December 21, 2009
Contact:
Anna Christopher, NPR


   

THE BIOGRAPHY OF A MEDICATION: NPR NEWS CHARTS
THE EVOLUTION OF A DISEASE, TO FIT THE PRESCRIPTION

SPECIAL 20-MINUTE REPORT FROM NPR'S ALIX SPIEGEL
AIRING TODAY ON ALL THINGS CONSIDERED

December 21, 2009; Washington, D.C. In the mid-1990s, Merck had a problem. The pharmaceutical company had developed a drug to treat osteoporosis, the bone density disease that primarily affects older women. But their drug, Fosamax, wasn't selling very well and Merck hired drug marketing expert Jeremy Allen to figure out why. Allen found that there weren't enough bone-density scanning machines to get lots of women diagnosed, and the scans that were available were hard to get and too expensive.

Fast-forward to today and the fix Jeremy Allen arranged has worked. Fosamax and drugs like it sit in the medicine cabinets of women with osteoporosis all over the United States. As it turns out, Allen's solution also helped Merck market the drug for women who didn't yet have osteoporosis.

In a special 20-minute report airing uninterrupted today on All Things Considered, NPR's Alix Spiegel has the fascinating story of how osteopenia a slight thinning of the bones which occurs naturally as women age became, along with osteoporosis, a condition that frequently is treated with Fosamax and other similar drugs. Spiegel's report focuses on the expansion of one diagnosis, but more broadly, this is the story of how many diseases evolve, and the role that drug companies can play in that evolution. This is the biography of a medication.

A web version of Spiegel's story is available now at: www.npr.org/templates/story/story.php?storyId=121609815&ft=3&f=90889243; the full audio of her report will be posted at 7PM (ET) at NPR.org. For local stations and broadcast times for All Things Considered, visit www.NPR.org/stations

To understand how osteopenia was given a name and transformed from a rarely discussed condition into a problem that doctors across America medicate, Spiegel starts at the beginning, almost 20 years ago when osteoporosis and osteopenia were defined during a medical conference in Italy. The doctors there intended the term osteopenia to be used only as a category for research purposes; two participants tell NPR they never expected people would be diagnosed and treated for osteopenia.

Spiegel explains that Merck developed a special dose of Fosamax for osteopenia and, as bone scans increasingly labeled women as having not just osteoporosis but also osteopenia, Merck lobbied to get Medicare to reimburse for tests and treatment. Fosamax eventually became a blockbuster drug. Merck sold over a billion dollars a year of the medicine.

As Congress considers legislation to overhaul health care, Spiegel regularly offers behind-the-scene reports on the intersection of health care spending and patient care. In October, she unraveled the complicated factors that drive escalating health care costs, and the roles of both doctors and patients, in a three-part series. NPR offers continuous health care coverage at NPR's health blog Shots, and through "Prescriptions for Change," a special web-only series following the Obama Administration's efforts to remake health care and explaining how various proposals to overhaul the system affect different groups of Americans.