Misdiagnosing an illness to sell a drug

This is a story about how a drug company set out to sell a new drug. It is a familiar story in our ailing health care system, but it’s a story that we should not have to tell.

No matter how much the corporations may own Washington, and therefore, have a unique control over our lives, we always have one thing that stands in our defense if we seek it; the truth. As long as the First Amendment exists, someone will do the research, ask the right questions and tell us the story.

A few months ago National Public Radio featured a story called “How a bone disease grew to fit the prescription.” This story explains how far a pharmaceutical company will go to sell their drugs and make a profit.

The drug company Merck America created a new drug to treat osteoporosis, and pushed into the light of day a fairly new diagnosis called osteopenia. Osteoporosis is a debilitating bone disease and osteopenia is disease thought of as being pre-osteoporosis, or an indicator that one is prone to develop osteoporosis.

The problem Merck had with selling the new drug about a decade ago was the cost of the tests. A big bone density machine was needed to measure the bones in a woman’s hip and spine in order to make a diagnosis. Before they could sell their new drug to a patient a diagnosis had to be made.

In order to get large numbers of women to take their new drug, Fosamax, Merck needed to make bone scanning less costly. The drug company set out to change the way our health care system tested for bone density, and they succeeded.

Merck created a non-profit organization called the Bone Density Institute. The Institute had no office, was not housed in a building and did not have a payroll; it consisted of one man named Jeremy Allen, who was hired by the drug company to market Fosamax.

Allen figured out that small “peripheral” machines could be used to scan bone density in smaller bones, like the wrist or ankle. Nevertheless, these smaller machines were still too expensive for most doctors and clinics to have on hand, so Allen set out to help with the development of new, less costly machines;¬† he began contacting manufacturers.

Some manufactures were opposed to the idea of scanning the smaller bones to diagnose the disease; they didn’t believe it was the best way to reach a diagnosis. So Merck threatened to support the competitors of manufacturers who refused to cooperate, and eventually, ¬†bought one of them out so they could control the manufacturing of the machines.

Merck aimed to show how low the cost of one of these machines could go. They wanted to sell them cheap so they were affordable, and even offered help with financing for doctors who were interested. The drug makers actions got everyone’s attention.

The machines were created. Congress was lobbied to pass the Bone Mass Measurement Act in 1997. The new law, among other things, allowed the testing to be paid for through Medicare. (And some complain they are afraid of government involvement in our health care system – “socialized medicine”).

The market was open and the diagnosis of osteopenia became very familiar. And Merck, well, they sold a lot of drugs thanks to their deep pockets and the greediness of Washington politicians.

One of the threatened manufacturers, who would not go along with Merck and the idea of using smaller machines to make a diagnosis, was the Lunar Corporation. A Lunar Corporation spokesperson, Richard Mazess, told NPR that Merck had plotted to misdiagnose patients and expose them to the risks of taking a medication they did not need. Allen, the one man institute, also spoke to NPR. He claimed he felt he was doing the right thing at the time.

So while some rant and rave about the threat of socialize medicine, the fact of the matter is, it is already alive and well and living in America.


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