In the UK, marketing drugs is illegal and therefore they don't need to go to that expense. All they have to do is convince an NHS board and then it's on the list of approved prescribed drugs.

Some similar claims I have looked at have used the "Selling, General, Administrative" off of an income statement as the marketing expense, but that category includes salaries and buildings and lots of other things, not just marketing expenses.

http://www.washingtonpost.com/blogs/wonkblog/wp/2015/02/11/b...

http://www.bbc.co.uk/news/business-28212223

Reading the BBC article reminded me of all the fines also. People are paying extra because drug companies push off-label uses on consumers and then get fined for it. It's not like the company really pays, they just up their prices a bit and push it onto the consumer. That sort of off-label usage doesn't happen in the UK so much, because doctors don't have any incentive to prescribe anything other than the NHS approved drug for a condition.

http://2013annualreport.jnj.com/sites/2013annualreport.jnj.c...

(linked from here: http://2013annualreport.jnj.com/financials )

In one place, it says this:

Advertising

Costs associated with advertising are expensed in the year incurred and are included in selling, marketing and administrative expenses. Advertising expenses worldwide, which comprised television, radio, print media and Internet advertising, were $2.5 billion, $2.3 billion and $2.6 billion in 2013, 2012 and 2011, respectively.

That advertising number most likely does not include money they spend directly marketing to doctors and so on. So the Global Data report referenced by the BBC implies they are spending $15 billion directly marketing to doctors and other medical people/organizations.

The next step would be to figure out what they are spending paying employees (with 120,000 of them, quite a lot), but I can't find good numbers on that.

Also note that there is not necessarily anything bad about off-label use of medicines.

Medicines could be off-label simply for the reason that the regulator - out of pressure from the public health insurer, or more bluntly just the Department of Treasury in the country - does not approve using a medicine for some purpose, even though it is known to be efficient and without bad side effects.

In fact, in some cases patients are complaining bitterly because they cannot get the medicine that their doctor knows would help them, because their regulators do not approve off-label use.

When we look at popular off-label meds and the eventual evidence we often find that they're not very useful, or even actively harmful.

Of course that keeps the prices lower. That's the purpose. It also keeps some medication unavailable for some patients. I don't think it's a huge problem, but it's there.

Whoa there. Says who? The largest part of marketing drugs is paying sales reps to visit doctors. Are you saying that's banned in the UK? From what I've seen that's not true.

If you're saying DTC (direct to consumer) marketing is banned, then I agree (for prescription drugs). DTC is not all there is to drug marketing.

Also, you're fooling yourself if you think doctors have the time to research new drugs. That's why there are reps. They provide educational information, data from new trials, etc, etc.

Individual doctors don't make purchasing decisions, but they do make prescribing decisions which drive sales. They are the key stakeholder when it comes to pharmaceutical marketing. They may not be buying lunches in the UK, but sale reps are getting time with doctors and talking up their products.