Tuesday, February 06, 2007

Qui bono?

Texas has become the first state to enact legislation requiring girls age 12 & up be vaccinated against Human Papilloma Virus; 18 states and the District of Columbia are considering similar measures. Ostensibly at issue is the desire to protect young women from a potentially fatal disease - not HPV itself, but cervical cancers which can develop in very rare cases in women with HPV infection.

Why would a government mandate intervention in a health issue that is not one of epidemiology? To date, vaccines have only been required for deadly diseases spread by casual contact, with the aim of preventing epidemics. In the case of the HPV vaccine, government is being heavily lobbied by Merck, the pharmaceutical company that developed the only vaccine available, and which stands to profit to the tune of a billion dollars if even a few states enact the legislation on the table.

You may already have seen the infomercials aired by Merck - the black-and-white images of "real" women saying that if they knew of something that would help their sisters, mothers, daughters, they would surely tell. Well, of course - only a monster would withhold such information. The ads are long on emotion; however, short on facts. Here are a few things all women should know about HPV and cervical cancer, courtesy of the U.S. Department of Health and Human Services Centers for Disease Control (emphasis mine):

All types of HPV can cause mild Pap test abnormalities which do not have serious consequences. Approximately 10 of the 30 identified genital HPV types can lead, in rare cases, to development of cervical cancer. Research has shown that for most women (90 percent), cervical HPV infection becomes undetectable within two years. Although only a small proportion of women have persistent infection, persistent infection with "high-risk" types of HPV is the main risk factor for cervical cancer.

A Pap test can detect pre-cancerous and cancerous cells on the cervix. Regular Pap testing and careful medical follow-up, with treatment if necessary, can help ensure that pre-cancerous changes in the cervix caused by HPV infection do not develop into life threatening cervical cancer. The Pap test used in U.S. cervical cancer screening programs is responsible for greatly reducing deaths from cervical cancer. For 2004, the American Cancer Society estimates that about 10,520 women will develop invasive cervical cancer and about 3,900 women will die from this disease. Most women who develop invasive cervical cancer have not had regular cervical cancer screening.

The vaccine developed by Merck addresses only 4 of the 30 types of HPV and does not address any other causes of cervical cancer - so the idea that this vaccine will do away with cervical cancer is misleading.

Who stands to benefit the most from the Merck vaccine? At what point do we as a society begin to put women's health issues ahead of corporate profit?

The series of three shots will cost each woman $360 - multiply by the approximately 80 million women of reproductive age in this country. That's a big enough chunk of change to justify a few million on TV ads! In addition to the television campaign, Merck funnels money through a political interest group called Women in Government. Neither Merck spokespersons nor Women in Government leadership will disclose exactly how much money. But it is known that Merck doubled its spending on lobbyists in Texas (to $250,000 this year) to push the vaccine bill into law there.

Call me cynical, but I don't believe the nice people at Merck are laying out all this cash to benefit me...

Merck is the manufacturer of Vioxx, the anti-inflammatory drug that was rushed to market in 1999 as a miracle treatment for arthritis. Vioxx was pulled in 2004, when it became linked with increased risk of heart attack. As of December 2006, the company faced approximately 27,000 personal injury lawsuits, and had set aside $1.6 billion to pay damages. Someone's going to foot that bill...and apparently, Merck intends that 'someone' to be every woman in this country.

I don't know - or care - what can be done about Merck's bottom line. But as for cervical cancer, the Pap test is a widely accepted, highly effective and affordable method of prevention. Women without health insurance can receive free or low-cost screening for cervical cancer (a Pap test) through programs funded by the National Breast and Cervical Cancer Early Detection program, or through Planned Parenthood.

Take care of yourself - no one else is going to!

4 Comments:

Blogger Trina said...

Dude. I am SO with you. Did you see my post about it last April? It's here:

http://mylifemywordsmymind.blogspot.com/2006/04/correlation-is-not-causation.html

Thank you for writing this! All the commercials on tv lately have been making me want to scream and tear my hair out.

8:14 PM  
Blogger red-queen said...

Heya T - yes, I did read your post when the TV ads first started. I am appalled that there is no public accounting of how much the pharm companies spend to peddle their influence. This is going on at the same time that children in this country are doing without basic medical care...a travesty. I know you'll speak out about this to everyone you know...and, I hope, to your congresspersons, too.

9:34 PM  
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