@gravity3 agree…. I guess require maybe isn’t the correct wording….no doctor can make a patient take a drug. By “require” I meant a bone condition that warranted treatment. I need both shoulders replaced, both knees, spine surgery and cervical surgery. My osteoporosis was so bad before Forteo, no surgeon would touch me. I am now scheduled for spine surgery next month because Forteo improved my spine enough to move me from severe osteoporosis to osteopenia. My doctor told me my hips were so bad, a fall could kill me. That was enough to get my attention and start medication. Thanks for sharing your positive results.