Osteoporosis is a disease that causes bones to become thinner, more porous and break more easily. Osteopenia is different from osteoporosis -- it is a slight thinning of bones that occurs naturally as women get older and typically doesn't result in disabling bone breaks.
Osteopenia is a condition that only recently started to be thought of as a problem that required treatment. Until the early 1990’s, only a handful of people had even heard of the word. But osteopenia has transformed from a rarely heard word into a problem that millions of women swallow pills to treat.
The term “osteopenia” was never originally meant to be considered as a disease -- it was a research category used mostly because some thought it might be useful for public health researchers who like clear categories for their studies.
But in 1995, a man named Jeremy Allen was approached by the drug company Merck. The pharmaceutical giant had just released a new osteoporosis drug called Fosamax. Since osteoporosis is a serious problem that affects millions of women, the potential market for Fosamax was enormous. But the drug wasn’t selling well.
Allen persuaded Merck to establish a nonprofit called the Bone Measurement Institute. On its board were six of the most respected osteoporosis researchers in the country.
But the institute itself had a rather slim staff: Allen was the only employee.
In 1997 the institute and several other interested organizations successfully lobbied to pass the Bone Mass Measurement Act, a piece of legislation that changed Medicare reimbursement rules to cover bone scans. More and more women got bone density tests (at Merck’s urging), and the very existence of the word "osteopenia" on a medical report had a profound effect.
Millions of women were worried by the diagnosis. And when clinicians saw the word 'osteopenia' on a report, they assumed it was a disease. Merck did not disabuse them of the notion.
There are no long-term studies that look at what happens to women with osteopenia who start Fosamax in their 50’s and continue treatment long-term in the hopes of preventing old-age fractures. And none are planned.
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Dr. Mercola's Comments:
I don’t believe for a minute that Merck’s motivation for pushing the label “osteopenia” was to make it convenient for the researchers. It’s very clear that Big Pharma has one overriding goal—a handsome sales report at the end of the quarter.
Since 2003, annual sales of osteoporosis drugs have about doubled to $8.3 billion, and $3 billion of that was from Fosamax alone.
Convincing you that you have a disease when you don’t is nothing short of medical molestation. It’s unethical, self-serving, and demonstrates the upside-down priorities of the pharmaceutical giants.
But it isn’t surprising, I’m sorry to say.
Manipulating Research and Massaging Data
[i] Jarvinen T.L.N., Slevanen H., Khan K.M., Heinonen A., and Kannus P. “Shifting the focus in fracture prevention from osteoporosis to falls” BMJ (January 19, 2008) 336:124-126The manufacturers of osteoporosis drugs exaggerate the benefits and downplay the risks of so-called bone-strengthening drugs, according to a report in the January 2008 issue of British Medical Journal (BMJ)[i].
The paper states that the strongest single risk factor for fracture is falling, not osteoporosis.
Authors emphasize that “drug treatment is not a panacea,” and that women with osteopenia have such a low risk of fractures that drug treatment provides no benefit at all—but comes with all of the risks.
The paper states:
“What the drug makers do is argue that the effect of treating pre-osteoporosis (osteopenia) and osteoporosis is similar. This move to treat pre-osteoporosis raises serious questions about the benefit-risk relationship for low-risk individuals and about the costs of medicalizing and potentially medicating an enormous group of healthy people.”
The paper also states that all four studies cited by drug companies to substantiate the benefits of giving osteoporosis drugs to women with osteopenia were exaggerated[ii]. For example, one study claimed a 75 percent reduction in the risk of fracture, but the real risk reduction was only 0.9 percent.
These same studies also downplayed the potentially harmful side effects of these drugs. In one, they simply “forgot to mention” that raloxifene (Evista by Eli Lily) increased your risk for blood clots.
The BMJ article also mentions that many of the authors of the four studies were employees of the pharmaceutical industry, not surprisingly.
[ii] Edelson E. “Bone strengthening drugs may be overprescribed” (January 18, 2008) The Washington Post
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