According to "The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States," published in the Public Library of Science Medicine, pharmaceutical companies spend double the amount of money on marketing efforts as they do on research and development for new products.
To come to this conclusion, the study's authors, Marc-André Gagnon and Joel Lexchin, analyzed the 2004 data from IMS, a pharmaceutical market intelligence firm, and CAM, a market research company. What the data suggested was that at minimum, pharmaceutical companies in the United States spend $57.5 billion on marketing-related activities and $31.5 billion on R&D. (2004 was used as a benchmark because it was the latest year in which comparative data was available.)
CAM collects its data through surveys of primary care providers and specialists, as well as by averaging the cost of sales rep visits. IMS surveys firms and monitors products. Essentially this system partially relies on the honor system, assuming that the companies will provide accurate information.
However, as the authors explain, "[t]here are other avenues for promotion that would not be captured by either IMS or CAM." In order to promote their products, for example, drug companies give out free samples, send drug representatives to doctors in order to promote their products, advertise directly to consumers, and conduct email promotions. However, other more controversial — and often unaccounted for — activities include ghostwriting in medical journals, the use of off-label marketing, as well as conducting "seeding trials," which have little to no scientific value.
What the authors conclude as a result of their findings is that the industry is founded upon marketing and promotions, just like every other profit-seeking company is. Even if they try not to admit it. As Gagnon and Lexchin state, the results of the study "confirm the public image of a marketing-driven industry and provide an important argument to petition in favor of transforming the workings of the industry in the direction of more research and less promotion."
