There's your problem right there. Outside the US there just isn't a huge spend on marketing (they definitely try to influence doctors though). And honestly, I find it really weird that pharmaceutical companies actually advertise to patients. Part of the reason I spend so much money on a medical doctor is so that I don't need to decide what medicine I need to take. In fact I don't think I should be involved in the conversation. The doctor should just do his or her job without me weighing in one way or the other because I've seen some advertisement on television.

The vast majority of what drug companies spend isn't on advertising to patients but advertising to doctors, having people on staff devoted to answering doctor's questions, and sending free samples to doctors.

It's sort of screwed up that drug companies are expected to educate doctors about their drugs since there's a huge conflict of interest there. But nobody else is paying to train doctors in this.

EDIT: From the article that mikeyouse linked, pharma companies spent $20B on R&D, $16B on free samples for doctors, $20B on doctor education, and $4B on consumer advertising.

> It's sort of screwed up that drug companies are expected to educate doctors about their drugs since there's a huge conflict of interest there. But nobody else is paying to train doctors in this.

The medical profession has continuing education requirements, much like other regulated professions, and a lot of that is about keeping up with new developments in each practitioner's area of practice. To the extent that continuing education isn't directly subsidized by employers, the need to do it is part of what justifies the high salaries doctors receive. So, yes, people -- other than pharmaceutical vendors -- are paying to train doctors to keep up with relevant developments in their field.

Pharma companies aren't spending vast sums of money marketing to doctors because there is an education gap, they are doing it because the sales of prescription drugs aren't at the sole discretion of the consumer -- that's the whole point of the prescription requirement -- so doctors are the key decisionmakers that they need to sell to.

I'm skeptical. On any given ad break on any major network, there is an 80%+ likelihood that there will be an ad for a drug, if not two.

The US is the only country in the world that allows the advertising of prescription drugs - often with ads that would be hilariously vague, if not so dangerous ("Do you sometimes feel tired? Cymbalta could help! Ask your doctor!") - cha-ching, co-pay and insurance, and possibly a script for a drug that's really not needed.