Some fragility fractures – those that occur at standing height – may be preventable by modifying a patient’s prescription drug regimen.
Older adults are more prone to these types of fractures, costing the U.S. health system about $16 billion annually in direct medical costs. Patients who already have had one fracture are more likely to incur additional ones. Continue reading
NPR correspondent Alix Spiegel’s latest piece, an examination of how Merck manufactured a disease (and an epidemic) en route to turning Fosamax into a blockbuster drug, is set to air on All Things Considered tonight.
We all know how the story ends, but the real focus is the journey. As Spiegel says, “it’s the story of how the definition of what constitutes a disease evolves, and the role that drug companies can play in that evolution.”
In the case of Fosamax, it’s a real humdinger, going all the way from a sweltering meeting room in Rome to the shady backrooms of corporate America and, just in case that isn’t Da Vinci Code enough, it even involves dubious decisions at the highest levels of government.
In a sidebar added to the story after this entry was posted, journalist Gisele Grayson writes about learning that she has osteopenia.
Maryann Napoli writes in the American Journal of Nursing that “in the name of prevention, millions of Americans have accepted the idea that it’s reasonable to treat a risk factor such as bone loss or high cholesterol as if it were a disease.”
Napoli zeroes in on low bone density, a risk factor for hip fractures that, through careful marketing, promotion of regular screenings and celebrity endorsements — all funded by a major pharmaceutical corporation — has been inflated into a disease that has sold millions of dollars worth of bone-density drugs. All this despite the fact that the affect of the drugs in prevention of hip fractures is minimal at best.
According to Napoli, “consumer advocate Barbara Mintzes summed up the situation nicely: “Bone mineral density testing is a poor predictor of future fractures but an excellent predictor of start of drug use.””
More people should question the wisdom of starting long-term drug therapy. Often the magnitude of the risk factor has been overestimated, or the danger of the disease itself exaggerated, by people trying to sell you something —like a drug you must take for the rest of your life.