If people could instantly know about which drugs are relevant to them, or doctors meticulously searched the literature for all available treatments for all patients, then alerting the world about the existence of your new drug would be a complete waste. But we don't live in that world.

If pharmas really are offering identical products, that's a problem of creating unnecessary drugs, not marketing per se, and would be exposed when the relevant people make the cost benefit calculation.

Not true at all: Could you sit in an empty, white-walled room and tell us exactly which new drugs will be needed over the next decade and how they will appeal to doctors and different patient groups? Whether they'll be worth developing at all? How existing patients on inferior (or no) treatments will find out about them without you spending a nickel?

Marketing is not just ads.

As a society, marketing more than useless. It manipulates and confuses actual knowledge.

Even if you think DTC is worthless or actively harmful, surely there's some value in marketing to (nominally) informed, expert doctors and insurers, unless you think marketing anything is an essentially fraudulent or worthless activity. Would Ford or their potential customers be better off without marketing? What makes drugs any different?

[1] http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/105x...

I don't think marketing is either fraudulent nor worthless, but it is a tragedy of the commons these days. People have more than enough tools at their disposal to discover the products they want and need to buy on their own. Marketing by an individual entity is useful and necessary, but the whole field is just pointlessly rearranging the chairs. We'd all be better off if we could somehow all agree to quit it, at least the fluffy parts that convey only emotion and not information.