Pfizer has a new playbook for reviving sales—and it’s starting to pay off

So last year the company created a phone line for doctors and patients to call Pfizer directly for help. Pfizer now credits that and other changes for a 31% increase in Nurtec’s U.S. sales last year.

The beleaguered drugmaker’s shares still haven’t recovered from their post-Covid slump, and shareholders are wary. But sales of products such as Nurtec and the vaccine Abrysvo that the company has been counting on are rising, and an activist shareholder’s push has lost steam.

Pfizer did it by shaking up its U.S. sales strategy, shifting where it deploys its sales representatives, how they market to doctors and how the company helps patients pay for their prescriptions.

Nurtec sales have picked up. The drug delivered $1.2 billion in U.S. revenue last year, up 31% from 2023.

Chief Executive Albert Bourla says the company is on an upswing, after Pfizer beat analyst estimates recently for the fourth consecutive quarter.

“Everything is clicking," Bourla said.

Pfizer made a big bet on Nurtec. The drug was the crown jewel of an $11.6 billion deal that closed in 2022. Analysts estimated the medicine would ring up $4 billion in yearly sales by 2030, revenue Pfizer was counting on as sales from older products faded.

But Nurtec sales under Pfizer got off to a disappointing start. It was Pfizer’s fault, said Peter McAllister, a neurologist and co-founder of New England Institute for Neurology and Headache, one of the country’s biggest prescribers of migraine drugs, in Stamford, Conn.

“Instead of really getting out there promoting" Nurtec, he said, Pfizer “made it an orphan stepchild of their cardiovascular division. They assigned reps and people who really had priorities that were not in the headache space."

Aamir Malik, who began leading Pfizer’s U.S. commercial business early last year, gave priority to turning around Nurtec. “We felt like there was a lot more that could be done," he said.

Peter McAllister, a neurologist, says Pfizer has put more emphasis on its migraine business than it did a few years ago.

Pfizer revamped its sales approach. It shifted dozens of reps—the salespeople who call on doctors—to the eastern U.S. from the West. The reason: Many of the more than 800 migraine specialists and headache centers like McAllister’s are there.

The company also encouraged the reps to spend more time with doctors, especially those who prescribed a lot, to explain the drug’s benefits and answer questions. It told the reps to dial back the virtual sales meetings that had increased during the pandemic and to see doctors in person—and for longer. It tied employee bonuses to meeting with frequent prescribers, rather than with doctors broadly.

McAllister sees a difference. “They needed to get reorganized and to put more emphasis on it, and I’m seeing that now," the doctor said. McAllister has consulted for migraine drugmakers, including Pfizer.

Another reason that physicians weren’t prescribing Nurtec: reimbursement. Health plans tend to restrict coverage of migraine drugs, requiring patients to try older, less expensive medicines first and doctors to fill out paperwork. Doctors weren’t prescribing Nurtec figuring plans wouldn’t cover it.

Pfizer began offering help. It set up a website to explain to patients what insurance policies say and how they can get financial support. It created a toll-free hotline for doctors and patients to ask for help navigating prior authorization and other insurer restrictions. Its reps gave doctors such as Alan Finkel, a neurologist and co-founder of the Carolina Headache Institute in Durham, N.C., pamphlets breaking down insurance policies.

The company’s efforts help him and his office navigate health coverage that is complicated “because there’s a lot of caveats," Finkel said. He has consulted for migraine drugmakers, including Nurtec’s developer.

Nurtec sales have picked up. The drug delivered $1.2 billion in U.S. revenue last year, up 31% from 2023.

Abrysvo, Pfizer’s shot for a respiratory virus known by its initials RSV, was supposed to build on the company’s success with a Covid-19 vaccine. Analysts expected a blockbuster with yearly sales reaching some $2 billion.

Pfizer’s RSV vaccine Abrysvo in the manufacturing process.

But a rival RSV shot, GSK’s Arexvy, got off to a better start. To catch up, Pfizer overhauled how it packages, sells and distributes vaccines.

The company improved the shot’s vial after pharmacies and hospitals complained that the vaccine used up too much refrigerator space and took too long to prepare. Pfizer redesigned the vials to make them easier to store and use.

The company had been selling Abrysvo alone, rather than bundled with other company shots. Yet pharmacies—where most RSV vaccines are given—found buying bundles of vaccines to be more convenient. And Pfizer, by bundling vaccines together, could compete on the breadth of its offerings, rather than simply price.

Pfizer poached workers from rivals who knew how to write vaccine contracts and bundle shots. The company began offering pharmacies a package including Abrysvo and Prevnar, Pfizer’s big-selling pneumonia shot.

Abrysvo’s share of vaccine administration in retail pharmacies increased to 43% during the RSV season last year, up from 32% during the period in 2023, according to prescription data-tracking firm Iqvia. By the second half of 2024, Abrysvo had a 48% share in pharmacies and other locations, Pfizer said. Abrysvo sales have pulled roughly even with those of GSK’s Arexvy.

Write to Jared S. Hopkins at jared.hopkins@wsj.com