Interesting Article on Cervical Cancer Vaccine Economics

Via CNN:

But in the real world, Gardasil is getting used less than doctors would like. Pediatricians and gynecologists from Arizona to New York are refusing to stock Gardasil because of its $360 price for the three doses required and “totally inadequate” reimbursement from most insurers.

It’s a well-written piece, much better than usual.

And, it’s another reason I’m glad I don’t have an office practice.


  1. for years most insurance companies would not pay for birth control for women, then when Viagara came out and they covered that, women began to sue their insurance companies for sexual discrimination. Once again this is a case of sexual discrimination not to mention being extremely short sighted, what would cost an insurance company more, the vaccine series or treating woman with cervical cancer? Pencil pushing idiots!

  2. Goatwhacker says:

    Yeah, I have an office practice and can’t afford to stock the stuff. The insurance companies don’t reimburse what it costs me to buy the vaccine, let alone what it costs me after billing and other overhead. It’s pretty much the same with the shingles vaccine, too.

  3. Dr. Bob FP says:

    Actually, it’s a little more complicated than that. If I remember correctly, the estimate of the cost/benefit break even for Gardisil panned out at about $450-$500. Meaning the cost of the shot vs. the extra cost of colposcopies, Paps, cryotherapy, etc. that would be prevented by the shot. The manufacturer priced it about $360 trying to make as much money as possible, but unfortunately too closely to make it financially viable in an office. The cost of the vaccine is only part of the true cost for us office based docs. You also have to add the cost of inventory, administration of the vaccine, billing, and at least a minimal profit. I think the manufacturer just got a little too greedy. Now they’re turning to direct to consumer advertising to cause a public outcry, get the politicians to jump in, and force coverage. The real solution is to price it more competitively so that the cost/benefit is a no-brainer and everyone will then provide it.

  4. Well, discrimination by insurance companies is one way of looking at it. But folks should also pay attention to the fact that Merck is openly funding a lot of drives in state legislatures to make the vaccine mandatory for schoolgirls. Talk about the abuses of direct-to-consumer advertising; this is direct-to-consumer legislating. Paternalism, anyone?

  5. TheNewGuy says:

    Just saw a discussion on making the vaccine mandatory on either CNN or Fox.

    The pro-mandatory-vaccine lady was attempting to smear the anti-vaccine lady as some kind of fundamentalist christian zealot… Nothing like taking the high road in the debate.

  6. Cost aside.
    I would like to hear from the 55 year old women that received this vaccine at age 11 and had no problems with her menstral cycle, getting pregnant, carrying to term, and vaginal delivery of more than one child.

    This vaccine shows great promise, but forcing parents to have their daughters vaccinated is taking things too far.

    Nurse 1961

  7. ERNursey — maybe it’s discrimination or maybe it’s because impotence is a medical disorder and fertility isn’t. Should the health plans be forced to cover condoms? Actually if they were fiscally smart they would, the cost of the pill or condoms (uncovered) is less than the cost of a pregnancy or abortion (covered) but that is a business decision. I personally don’t think health “insurance” should pay for any of it but there is a fundamental difference between a disorder and a desire.

  8. Texas Gov. Perry has ordered that schoolgirls should be vaccinated against the virus that causes cervical cancer.

  9. PAP smears will still be required if someone gets the vaccine. The vaccine does not prevent 100 percent of cervical cancers, it only prevents infection from one form of HPV. So everyone who is throwing around the savings because women will no longer have to get PAP smears is wrong.

    This is not a cancer cure. It is a partial preventative. I have concerns about how it might affect the reproductive system – most of you are probably too young to remember the problems with the daughters of women who took DES to avoid miscarriage.

    And from what I have read, Merk got the vaccine fast-tracked by the FDA – so it has not been studied for as long as most vaccines. And what really bothers me is this – why do women always have to pay the price for all kinds of protection when it comes to sex?

    Boys get HPV also, and it is responsible for some penile cancers and some anal cancers. Personally – let the boys get the vaccine, not the girls. There are fewer boys than girls in the population – at least there used to be. And face it – the boys are carrying it and infecting girls, and they are likely to infect many more girls than the other way around.

  10. I would also like to know why there isn’t a vaccine for men. They are the carriers of HPV! But, that aside, I do think all girls should have this vaccine. Yes, I agree PAP tests will still need to be done, but, lets be honest. Almost all cervical cancer is caused from HPV. So PAP testing could go to a minimum. It certainly wouldn’t need to be done yearly.

  11. As far as the ‘vaccine for men’ line goes, my answer is the same as a male birth control shot: who carries the burden if it didn’t actually happen, or work quite right?

    If the male didn’t have the birth control shot, it’s not the male who’s going to have a baby. It’s the same with the HPV vaccine: the male isn’t going to get cervical cancer.

    Were I a woman I’d take my self protection seriously, and not rely on someone else.

  12. Package insert Gardasil(TM) HPV Vaccinesee the bottom of page 8 for this stunning disclaimer:
    “GARDASIL has not been evaluated for the potential to cause carcinogenicity or genotoxicity.”
    and page 9 for this admission:
    “However, it is not known whether GARDASIL can cause fetal harm when administered to a pregnant woman or if it can affect reproductive capacity.”

    Wouldn’t you want these questions answered before your daughter is given this vaccine? I am reminded of DES and Thalidamide (sp). How long has the effects of this drug been studied? Has it been studied on young girls? Below the age of, say 25? How about younger? If so where can I find the results and the actual study to read it?