The revelation that Novartis AG was linked with the Donald Trump/Michael Cohen/Stormy Daniels scandal is but one example of the pharmaceutical industry’s ongoing reputational crisis. Whatever the outcome, the controversy will further erode the public’s trust in pharmaceutical manufacturers. The timing could not be worse, given the increasing threat of price controls. Do pharma executives truly grasp the extent of the industry’s image problem? The implications are profound. Explore why this issues encompasses so much more than a single misstep and, instead, presents a challenge the industry as a whole must grapple with.