Drug executives say they must spend as much as $1 billion to promote a drug in its first two years on the market if they want it to become a "mega-brand" that will bring in sales of more than $1 billion a year. This extreme spending on promotion is why the chief executives of today's drug companies are less likely to be scientists than they are to be marketing gurus, salesmen, lawyers or Harvard MBAs

It would be wrong to believe that this is the end of the industry's wealth and power.