Most people can tell you we all lose bone density as we age, resulting in fragile bones that easily break in our old age. According to the Department of Health and Human Services, women generally, and those who are post menopausal, are at an increase risk for osteoporosis. It seemed, therefore, something needed to be done to help prevent bone density loss.
In March 1995 Merck decided to do something about bone density loss by creating a new drug, Fosamax, to prevent premature bone loss. The problem is, the World Health Organization (WHO) had already determined the costs of prevention would most likely exceed the benefits of prevention. So how would Merck’s new drug fit into a world where it was not welcome?
According to Shannon Brownlee, author of Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer, the answer was to create new medical conditions so Fosamax would have a place in the world it was not welcome.
The company helped fund a panel of medical experts to create diagnostic criteria for osteoporosis so that a diagnosis could be made before the patient actually broke a bone. The panel’s first step was to define “normal” bone density as that of the average 30-year-old woman. Next, the experts chose as their cutoff for osteoporosis a statistical point that was slightly below the bone density of their normal 30-year-old — a definition they admitted was “somewhat arbitrary.” Finally, they came up with a completely new disease — osteopenia — for bone density that fell somewhere between that normal 30-year-old and their arbitrary definition of osteoporosis.
Voila — 30 percent of post-menopausal women suddenly had a disease that needed to be treated early in order to prevent a problem — hip fracture — that wouldn’t occur for many years, if ever. According to the new guidelines, millions more women now had osteopenia, which their doctors needed to watch like hawks so that their patients could be treated once they progressed to osteoporosis. Merck then took the added step of helping doctors buy DEXA scanners, X-ray machines needed to scan your bones to get that all-important diagnosis.
As the Seattle Times article shows, sales of Fosamax between 1996 and 1998 were good, starting at $282 million and rising to $775 million. However, this was not enough for Merck. In 1999, the WHO set forth recommendations to measure the total health care costs associated with osteoporosis. What they did not disclose is that eight of the eleven members of the WHO panel were employed by drug manufacturers. What happened next could not be considered a surprise. Sales of Fosamax skyrocketed from $1.02 billion in 1999 to more than $3 billion in 2008.
Not bad for a drug that treats a disease that did not exist before the drug company created it. Far worse is the amount of money frivolously spent on Fosamax which could have been used to treat or cure real disease. You hear people complaining more and more about the high prices US consumers pay for prescription drugs, especially when you look at other countries around the world. The drug companies usually claim they need the additional money from the US so they can continue to do research and development.
If that is true, then why are they manufacturing drugs for non-existent diseases? It seems like the drug companies are concerned about researching and developing drugs which produce profits, not those that cure disease. Remember this next time you hear drug companies explain why you pay so much for you medications.
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