Companies make them because people are gullible and will fork over money for them. Plain and simple. Think about how a throttle body spacer works...it's supposed to swirl the air going into the intake manifold. What benefit would that have for us? None. Any spin imparted on the intake charge would be broken up by the intake runners before it reaches the cylinders. Now, they DO work to some small degree on older carbed engines, and engines with TBI/single point injection "wet manifold" systems, because the fuel/air mixture is mixed a little bit more thoroughly before passing through the intake runners and reaching the cylinders.
On a modern engine that has multi-point direct injection, where the fuel is injected directly into the cylinders before combustion (ie, our trucks), there is ZERO benefit to adding a throttle body spacer. Since there isn't any fuel to be mixed in the intake manifold, imparting any kind of spin on the incoming air is useless. The spin is defeated before it can be of any benefit.
As for the underdrive pully...it might free up a few hp, but nothing all that noticeable. I'd rather have my accessories and AC working at max potential.