I’m certainly not the only one who’s been irritated by the barrage of government-sponsored Gardasil ads that littered our airwaves and newspapers throughout the past year. The tone of these ads is frustrating in itself, as the drug’s spokeswoman attributes her decision to take the vaccine to her superior intellect. “Because I’m smart,” she says—the implication being that non-vaccinated females must be the opposite.
Gardasil, of course, is not a medical label. Rather, it’s a product name, referring specifically to the cervical cancer vaccine produced by Merck & Co. In light of the extensive recalls and lawsuits surrounding its Vioxx painkillers, Gardasil has risen to become Merck’s bread and butter as far as revenue streams are concerned. The fact that our own government has paved the way for this revenue stream by providing Merck with a ready-made market monopoly and a young, non-skeptical consumer base is enough to suggest a strong ethical conflict.
The other side of the conflict is a strong case in favour of the product. Human papillomavirus (HPV) is conclusively shown to be a precursor of cervical cancer. As its ads prominently state, Gardasil is 100 per cent effective against strains of HPV that account for 70 per cent of cervical cancers. Since it is only effective if taken before one becomes sexually active, why should the government not want to administer such an effective vaccine to all young girls?
Cause for skepticism emerges when one looks at the numbers that Merck hasn’t reported in its promotional material. Approximately .06 per cent of those vaccinated with Gardasil were found to experience harmful symptoms, including paralysis and death. The drug’s supporters will say that this small rate of harm is justified by the greater good of nationwide vaccination against cervical cancer. Is it?
While cervical cancer is the second most common cancer in females worldwide, it is less pervasive in Canada. It comes in at a close tie for third, alongside lung cancer and behind breast and colorectal cancers. Overall, cervical cancer accounts for 4 per cent of the cancers that affect 2.8 per cent of Canadian women. Being 100 per cent effective against HPV strains causing 70 per cent of cervical cancers, Gardasil can, at best, help .08 per cent of all women in Canada. Subtracting the percentage should extend life by 64 to 136 years. Given that women are typically diagnosed with cervical cancer in their 40s, this is unlikely. One can also look of women that Gardasil is expected to harm or kill, this leaves .02 per cent of women able to receive the vaccine’s benefits without any offsetting harm. At this rate, one out of every 5,000 women will receive such benefits. As Gardasil is currently the world’s most expensive vaccine, this amounts to $1.8 million spent on every woman who actually benefits. Is this money well spent?
Statistics on the effectiveness of breast cancer screening suggest that each year of life saved by such measures is worth $13,200 to $28,000. To justify its cost, Gardasil at the opportunity cost of these vaccinations—what opportunities are forgone by spending this money on Gardasil? $1.8 million could be spent on 36 years worth of the best treatment for children with autism, or 31,000 goats provided to the international poor through Oxfam.
The exorbitant cost of Gardasil begins to make sense only when one thinks of such pharmaceuticals as a futures market. Essentially, the government is betting that present-day young girls will grow into women whose cases of cervical cancer will cost more than $1.8 million each. Thus, money is saved by paying less now. In Gardasil, Merck provides the instrument for such a bet to be made, collecting significant profits from the government’s speculation in the process. The money circulates in this way, from taxes to government to pharmaceutical company, so long as cancer remains both expensive and abundant. While the effective monetization of the Internet remains a distant prospect, the monetization of cancer is well underway. With vaccines for prostate, skin, and colon cancer currently in development, Gardasil will soon have company in this new market. As housing markets fall for the first time in years, cancer is emerging as the next sure bet.
