Why Are Public Heath Officials Unwilling To Perform a Basic Cost Benefit Analysis ?
Is education and low-cost, readily available PAP testing a better solution?
By promoting vaccination as a public health imperative mandated by government, rather than as a private choice, Merck has opened the door to the inherently uncomfortable discussion of whether mandatory vaccination is cost effective.
Since Merck claims Gardasil protects against the two strains of HPV that cause 70 percent of cancers, women will still need but may be less likely to get Pap smear tests to catch the signs of cervical cancers caused by the other 30 percent of dangerous strains.
“Nationwide, the cost of vaccinating American girls with Gardasil will amount to some $800 million a year,” New Scientist reported in an analysis that, while overly simplistic, raises fundamental questions about public health priorities and drug company influence over them.
New Scientist estimates that Gardasil will save “around 1,200 lives. This is an unequivocally desirable outcome, but at $800 million per year, the cost of saving each life will be over $650,000…
If the goal is to save lives, there are more cost-effective ways of doing so.”
They include spreading public health measures including low-cost, readily available Pap testing to the non-white, poorer populations that now die in disproportionate numbers of cervical cancer.
The public health equation adds up differently in the developing world, which accounts for 80 percent of the world’s 275,000 cervical cancer deaths, with 30 percent in India alone. Because very few of these women have access to Pap tests, or indeed any regular health care, vaccination has proportionately greater benefits – if the program is publicly funded and the protection proves lasting.