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There are many factors that influence the exact drug that a physician prescribes to treat a patient's osteoporosis. Obviously, most patients hope that the greatest factor influencing a doctor's prescription decision is what is in the best medical interest of the patient and while that might be the overriding influence it would be naïve to think that it is the only factor that influences a doctor's decision with regard to prescriptions.
With the prevalence of the internet and drug advertisements on TV and in magazines, many patients arrive at their doctors' offices with preconceived ideas about what prescriptions they want and what medications they do not want.
The potential link between osteonecrosis of the jaw and oral bisphosphonate drugs such as Fosamax has been reported in the news for years. While Merck & Co., the manufacturer of Fosamax maintains that there is no reliable evidence linking Fosamax and osteonecrosis, other entities such as the American Dental Association and the University of Southern California School of Dentistry disagree and are concerned about the link between the drug and the painful and serious condition of osteonecrosis or jaw bone death.
Patients, and many doctors, have heard the news. Patients might be concerned about how Fosamax will affect their own jaw. They may pressure their doctors to prescribe another oral bisphosphonate to treat osteoporosis and, absent any medically significant reason to deny the patient's request, many doctors will honor it.
Also, as we all well know most doctors today are pressed for time and medical appointments are often short and rushed. Doctors simply do not have the time to present their case for prescribing a given drug. So, unless a doctor feels strongly that Fosamax is the only drug that will effectively treat a patient's osteoporosis, the doctor is unlikely to prescribe it to a patient. Instead many doctors will take the path of least resistance and provide the patient with another prescription if it is medically ethical and responsible to do so.
The Threat of Lawsuits
While Fosamax is still on the market and neither Merck & Co. nor the FDA have issued a recall of the drug for safety reasons related to osteonecrosis, many doctors may still be concerned about the potential for Fosamax lawsuits. Therefore, a doctor may not want to prescribe Fosamax, against a patient's stated desires, have the patient follow the medical advice and develop just the condition that the patient was concerned about developing.
Already, a dead jaw class action suit has been filed and more lawsuits are likely to follow given the recent study linking osteonecrosis and bisphosphonates.
Given the potential Fosamax risks and the potential for a Fosamax injury that results in a Fosamax lawsuit, many doctors may begin to shy away from the drug and instead prescribe a drug that has not received the same negative media attention as Fosamax. Whether patients will be safer as a result will take years to determine. In the meantime, each patient and his or her physician must determine what the right osteoporosis drug is for each individual patient.