When business chief executives joined politicians and public officials gathered at the World Economic Forum in Davos last month, one group of industry leaders was noticeably under-represented: those from the pharmaceutical sector. Some regulars in previous years, such as Hank McKinnell, the outspoken former head of Pfizer, the world’s largest drug group, have lost their jobs. Others, like Richard Clark from Merck and Daniel Vasella from Novartis, pulled out at the last minute. The message was clear. At a time of investor dissatisfaction with their companies and employee disgruntlement at cutbacks, they would do better to stay in their headquarters and focus on internal problems rather than debate the broader issues of the world.

To many, it seems hard to believe that the drug industry - long spoilt by lavish revenues and little need for controls on spending - is in crisis. In fact, its current malaise is characterised by a series of problems.