Depending on the method used to determine promotion spending, industry-wide the ratio of R&D spending to promotion ranges from 1.45 to 2.18 (sales representatives and journal advertising only) or from 0.88 to 1.32 (total promotional spending) for the years 2013 to 2016. The amount spent on promotion used in calculating the former set of ratios is more accurate but is limited to just two types of promotion. The amount spent on promotion used in calculating the latter set of ratios is an estimate for all types of promotion but is less accurate. Both sets of ratios also only apply to the amount spent on the 50 most heavily promoted drugs. For the individual companies promoting one or more of the 50 most promoted drugs, 2.11 to 2.32 times more is spent on R&D compared to promotion. Even using the limited data on individual company promotion, 8-10 companies per year still spent less on R&D than they did on promotion.
However, all of these results should be interpreted cautiously for a number of reasons. First, the QuintilesIMS reports only provide figures for spending on sales representatives and journal advertising whereas companies engage in a number of other methods of promotion, among them, distributing free samples, hiring key opinion leaders to give talks, sponsoring meals and meetings and using social media. Second, the estimate for total promotional spending based on the mean of the 2002-2005 figures assumes that the proportion of the total used on journal advertising and detailing remained stable. Finally, for many companies promotion spending was based on the amount spent on just 1 or 2 drugs.
The reason for the abrupt decline in spending on detailing and journal advertising in 2016 compared to 2013-2015 requires further investigation. The variation in the year-to-year amount spent on both R&D and promotion by individual companies most likely reflects research priorities and how many drugs companies are aggressively marketing.
Beyond examining the amount of money spent on R&D and promotion, looking at the focus of that spending and the outcomes is another way of assessing the priorities that companies attach to each of these activities. Innovative Medicines Canada (IMC), the organization representing the research-based industry, signals the importance that it attaches to R&D on its website: “At present, there are more than 500 new products in development in Canada, including therapies focused on cancer treatments, infectious diseases and vaccines. These products have the potential to help Canadians and people all over the world live longer and healthier lives” . However, industry spending on R&D in Canada has been declining ever since 1997/1998 when it peaked at 11.5% of sales and it now stands at 4.4% . Out of 564 new patented medicines introduced into Canada from 2010 to 2016 inclusive, only 37 (6.6%) were rated by the PMPRB as breakthroughs or substantial therapeutic improvements . Although most products that fail in the clinical development stage do so because of a lack of efficacy or for safety reasons, 57% and 17% respectively, 22% are stopped for commercial reasons  indicating that products that might be both safe and efficacious are not brought to market.
Industry is also positive about the role of promotion, especially the activities of sales representatives. This orientation is reflected in a statement about the role of pharmaceutical sales representatives issued by Rx&D, the predecessor to IMC: “Provider-supported detailing generates awareness about new treatments and provides science-based and Health Canada approved advice on how to administer these medications” . Previous research that examined the most heavily promoted products in Canada, showed that the vast majority of spending went to medications that offered little to no additional therapeutic value over existing therapies . The comprehensiveness of the safety information provided by sales representatives when they visit doctors was investigated in a study involving primary care practitioners in Vancouver and Montreal. “Minimally adequate safety information” defined a priori as the mention of one or more of the following: approved indications, serious adverse events, common non-serious adverse events and contraindications and no unapproved indications or unqualified safety claims (e.g., “this drug is safe”) was provided in 5/412 (1.2%) of promotions in Vancouver and 7/423 (1.7%) in Montreal. Representatives did not provide any information about harms (a serious adverse event, a common adverse event or a contraindication) in two-thirds of interactions .
It would appear that regardless of the amount of money spent on these two activities – R&D or promotion – that commercial objectives are one of the main considerations behind how pharmaceutical companies direct their expenditures.
These results only apply to companies that market the top 50 most promoted drugs in Canada in any given year. Results for other companies may vary. The pharmaceutical industry also disputes the R&D figures in the annual PMPRB reports because these figures are based on the definition of R&D used by Revenue Canada, whereas according to the industry other types of investment should also be included, increasing the amount of R&D spending .