It is hoped that a dramatic and historic price cut on leading HPV vaccines will help immunize millions more young women in developing countries and combat cervical cancer rates, but is this change one that should be praised or rallied against as not having gone far enough?
The HPV vaccines Gardasil and Cervarix, made by Merck and GlaxoSmithKline respectively, can cost developed countries like the United States more than $100 a dose. However, with this announcement, Merck and GSK will now offer the vaccines to poorer countries for just $4.50 and $4.60 per dose respectively.
Initially this is just for the period between 2013-2017, but hopes are that if this goes well, an extension might be possible. What’s more, Merck and GSK have vowed the price will drop further as demand increases.
This is a record low for the vaccines which target the human papillomaviruses (HPV), sexually transmitted infections that a number of studies have established dramatically increase a chance of women developing cervical cancer. A number of studies have also shown that the HPV vaccine can dramatically cut that risk.
While cervical cancer kills relatively few people in developed countries, it is estimated that globally, 275,000 women a year die from the disease. More than 85% of cervical cancer deaths occur in poorer countries and Sub-Saharan Africa accounts for 22% of all cervical cancer cases worldwide.
The issue is further complicated by the nature of the disease, which requires specific screening protocols relying on facilities not always available in developing countries, and by the vaccine itself, which must be refrigerated at all times prior to being administered and given in three doses over a six month period, increasing the difficulty of effectively deploying the vaccine. But with this price cut, that could change.
“By 2020 we hope to reach more than 30 million girls in more than 40 countries,” Seth Berkley, chief executive of the GAVI Alliance which helped negotiate the deal, is quoted as saying. “This is a transformational moment for the health of women and girls across the world.”
The program will target countries like Ghana, Laos, Madagascar, Malawi, Niger, Sierra Leone and Tanzania, with Kenya being the first to receive the vaccination program later this year.
GAVI plans to eventually deploy the HPV vaccination programs in more than 40 countries within the next seven years. GAVI will absorb the cost to reduce the on-the-ground charge to 20 cents a dose, covering the difference with government subsidies from developed nations and donations from organizations like the Bill & Melinda Gates Foundation.
While this move has been welcomed by many as a positive step, critics have slated pharmaceutical companies for not offering a better deal.
“Why are the pharmaceutical companies still making profits off the backs of the poorest countries?” The New York Times quotes Kate Elder, a vaccines policy specialist at the the charity Doctors Without Borders. ”It will still cost nearly $14 to fully protect a girl against HPV. It’s really disappointing that pharmaceutical companies haven’t offered GAVI a much better deal.”
It is estimated that Merck made $1.63 billion and GSK more than $416 million from their HPV vaccines in 2012. Still, Merck contends that the prices they have quoted are as low as they can go while covering manufacturing costs and reminds that there will be further reductions as demand increases.
Given that the price of the HPV vaccine has long been a contentious matter as it is among the most expensive vaccines in the U.S. and not for reasons of a difficult manufacturing process, but simply because the price is based on a speculative value of how much the health care system stands to save, this has also led some to ask whether the fact that pharmaceutical companies can now offer such a dramatic reduction (over 90%) means that prices have been kept artificially high even at the expense of poorer nations.
Still, this drastic reduction in cost undoubtedly offers a real step toward tackling cervical cancer rates in developing countries and, as such, is welcome, but with the caveat that there is yet more work to do.
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