nice to see a bit of discussion sparked up on this!I'd go with one of the suggestions above about going to a niche consultancy if that is the area you really want to focus on, a larger one may have pharma clients but there is a very real chance you won't get to touch these due to resourcing needs on other projects. At least until you have gained a bit of credibility and can start to request certain transfers (and get them approved!)Just to go back to some of the points comparing Cap, IBM, Big 4, Bain etc. I'd break it down as...1. Bain, BCG, BOOZ, OW 2. Deloitte, EY, PWC Accenture (although they are an Systems Integrator and not a real consultantcy ;) ! )3. KPMG, Cap, IBM et alThe problem when you move down towards IBM (in my opinion) is it's too heavily sales focused and tied to a single product removing the ability to offer unbiased client advice