Neil Turner

In 2003, Big Pharma produced only a dozen new drugs. At the same time, it came under new pressure to create value from those thin pipelines. In that "hot squeeze" of a climate, pharma companies needed price premiums for every product in every market. They were more successful in some countries than in others. Other pricing trends also took their toll.

A jittery stock market, repeated profit warnings, concern about accounting practices, another industry mega-merger, and a new raft of legislative proposals. Small wonder that US analysts find it difficult to separate the words "troubled" and "pharmaceutical industry."

While making small talk at a party, a new acquaintance asked a senior pharmaceutical executive what line of business he was in. "I work for a multinational pharmaceutical company," he replied.