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Comment by consumer451 | Hacker News Reader

Thanks for checking me on this. It was just what I recalled from memory, but I believe that the following links confirm this.

> The pharmaceutical industry devoted $83 billion to R&D expenditures in 2019. Those expenditures covered a variety of activities, including discovering and testing new drugs, developing incremental innovations such as product extensions, and clinical testing for safety-monitoring or marketing purposes [0]

> $6.56 billion spent on direct to consumer pharma advertising in 2019 [1], with nearly $8.1 billion spent in 2022. [2]

[0] https://www.cbo.gov/publication/57126#_idTextAnchor003

[1] https://www.statista.com/statistics/686906/pharma-ad-spend-u...

[2] https://www.fiercepharma.com/special-reports/top-10-pharma-d...

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In "clinical testing for safety-monitoring or marketing purposes", "marketing purposes" doesn't mean spending money on ads and stuff like that, it means doing clinical trials to see if a drug works for a certain disease or population, or to compare their drug against a competing drug, or whatever. This is the insanely expensive research that pharma companies do to see if drugs actually work, that everyone likes to ignore when talking about greedy pharma companies.

Results of clinical trials (if successful) can then be used in ads, but that would not be R&D expenditure.

Hmm, thanks. Now that I search more, I am not as sure of my original point.

However, could we agree that DTC pharma advertising has very controversial benefits for patient outcomes, at best?

I will agree with that, if we can also agree that pharma companies spend tons of money on clinical trials, and it's difficult to imagine where that money would come from if they didn't exist :)

Does it? What would those be?

In fact anything that pharma companies say about a drug must be information from a clinical trial. One of those little surprising but obvious in retrospect facts. Clinical trials must be designed not just to 1) find out whether the drug works, 2) find out whether it’s safe, 3) ideally avoid information that it’s not safe, but also 4) generate the numbers they can put on brochures to compare it against alternatives. Then all of those are balanced against the immense cost (to pharma) and complexity (to pharma, CROs, trial sites, and trial participants).

It’s a ludicrously complex business process.

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