Bone Measurement Institute

The Bone Measurement Institute is a front group formed by big drug maker Merck to help expand the market for its drug Fosamax by encouraging doctors to use bone-measuring devices in their offices and convincing women at or around the age of menopause that they have a new, heretofore little-known condition called "osteopenia." Osteopenia was formerly merely a state of slight weakening of women's bones as they age, but the marketing efforts of Merck and other makers of bone density drugs like Fosamax worked to transform osteopenia into a condition that required drug treatment.

In 1995, after the FDA approved Fosamax, Merck started promoting portable bone-measuring devices that doctors could use in their offices to identify those with bone loss. When Merck started its effort in 1995, there were 750 bone-measuring devices in the United States. By 1999, there were between 8,000 and 10,000, according to Merck.

"The drug companies started to make machines available to doctors' offices and enter into big agreements to reimburse them for scans," said Dr. Andrea LaCroix, senior investigator for the Center for Health Studies at Group Health Cooperative in Seattle.

The Bone Measurement Institute targets women in their 50s and makes them believe that their bones are in such a weak condition that they require medical treatment. Drug companies and their advocacy groups accomplished that by:

-- Expanding the disease of osteoporosis to include a new condition, "osteopenia," or pre-osteoporosis, with boundaries so broad they include more than half of all women over 50.

-- Promoting osteopenia and osteoporosis directly to younger, healthier women, making them believe that they are at risk and should consider taking bone-strengthening drugs such as Fosamax.

-- Shaping the way osteoporosis and osteopenia are defined, with readings from bone-density machines that the drug industry promoted, subsidized and helped put in doctors' offices.

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