Editorial misses the real problem
Sunday’s Oregonian published an editorial, “A chance to end cervical cancer”, asserting: “Lawmakers can save the lives of scores of Oregonians by making cancer vaccination a routine part of growing up.” You’d expect a woman who’s a mother and a Registered Nurse to endorse wholeheartedly their call for legislation requiring the new Gardasil vaccination for all early-teenage girls, protecting them against the 70% of cervical cancers caused by the human papilloma viruses (HPV). And I would…. if the editorial board hadn’t ignored a big problem:
According to an Associated Press report posted Friday on CNN.com, health care providers all over the country are finding they can’t afford to stock and provide the vaccine, even for patients with insurance coverage.
The Oregonian‘s editorial states, “The main hurdles are education and access. The vaccine is administered in a three-shot regimen costing, at least for now, more than $300”. But that’s all they say about access. If I hadn’t read the other article, I would assume that at least people with health insurance would be able to get the vaccine, and that if the Legislature passes a plan to cover all Oregon’s children as proposed by Governor Kulongoski, the access problem would be solved.
“But in the real world, Gardasil is getting used less than doctors would like. Pediatricians and gynecologists from Arizona to New York are refusing to stock Gardasil because of its $360 price for the three doses required and “totally inadequate” reimbursement from most insurers.”
“Pediatricians and gynecologists at solo and large group private practices contacted by The Associated Press said they would, at best, break even if they stocked the vaccine.”
“Many practices must tie up $50,000 or more in vaccine inventory, run multiple refrigerators, insure the vaccines and spend lots of time on inventory management. They also must absorb the cost of broken or wasted vials and say that’s not possible with most insurers reimbursing at just $2 to $15 over the $120 per dose charged by Gardasil’s developer, Merck & Co. of Whitehouse Station, New Jersey.”
It is possible that if many states required the vaccine to be given to all young girls, just as they require rubella immunisations to prevent German Measles with its risk of harm to fetuses, this issue would have to be dealt with. It doesn’t seem fair to put the financial cost of protecting the women of tomorrow on today’s family practitioners, pediatricians, and gynecologists, who don’t get adequate reimbursement for providing the vaccine. In addition to calling for state legislation to increase use, The Oregonian‘s editorial board should be informing citizens that the pharmaceutical manufacturer, Merck, and insurance corporations aren’t making it affordable and readily available.
Merck’s net profit in the last quarter of 2006: $473.9m.