Ever since its cholesterol-fighting drug Lipitor lost the crux of its patent protection back in 2011, Pfizer Inc. (NYSE:PFE) investors have approached PFE stock with caution. And, perhaps for good reason. Though the PFE stock price has almost doubled since generic versions of Lipitor were introduced (bear in mind Pfizer shares suffered plenty before the drug fell off the patent cliff), revenue only began to grow again last year.

Investors remain a little unsure, even the ones that were willing to take a shot on it. Those fears, however, may be more than a little overblown in light of what the pharmaceutical giant’s got in the hopper.

In the Queue

Lipitor is a tough act to follow, to be fair. Launched in 1996, it’s amassed on the order of $150 billion in total revenue, easily making it the world’s most successful drug ever. At its peak, it accounted for roughly a quarter of the company’s revenue.

Now, it’s only producing a fraction of its former business, competing with generic statin rivals as well as alternatives like rosuvastatin and pravachol. You know them better as Crestor and Pravachol, made by AstraZeneca plc (ADR) (NYSE:AZN) and Bristol-Myers Squibb Co (NYSE:BMY). The list of alternative drugs — generic or otherwise — is lengthy. Ditto for the list of companies making them.

Fear not, however, fans and owners of PFE stock. Pfizer’s got some appreciable plans. One of those plans is the ongoing cultivation of breast-cancer-fighting drug Ibrance. It drove $878 million in sales last quarter, up 60% year-over-year.

That’s just the beginning though, at least according to Piper Jaffray analyst Richard Purkiss. Early this week, Purkiss made a point of saying sales of Ibrance is being underestimated, suggesting that rather than achieving just a little less than $7 billion in revenue in 2023, it could actually produce nearly $13-billion worth of business that year as its approved uses were expanded and caregivers saw its efficacy.

It’s not just Ibrance, though. Eliquis, Xeljanz and Xtandi lay the “beginning of an expected multiyear wave of potential new product launches and product line extensions,” as Chief Executive Ian Read put it in the most recent quarterly report. Purkiss also argues those therapies may be underestimated.

Pfizer has more in motion too, such as spinning off its consumer healthcare business. It’s not the first time PFE stock holders have heard the notion, but each time they hear it, the premise sounds a little more credible. Not only would such a deal fetch something on the order of $15 billion, it would shed a division that’s become something of a distraction to Pfizer’s core business and current competencies.

Such a sale could also help fund a long-rumored and much-needed acquisition of new prescription drugs. The aforementioned Bristol-Myers Squibb has been suggested as one possibility, and Biogen Inc (NASDAQ:BIIB) is another plausible possibility. Though Biogen’s present strengths are in multiple sclerosis and Alzheimer’s — arenas that aren’t quite in the middle of Pfizer’s wheelhouse at this time — both are opportunities Pfizer could readily manage.

However, things are moving even beyond whispered acquisition ideas that point to a larger shakeup. Come Jan. 1, Pfizer’s Innovative Health chief Albert Bourla will take over as Chief Operating Officer, a newly created role that will allow Read to “spend more time focusing on the company’s long-term strategic direction, ensuring continued R&D productivity and engaging with government policy and industry leaders on key issues facing the future of the healthcare industry.”

What that means to current and would-be owners of PFE stock still isn’t exactly clear. It could simply be the usual nondescript corporate cheerleading. But it could also mean that Read has a vision that wasn’t being fully realized until now.

Bottom Line for PFE Stock

The wheels are turning, so to speak, in a way they’ve not spun for Pfizer in a long while. Although the direction the pharmaceutical company is going isn’t entirely clear and certainly isn’t concrete, it’s in motion nonetheless. And, one can’t help but wonder if the relatively unclear ambitions are in and of themselves a sign that the changes coming are bigger than can be effectively described.

Whatever’s in the cards, even if Pfizer hasn’t yet earned a spot in your portfolio, PFE stock has at least earned a spot on your watchlist.

As of this writing, James Brumley did not hold a position in any of the aforementioned securities. You can follow him on Twitter.