> The sales and marketing departments in most companies are more powerful than their R&D departments.<p>Yes, this is correct.<p>> Hence, the design, conduct, reporting, and dissemination of this clinical evidence becomes an advertisement tool.<p>This does not follow well logically. The design of clinical trials still belongs to R&D and not Marketing/Sales departments. Even if Marketing/Sales want to target for a specific outcome, there is nothing saying that this particular outcome will be met until you actually try it clinically. And specific outcomes are usually desirable outcomes: for example, showing that your drug is non just superior to placebo, but superior to the current best-in-class treatment. Or measuring patient-related outcomes that are tied to economic value (for example, making a patient recover faster has tangible societal benefits - they can come back to work, be an active family member, etc...) is also relevant these days.<p>So, there is not a strong link between "pushing for an outcome that you can advertise" and "this outcome being clinically meaningless". If it were meaningless, FDAs and other regulatory bodies would not even accept it during the clinical trial design review phase.<p>> As for basic research<p>Basic research should be the responsibility of academics, not companies. And they do. But not many academics focus on "checking whether what we have been using for 20 years really works", there's too much priority on new clinical targets.