Are HPV vaccines worth the cost? A study in the New England Journal of Medicine concludes that they aren't--at least not for women over 18. They'll only be cost-effective, the resesarchers decided, if they're given to pre-adolescent girls, if they prove to protect girls for a lifetime (so far, they've only been studied for six and half years, so the jury's out) and if current methods of screening for cervical cancer using Pap smears can be adjusted to reduce costs, so that the $400 price tag for the shots can be recouped.
The study could be a blow to Merck's Gardasil and GlaxoSmithKline's Cervarix. Merck has already had some difficulty getting college-age and older women to get the vaccines, contributing to a slowdown in sales for Gardasil. And GSK, which hopes to introduce Cervarix in the U.S. this year, could find doctors and patients slow on the uptake. Plus, one of the companies' strategies has been persuading governments to push the shots, even make them mandatory, and in countries where governments control drug reimbursements, cost-effectiveness often comes into play.
In developed countries, Pap smear screening and treatment have cut cervical cancer deaths to very low levels already. And because the vaccines only protect against two of the cancer-causing strains, that sort of screening still needs to continue even in vaccinated patients. In fact, some women's health advocates have publicly worried that vaccinated women might get lax about their Pap smears, thinking they're in the free and clear because of the shot.