NEW YORK - Pharmaceutical companies have an image problem. Some seem to be starting to care more about it.

Pfizer Inc. collects more money from prescription drugs than any other company on the planet, with 2012 total revenue of $59 billion and net income of $14.6 billion. Finances are part of the dilemma the drugmaker tried to address this week when it invited reporters to its headquarters to listen to company leaders discuss improvements to research and development of vaccines that save lives and prevent diseases that can cripple children and ravage societies.

"Frankly," Pfizer chief executive officer Ian Read said in his opening remarks, "what we do, we believe, is important to society."

Before taking a few questions from the 18 reporters, several from London-based media, assembled at Pfizer's Midtown headquarters, Read discussed the issue of image. Fixing that image, of course, would serve Pfizer financially.

"There is a contract between the industry and society," Read said.

Patent rights, Read said by way of example, might be based on innovative research, but are conferred upon companies by governments, partly with the expectation that their holders will do right by the community.

"In the end, what we sell is confidence," Read said. "We sell that we've done the research, done the clinical trials; that the data is done to a very high standard and is believed. The trust in society on quality is important to us. This trust is not where it ought to be."

Some Pfizer employees involved in vaccines operate from Collegeville, Montgomery County.

This is not a great time for a decline in trust, not for a profit-driven industry reliant on sometimes-blind customer confidence. There is endless discussion in America about reducing the cost of health care. But Wall Street and shareholders demand rising profits and steady dividends.

Multibillion-dollar financial penalties and criminal convictions, often tied to promoting drugs for unapproved purposes, don't help.

Drug industry leaders, including Pfizer officials at Tuesday's meeting, said the entrepreneurial spirit inherent in a for-profit enterprise leads to innovative medicine, which should also bring financial reward.

Read's 2012 compensation, by the way, was $25 million, according to Bloomberg News.

Industry leaders are quick to say that the most efficient of the health-care sectors is pharmaceuticals. The industry represents only about 10 percent of the health-care-spending pie, and greater adherence to medication plans by patients would curtail costlier hospitalizations. But the payers - public or private insurers in America, or governments in much of the rest of the world - are looking at all sectors.

Individuals - even if they smoke, fail to eat properly, and don't exercise - are often more aware of drug costs if they hand over co-pays at the pharmacy counter and face higher deductibles in their insurance plans.

"There is a perception gap," Read said of image vs. the great value of good medicine. "It is vital to close that gap if this industry is to enjoy the support of society."

Many developed nations already have greater price controls than the United States. Drug companies hoped that the expanding middle-class populations in India and China would lead to greater use of the medicines they produce. But China's recent crackdown on drug companies, notably GlaxoSmithKline, is seen by some industry analysts as one way of controlling costs. Meanwhile, India has been waging more public patent fights with brand-name drugmakers so cheaper generics can be produced and sold there.

In the United States, there is a slow and shaky shift to a different health-care model - a more holistic, patient-centered model that measures outcomes rather than a string of fees for services. But how those outcomes will be measured differently than in the past is an open question.

Susan Silbermann, president and general manager of Pfizer vaccines, said the company was trying to find ways to show more of the value it already delivers.

"We save lives," Silbermann said.

Although the price matters, vaccines that prevent horrible diseases or that reduce infections that prolong expensive hospital stays would seem to be a cost-effective tool.

Emilio Emini, the senior vice president of vaccine research and development, lives in Montgomery County and works mostly from Collegeville, though he travels quite a bit. He has been working on vaccines for 30 years.

"It is always better," Emini said, "to prevent a disease than to treat a disease."