemingly insurmountable. Technology, particularly artificial intelligence and machine learning, has been pivotal in this acceleration. These tools significantly reduced the development time for the COVID-19 treatment Paxlovid, from an estimated four years to just four months, by enabling the design of molecules with higher success rates and fewer candidates.
Beyond oncology, Pfizer is also making significant inroads into the burgeoning obesity market. Following the setback of an internal oral GLP-1 candidate due to liver toxicity, the company pivoted to acquire Metsera, a clinical-stage biotech firm. Bourla described the acquisition process as a fiercely competitive bidding war, ultimately won by Pfizer after intense negotiations. He recounted a “10 days of wildness,” where the prospect of losing the deal loomed large, yet a deep-seated resolve, inspired by his mother’s resilience, pushed the team forward.
Bourla frequently draws inspiration from his mother, a Holocaust survivor whose unwavering optimism shaped his leadership philosophy. She viewed every obstacle as an opportunity and believed nothing was impossible, a perspective Bourla strives to embed within Pfizer. This enduring spirit, combined with a pragmatic approach to scientific advancement and market dynamics, underpins Pfizer’s substantial bet on cancer and other critical health challenges, including navigating political pressures to address drug pricing. His steadfast belief remains that with the right team and an optimistic outlook, “nothing is impossible,” even the monumental task of reshaping the future of cancer care.
