Its also golf trip and all expense paid vacations for doctors who prescribe certain drugs.

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

How much of that $9.4 billion includes activities like these?

According to a 2009 CBO report[1], direct-to-consumer (DTC) accounted for about 1/4 of total promotional spending (not counting the retail value of free samples to doctors, which, if included, would cut the DTC fraction in half). And that apparently doesn't count aspects of "marketing" that are not related directly to promotion (though it's hard to see how CBO or anyone else would draw a clean distinction there). It was also dropping in both relative and absolute terms as the number of new drugs with broad patient appeal tailed off.

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'm a little confused. Which category in that report represents figuring out what drugs will be needed in the future and whether they're worth developing?

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.