KEY THOUGHT: According to the Times “We’re in a world where we need leaders to improve the state of the world, not just the state of the bottom line,” Marc Benioff, the co-chief executive of Salesforce, said in an interview. “Every C.E.O. has this on their mind right now.” Does this apply to pharma CEOs?

Merck on Tuesday reported second-quarter earnings and revenue that easily beat Wall Street’s expectations and narrowed its earnings and revenue forecast for the year. On the other hand, a group of parents brought the ashes of their dead children to a Sanofi in Massachusetts to protest the cost of insulin. They said the company, Sanofi, helped cause the deaths of their diabetic children, who had to ration their insulin when they couldn’t afford to pay as much as $1,000 a month for the vital hormone.

Last month, the Business Roundtable, a group of influential chief executives, sought to redefine the role of business in society. “Companies, and by extension their management teams and their C.E.O.s, have a moral obligation to try to be a force for good,” Dan Schulman, the chief executive of PayPal, recently said. “I don’t think there’s any way that we can shirk that responsibility, and I don’t think there’s any way to fully stand away from the culture wars around us.”

The optimists in our industry point to the fact that people will cancer are living longer and cures for HepC and longevity for HIV positive patients. Pessimists point to the fact that too many people still can’t afford their prescription medications as pharma CEOs earn a LOT of cash based on financial performance.

I guess I was raised in a different time. There is no way that I could take home millions of dollars in compensation knowing that people are strugeling to pay for their medicines. You could point to the fact that a lot of chronic health problems are the result of our own for health habits but today people don’t want to hear that.

If pharma wants to win back the trust of the public someone has to step forward and say “we are going to ensure that people who can’t afford our drugs will get them”. The financial assistance programs, currently offered by almost every pharma company, are a total bureaucracatic mess. It’s time to step forward and say “enough is enough” and simplify the process.

“Companies need a mission statement that is concrete enough to describe what they will do, as well as what they won’t do,” said Brad Smith, Microsoft’s president and chief legal officer. “If you promise too much, you risk having something that’s meaningless.”

“At the end of the day, it’s still mostly about stock price if you’re a public company C.E.O.,” When the rubber meets the road and you’re sitting in the room with investors, they are looking at spreadsheets and asking you about what the numbers are going to look like.” The problem with that approach is that patients and caregivers are too often left behind.