In a speech preaching the virtues of healthcare reform last week, President Barack Obama could have been speaking directly about the fate of the big pharmaceuticals companies themselves when he said: “The status quo is the one option that is not on the table.”

The pharmaceuticals industry is on the edge of a precipice and investment banks, fired up after a sustained period of inactivity, are lining up to guide drug companies to safety through consolidation, picking up lucrative advisory fees in the process.