From Misalignment to Market Leader: How Open Water Helped Set the Stage for a $13.3B Blockbuster
Unlocking growth through alignment
Turning misalignment into success
Sparked breakthrough growth
The same team that launched the brand was the one that turned it around. Once trust was established, we could take bold steps with confidence. The rest is history.
Tolga Tangular, Former President of Rare Diseases, Pfizer, USA
When Pfizer partnered with another global pharmaceutical company to bring a next-generation anticoagulant to market, the opportunity was enormous. The drug had the potential to change the lives of heart and stroke patients worldwide. Yet, despite its clinical promise, it was failing to gain traction in the market.
The challenge wasn’t the science – it was alignment.
Pharmaceutical drug development is a high-stakes game. Costs run into the billions, timelines span decades, and even the most promising therapies face steep commercial hurdles. Pfizer had entered into an alliance to share both the financial burden and the rewards of this new product. But while the partnership made sense on paper, it was faltering in execution.
The disconnect was clear:
• Competing Commercial Approaches – The two companies had different strategies for launching and positioning the drug.
• Internal Misalignment – Even within Pfizer, teams were not fully invested in the product.
• A Lack of Trust – Decision-making was fragmented, slowing progress and undermining momentum.
As Tolga Tangular, Former President of Rare Diseases at Pfizer, put it:
"Everybody expected this product to succeed, but there was no shared clarity on how to get there – not just between the two companies, but even within our own teams."
Pfizer engaged Open Water to align leadership, build trust, and instil a shared sense of ownership. Our role was to lay the foundation for long-term success by shifting mindsets, fostering collaboration, and ensuring the alliance could operate as a high-performing team:
1. Creating Internal Alignment at Pfizer
Before the alliance could work together effectively, Pfizer’s own teams needed to take full ownership of the drug. We helped shift internal perceptions, ensuring they saw the product as integral to their portfolio rather than just a co-developed asset.
2. Establishing Trust Between Organisations
Through confidential interviews and leadership coaching, we surfaced unspoken tensions and roadblocks. By addressing these early, we helped leaders move from a transactional partnership to a collaborative alliance.
3. Designing a Clear, Collaborative Roadmap
Open Water facilitated intensive workshops that enabled the alliance to develop a shared commercial strategy. A phased market approach was introduced – targeting cardiologists first before expanding to primary care.
4. Instilling a Winning Mindset
One of the biggest barriers was belief. Neither company truly saw the drug as a category leader. By shifting their internal messaging and creating a culture of shared ambition, we helped the alliance move from skepticism to confidence.
The results were transformative:
• Cultural Shift – The alliance moved from a blame-based culture to one of shared ownership and trust.
• Clear Strategy – A targeted, phased approach streamlined decision-making and execution.
• Mindset Transformation – Leaders and teams believed in their product – and that belief drove market success.
• A Strong Foundation for Growth – The alliance team became aligned and equipped to execute with clarity.
At the time of Open Water’s engagement, the drug was generating $1 billion in annual revenue. By helping the alliance reset its approach, we enabled the conditions for future success. Over the following decade, the product continued to gain momentum, becoming one of the world’s top-selling drugs, reaching $13.3 billion in 2024.
"The same team that launched the brand was the one that turned it around. Once trust was established, we could take bold steps with confidence. The rest is history."
Tolga Tangular, Former President of Rare Diseases, Pfizer, USA
The work done at the time helped remove the internal barriers holding the product back, allowing the alliance to build on this momentum in the years that followed. Today, the brand continues to evolve and expand – something that wouldn’t have been possible without the strong foundation established during Open Water’s intervention.
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From Misalignment to Market Leader: How Open Water Helped Set the Stage for a $13.3B Blockbuster
Unlocking growth through alignment
Turning misalignment into success
Sparked breakthrough growth
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