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The money they spend on sales and marketing won't include the $263 million they spent bribing law makers (they have three lobbyists for every member of Congress) or the dark money they're spending on bribes we're not even allowed to know about.

They also spend money making tiny tweaks to existing drugs that work just fine for the sole purpose of extending their patents and keeping drug prices as high as possible (https://en.wikipedia.org/wiki/Evergreening)