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Gardasil Math 2: Now with Doctors’ Fees!



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Over at Scientific American, John Horgan has an interesting write-up:

Critics fretted that the HPV vaccine, which can cost up to $1,000 per dose to administer when counting physicians’ fees, may represent an inefficient deployment of scarce health-care resources. HPV is ubiquitous, infecting as many as 80 percent of all adult women, and yet cervical cancer is relatively rare; it kills about 3,600 women a year in the U.S., less than a tenth the number killed by either breast or lung cancer. Because Gardasil and Cervarix vaccines do not prevent all forms of cervical cancer, they do not eliminate the need for pap smears, which can detect cervical cancer in its early, most treatable stages. Nor is it clear how long HPV vaccines provide protection against the papillomavirus.

[The NYT's Elisabeth] Rosenthal asserted that the HPV vaccines “are straining national and state health budgets as well as family pocketbooks. These were among the first vaccines approved for universal use in any age group that clearly cost the health system money rather than saved it, in contrast to less expensive shots, against measles and tetanus, for example, that pay for themselves by preventing costly diseases.”

It seems that when Horgan writes that the vaccine “can cost up to $1,000 per dose,” he’s using “dose” to refer to the total three-shot vaccination process. Nonetheless, I previously estimated that if we (A) assume that Gardasil provides lifelong protection against the forms of HPV that cause 70 percent of cervical cancers and (B) count only the $360 cost of the shots themselves, each case of cervical cancer prevented costs about $75,000 — a worthy precaution for a parent or a young woman to take, perhaps, but hardly a good reason for the government to mandate STD vaccinations for 12-year-old girls. If we use $1,000 to get a high-end estimate — while still assuming, without proof, lifelong protection — we arrive at $210,000 per case of cancer prevented.

For the record, however, I’d like to join the various writers here at NRO who’ve criticized Michele Bachmann’s evidence-free assertion that HPV vaccines are actually dangerous or harmful. (I was hardly leaning her way before, to the extent I was leaning at all, but that comment put the coveted Robert VerBruggen endorsement beyond her reach.) They are not, and anyone at risk for HPV should weigh the benefit of reducing their chance of developing cervical cancer against the price of the vaccine.



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