Gardasil Math

by Robert VerBruggen

Like Jonah, I don’t have a strong opinion on the matter, but I do think it’s worth calculating how much HPV vaccinations cost for the benefit they provide in preventing cervical cancer.

According to the federal government, about 0.68 percent of women born today will be diagnosed with cervical cancer, and about 70 percent of cervical-cancer cases are caused by the forms of HPV that Gardasil protects against. This means that — if we assume Gardasil provides lifelong protection against these types of HPV, which is not yet established — shots given to young girls will prevent cervical cancer in about 0.48 percent of them. In other words, every prevention will require around 210 vaccinations.

Vaccinations cost about $360 apiece, so preventing a single case of cervical cancer costs about $75,000. Bear in mind that in the U.S., cervical cancer is usually not fatal. Also bear in mind that no one is talking about banning Gardasil; even if state governments don’t subsidize it or require insurance policies to cover the shots, anyone who wants them can purchase them with their own funds.

Regardless of whether, in the abstract, it’s worth $75,000 in taxpayer (or mandated insurance) money to prevent a single case of cervical cancer, I think it’s highly likely that governments could find a way to use that money that saves just as many lives without raising the controversy that HPV vaccinations have.

UPDATE: A commenter encourages me to “finish the math” and explain how much it costs to treat cervical cancer, especially for patients on government health care. This misses my point a little: Even if spending $75,000 on Gardasil today saves more than $75,000 later, it does not follow that Gardasil was the best way to spend the $75,000, especially given the fact that this move is controversial and socializes the costs of promiscuous sexual behavior. Regardless, here are the findings of a recent study I found:

Total Medicaid costs at 6 months after diagnosis were $3,807, $23,187, $35,853, and $45,028 for in situ, local, regional, and distant cancers, respectively. [Most cervical cancers are detected fairly early in the U.S.] The incremental cost of cancer treatment for local and regional cancers was $13,935 and $26,174 and by 12 months increased to $15,868 and $30,917, respectively.

UPDATE II: This seems self-evident to me, but it’s coming up in the comments, so I’ll address it: There’s a big difference between a pre-vaccine incidence rate and a post-vaccine incidence rate. The fact that HPV-caused cervical cancer occurs in only .48 percent of women before a vaccine has been introduced is a reason to think carefully before requiring an expensive vaccine. The fact that polio and diphtheria are rare after decades of vaccinations is not a reason to stop the vaccinations. In the former case, there is relatively little good to be done; in the latter, the existing measures may be preventing a great deal of harm.

Also, for clarity/accuracy, I added “(or mandated insurance)” to the original post.

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