It could easily be the case that without the advertising spend they would not be profitable. Do you think these publicly traded companies are wasting tons of money on advertising? Where is the shareholder outrage?
I worked in pharma advertising for a little bit: There are two sides, consumer and clinical which I believe are about equal spends (might be wrong, but it's significant anyway). Clinical advertising is mostly used to recruit doctors to recruit patients to take part in clinicial trials, and is a necessary component of R&D. Think lots of tradeshows with fancy signage, interactive touchscreens, apps, etc.