> I think it demonstrates pharma has excess cash. It's only "excess cash" if you assume the ROI on marketing is negative, which is a bold and unsubstantiated

> I think it demonstrates pharma has excess cash. It's only "excess cash" if you assume the ROI on marketing is negative, which is a bold and unsubstantiated claim. > Also in countries where there’s a public system pharma usually has 0 advertising because people have no choice anyway. Direct-to-consumer advertising is only one tiny portion of marketing. European pharmaceutical companies spend massive amounts of money on marketing within Europe.