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For Acrobat, we have been looking at Qoppa's product - http://www.qoppa.com/pdfstudio/ - which I found to be remarkably similar to Acrobat in functionality and actually a bit easier to use. Pricing is very, very close to an Acrobat-only ETLA and gets us out of having any Adobe footprint.
Otherwise the products from that link have been prominent. Gimp, Kompozer or SeaMonkey, and then a few other products here and there. We don't have a huge user base for the full CS lineup but there are viable alternatives.
Ton of conversation on this on the Licensing list.
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