There are still plenty who think the industry still hasn't made the necessary changes, including Rea.
"There are companies that have embraced the need to change, but they are not typical - the norm is a company staring at the need to do things differently, but continuing to do the same while they're afraid to take the leap," he told CNBC.
One key shift in mindset has been towards curing rarer diseases, with smaller patient populations, as governments have sped up the approval process for conditions where there is no existing treatment.
"Many more products whose market ambition is a niche have hit the market. There has also been a tremendous change in the regulatory groups, who have brought about a new mindset with accelerated approval pathways," Rea said.
Yet these treatments are often priced according to their rarity, causing problems for insurers and governments, depending on who is funding healthcare systems.
"Although these important treatments are coming through, how many healthcare systems are going to be able to pay for them? We need more innovation in the commercial model, too," Pisani argued.
Alarmingly, there have been some areas where big pharma has almost entirely exited the stage, believing that there was little profit or innovation to be found – antibiotics is one of the most immediately concerning examples of this.