Eli Lilly & Co. (LLY), Amgen, Inc. (AMGN), Merck & Co., Inc. (MRK): Where We’re Headed

Page 1 of 3

Over the past couple of months we’ve discussed many of the biggest risk factors associated with some of the leading causes of death in the United States — heart disease, cancer and stroke. Today I want to turn the tables a bit and look at a disease that affects an equally large number of people. While it may not in itself be deadly, it can make a person’s life miserable if it isn’t properly dealt with. The disease: osteoporosis.

Osteoporosis is a condition whereby a person’s bones become so brittle and frail that they can break or fracture from a fall to something as simple as a heavy cough. The condition, in its simplest form, arises because the body is unable to make new bone tissue faster than the rate at which the body is absorbing old bone tissue. While osteoporosis can occur anywhere, it’s most common in the wrist, hip, and spine.

Eli Lilly & Co. (NYSE:LLY)

According to the National Institutes of Health, more than 40 million people either have osteoporosis, or are at a higher risk of developing the disease because of low bone mass.

Figures in percentages for persons surveyed over 50 years of age. Source: Center for Disease Control and Prevention, National Health and Nutrition Examination Survey 2005-2008.

When both the femur and spine are taken into account, roughly one in two respondents (49%) over age 50 in a CDC and National Health and Nutrition Examination Survey were found to have low bone mass, which is an early-stage warning for developing osteoporosis. That represents a huge opportunity for the pharmaceutical industry, but it also serves as a wake-up call to the rest of us to do what we can to avoid the biggest risk factors of the disease.

According to the Mayo Clinic, there are five big risk factors that people should be watching out for if they’d like to reduce their chances of developing osteoporosis.

1. Genetic factors
Whereas the majority of factors on the Mayo Clinic’s list can be altered by lifestyle changes, your genetic make-up is unfortunately not one of those. Women, for instance, are more prone to developing osteoporosis than men, particularly because of their smaller bone structure. Particular races also tend to be more prone to developing the disease, such as women of Caucasian and Asian descent. Similarly, having a family member with a history of osteoporosis will put you at a greater risk of developing the disease. Finally, we can’t control the fact that we’re getting older, no matter how many 29th birthday anniversaries we have (I should know, as I’ve had a few), and age is a primary risk factor in developing osteoporosis.

2. Hormone levels
One of the bigger risk factors for both women and men as they age is a decline in their sex hormone levels — estrogen for women and testosterone for men. It has been shown that a decline in these hormones can lead to bone deterioration and thus put a person at a greater risk of developing osteoporosis.

The good news is that there are plenty of options to counteract the decline in estrogen for women and testosterone for men; however, physicians don’t often recommend utilizing estrogen solely to counteract bone loss in women. Men, however, have FDA-approved Androgel 1.62%, made by AbbVie , to fall back on. Androgel is prescribed for men who have zero to low testosterone production, and, among other things, it can help improve bone mineral density. Through the first six months of the year Androgel was AbbVie’s second best-selling drug at $498 million in cumulative sales and could be in line for future growth as baby boomers continue to age.

3. What you eat
If you haven’t noticed by now, what you eat can play a big role in whether you develop a type of disease. Even in cases where the cause of a disease isn’t completely known, such as in osteoarthritis, poor diet is often blamed as an exacerbating factor that can increase your risk of developing a disease. In terms of osteoporosis, diets that are low in calcium can result in early-life bone loss. Extenuating factors can also affect your bone density, such as whether you’ve had some form of gastrointestinal surgery, or if you have anorexia, an eating disorder that starves the body of numerous nutrients, including calcium.

Specifically, vitamin D and calcium intake are the two most important dietary factors as it relates to reducing your risk of osteoporosis. Vitamin D is a crucial component to calcium absorption in the intestines. Fish, many cereals, eggs, and several dairy products (including milk), serve as excellent sources of vitamin D. You can also get it from exposure to the sun. Calcium, which is one of the primary building blocks of our bones, is often found in low-fat milks and cheeses, as well as dark leafy green vegetables.

Page 1 of 3