Last year, pharmaceutical manufacturers significantly increased the amount of money they spent promoting new drugs, which they do mainly by sending sales representatives to visit physicians in their offices  However, two years ago there was an average of 640 such visits per representative, whereas last year that figure fell to 501
So the additional promotion must have been counterproductive, making physicians less willing to receive visits by pharmaceutical sales representatives
Most pharmaceutical companies did not increase the amount of money they spend promoting drugs through advertising targeted directly at consumers.