This was from a web-page by Merck about Fosamax - a screen shot taken in August 2005.

This interpretation is misleading and trying to convince women that they are at a higher risk than they actually are. Also it encourages them to take medication that they do not need.

First of all, the definition of osteoporosis is a T-score of -2.5, not of -2.0. A report by Schousboe found that alendronate is NOT cost-effective in treating women with osteopenia who do not already have an osteoporotic fracture.

Second, the marketing people have substituted "normal" for "average". A person with a T-score of -2.0, for example, is about 20% below AVERAGE for a 20-year-old, which is only 10% below the WHO-definition of normal. This sounds much worse than it really is.

The T-score is not really a percentage. The coefficient of variation is about 10% for the spine, but is 13 or 14% for the hip, so you don't have osteoporosis until you are 32% below young average.

I recommend that you all read the book by Marcia Angell (former editor of the New England Journal of Medicine): The Truth About the Drug Companies: How They Deceive Us and What to Do About It (Random House, 2004)

Updated 8/8/05
This is the last case.