by Kristin Johns
January 15, 2010
Maybe it’s just me. But I found it extraordinarily offensive that on the same day that scientists in Britain reported that 100,000 deaths from cervical cancer could be prevented annually by the use of a $2 test overseas, reports surfaced that Merck is once again trying to get approval for Gardasil (cost: $360 per person, plus whatever health care providers charge for administering it) to be used for women aged 27-45.
The difference is, of course, that expensive Gardasil will be used in the US, where it is least needed. Although at least 80 percent of women here will be infected by the HPV virus, 95 percent of those infections will be shrugged off by healthy immune systems, leaving in their wake a natural immunity to further infection. Of the small percentage of cases that become persistent, many could be avoided by eating a healthy diet with fruits and vegetables, quitting smoking, getting enough sleep, limiting sexual partners, etc. And most (granted, not all) persistent HPV infections that do turn to cancer can be caught early by regular screening.
Still, an incredibly effective marketing scheme that fails utterly to accurately inform women about the pros and cons of the vaccine has convinced women that unless they pony up big bucks they’re going to get cervical cancer.
Now Merck, dismayed by flagging sales and by clear evidence that Gardasil isn’t cost-effective for the potentially lucrative male market and its recommendation only as a wart-preventer and not as a cancer preventative for boys, is once again going after the older women market. It will be interesting to see whether they have found a way around earlier evidence that Gardasil may actually cause existing HPV infections to become cancerous.
Meanwhile, in developing countries, where women often aren’t able to get regular life-saving Pap smears and equally often have depleted immune systems due to inadequate diet—countries where Gardasil would actually make sense—a simple, dirt-cheap test could really, truly save lives. It can be used in rural areas without sophisticated equipment and labs; a nurse, midwife, or OB/GYN simply swipes the patient’s cervix with acetic acid (vinegar) and then looks at the tissue. If lesions are present, the tissue turns white.
The only obstacles? Raising awareness, and getting enough money and qualified people to do the $2 tests and follow-up. Without, of course, a fraction of the budget that Merck has used to sell the largely unnecessary Gardasil vaccine.
So once again, I’m telling Blue Cross/Blue Shield: thanks for offering my girls the vaccine, but please send the $800 to an appropriate charity that offers VIA screenings to women in developing countries instead. Hey, that’s 400 potentially life-saving tests. Doesn’t that sound more cost-effective than inoculating two very low-risk girls?