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Your second article is very sketchy. It basically evaluates two different sources for various categories of promotion, takes the larger number of the two in each category, and adds a $15 billion vaguely-defined "unmonitored promotion" category. Some of the underlying expenses should not even be counted as "promotion." A quarter of the $60 billion is free samples, which generally are ultimately given out to patients. Other estimates put free samples at more than half the cost of drug "marketing": https://en.wikipedia.org/wiki/Pharmaceutical_marketing.

A better way to look at it is R&D expenditures as a percentage of revenue: https://blogs.sciencemag.org/pipeline/archives/2013/05/20/ho.... (That is, after all, what we care about at the end of the day--what customers are paying versus what is invested in future development.) Drug companies are in the same ballpark on that metric as tech companies, spending 10-20% of revenues on R&D.




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