By switching to the latest version of the Gardasil vaccine, which can thwart a virus that leads to cervical cancer, the nation’s health care bill could drop by an estimated $2.7 billion over the next 35 years, according to a new study published on Monday.
How so? The newer vaccine is expected to lower the incidence of cervical cancer and death. The current vaccines used to tackle the human papillomavirus reduce the onset of cervical cancer by 63 percent and deaths by 43 percent. But by using Gardasil 9, as the newest version is called, the incidence of cervical cancer would decrease by 73 percent and death by 49 percent, the analysis found.
“There’s a potentially large societal cost that can be lowered over time” by using the newest version, said David Durham, an associate research scientist in epidemiology at the Yale University School of Public Health and lead author of the study, which was published by the Proceedings of the National Academy of Sciences.
The study also found that targeting increased use of the vaccine in states where vaccination rates are currently lowest would provide the greatest health gains. The cost of the newer Gardasil, which is made by Merck, is approximately $126 per dose for a three-dose regiment, roughly $13 more than the older version and $18 more than another vaccine called Cervarix.
Durham explained that there may be barriers, at least for now, to widespread adoption of the newest Gardasil vaccine. For instance, he noted that the higher cost may seem minimal on a per dose basis, but there may be concern that the added expense can add up over the long run. Moreover, some physicians and government health agencies may have stockpiled large amounts of the older, cheaper vaccines.
“The main policy message is that the new vaccine is cost effective and that focusing on states with lower coverage gives you more bang for your buck,” Durham told us. We should note that Durham and another study author have done consulting work for Merck, which, of course, benefits from this comparison. (Yet another study author has consulted for, and received research funding, from GlaxoSmithKline, which sells Cervarix).
The findings come amid ongoing concern among public health officials that HPV vaccination remains at unacceptably low rates. Barely 40 percent of girls between the ages of 13 and 17 received the full three-dose regimen in 2014, according to the US Centers for Disease Control and Prevention. And for boys in the same age range, less than 22 percent were administered all three doses that year.
The initial version of Gardasil was approved by regulators a decade ago for treating HPV, which is a sexually transmitted virus, in girls and women between 9 and 26 years old. The vaccine was also approved to prevent genital warts caused by some HPV strains in boys and men in the same age range. The Cervarix vaccine, by the way, is not used as widely as Gardasil.
The newer Gardasil 9, which was approved by the US Food and Drug Administration in late 2014, can protect against an additional group of HPV strains. Whereas the older vaccine can combat strains that cause about 66 percent of cervical cancer cases, the newest version can thwart strains believed to be responsible for about 80 percent of such cancers.
From the start, though, Gardasil has been dogged by controversy.
For one thing, some parents have been concerned that vaccination may lead their teenage girls to engage in casual sexual behavior. In late 2014, however, a study found that vaccination was not associated with risky sexual behavior. And a study published in 2012 found that HPV vaccines did not lead to an increased risk of pregnancy, sexually transmitted infections, or contraceptive counseling.
At the same time, Gardasil has been plagued by broader safety concerns that have plagued many vaccines. Specifically, some families have complained that the vaccine caused chronic pain or dizziness. Last year, however, the European Medicines Agency conducted an extensive review and found there was no link, and no change was needed to vaccination.
We asked SaneVax, an advocacy group that has maintained Gardasil safety is questionable, for comment about the study findings and will update you accordingly.