Fosamax: Inventing a diagnosis, creating a blockbuster drug

Pillbox Biography: The Creation Of A Blockbuster Drug - NPR

With millions of women affected by osteoporosis, Merck knew it had a potential blockbuster drug when it developed Fosamax. The problem: A lack of bone density scanners and high costs meant not many women were getting diagnosed. Merck worked hard to make bone scan machines cheaper and more prevalent — and was wildly successful. By 2005, Fosamax sales peaked at almost $3.2 billion worldwide. Medicare claims for bone screening exams continued to increase, reaching 2.8 million in 2007. The drug went off patent in 2008. Currently, Congress is considering reducing Medicare payments for many types of scans.

How Merck did it - NPR

1992 World Health Organization osteoporosis meeting coins term osteopenia

1993 Fosamax approved in Italy

1994 Fosamax approved in Mexico

1994 77,000 file for Medicare reimbursement for mineral density studies

1995 Merck creates the Bone Density Institute

1995 Fosamax approved by FDA

1995 Only 1,000 U.S. sites have bone density testing machines

1997 Fosamax approved by FDA for preventive use Merck SEC filing says number of eligible women increases from 20 million to 39 million

1997 Pres.Clinton signs Bone Mass Measurement Act requiring Medicare to pay for bone density studies for post-menopausal women

4,000 sites have capacity to measure bone density

1998 Bone Mass Measurement Act goes into effect

1999 1.25 million women file Medicare claims

2000 Fosamax sales are $1.2 billion

2004 2.6 million women file Medicare reimbursement claims

Jeremy Allen - Merck strategist:

Images: graph - NPR, photos: Coburn Dukehart/NPR

Katie Benghauser, 57, has been diagnosed with osteopenia and takes Fosamax as treatment to prevent osteoporosis; Jeremy Allen