There are two niches in which your analysis is incomplete. First, There are underdiagnosed diseases for which patients don't seek care, sometimes because they

There are two niches in which your analysis is incomplete. First, There are underdiagnosed diseases for which patients don't seek care, sometimes because they do not believe there to be a treatment. The lack of treatment means that it isn't as vital for physicians or patients to pursue diagnosis. Those patients might see an ad and return to a physician to ask if that treatment is a fit. Second, not all physicians are as on top of new treatment options as we expect. It might have slipped their notice or be in a field with which they aren't the most familiar, and those patients might benefit from revisiting whether a new treatment is a good fit. I don't really think these two cases make up for all of the advertising, but they might be missed if advertising is cut or abolished. It might have some fairly large drawbacks, but I think it would be good for pharma and biotech companies to put some amount of money into a fund based on the disease and have awareness campaigns around the diseases. For example, companies with diabetes treatments could form a group that puts out diabetes ads urging patients to talk to their physicians. It gets dicey for first-in-market treatments, but I think it would be an overall improvement from the current system. Disclaimer: I work in big pharma biology research; pricing and advertising are done in a fancier building with more marble floors, so I've thought about this a bit, but it isn't my department.