Gardasil, Katie, Merck, and I

December 10, 2013

Katie Couric is currently catching some well-deserved flak for recently airing anti-vaccination propaganda on her daytime television show. Couric has since apologized for her segment, acknowledging that "Following the show, and in fact before it even aired, there was criticism that the program was too anti-vaccine and anti-science, and in retrospect, some of that criticism was valid."

While Couric sifts through what remains of her journalistic credibility, I thought I'd share my brief HPV vaccine story. About two years ago I paid $700 to get vaccinated with Gardasil. It was not covered by my health insurance because even though HPV vaccination is recognized as safe and effective for men, it was (and, I think, still is not) officially recommended for men.

Part of the issue was a miscommunication with my doctor, who told me that Gardasil would cost about $150. That did not seem unreasonable to me, though he hadn't mentioned that a three-dose regimen is required, and that the quoted price was per dose. Thus my cost suddenly tripled to $450, which was much more than I had originally planned, and by far the most vaccination I've ever gotten.

When the final bill came I noticed that there was a $35 "administration fee" -per injection, of course, which added another $105 to the bill, and by the time another mystery charge and my office visit copay was included, I spent almost exactly $700 on my vaccination against the human papillomavirus, which causes about 70% of cervical cancers, as well as some anal, penile, and throat cancers. I challenged the bill, but after months of back-and-forth demands I finally gave in and paid it.

Then a recent piece in the New York Times noted that "The two companies that make vaccines against cervical cancer announced Thursday that they would cut their prices to the world's poorest countries below $5 per dose, eventually making it possible for millions of girls to be protected against a major deadly cancer.... The lower prices - $4.50 for Merck's Gardasil vaccine and $4.60 for GlaxoSmithKline's Cervarix - were negotiated through the GAVI Alliance, which was created in 1999 with a grant from the Bill and Melinda Gates Foundation to deliver more vaccines to the world's poor. The low price will initially apply to a few million doses for demonstration projects in Kenya, Ghana, Laos, Madagascar and elsewhere, but Dr. Seth Berkley, the alliance's chief executive, said he hoped that by 2020, 30 million girls in 40 countries would get the vaccine at that price or less."

I have mixed feelings about my experience. On one hand I'm glad I got vaccinated, not only for my own health but that of my partners. On the other hand, I'm a writer and editor for a non-profit educational organization. I don't earn a lot of money, and $700 is a lot of money to me. I don't at all begrudge the fact that my money might help vaccinate poor girls and women around the world, but the fact that I paid about $685 more than someone in Kenya or Laos kind of galls me. They deserve vaccines at a price they can afford-but so do I. I don't deserve to be gouged for my Gardasil, and the fact is that vaccinating (heterosexual) men indirectly helps prevent the spread of HPV to women. Cancer doesn't discriminate, and the cost of vaccinating someone is nothing compared to the cost of treating them for that disease. For that reason, among many others, I think all vaccines should be free to all-it is a great cost savings in the long term.

It's also important to note that HPV vaccines were developed with taxpayer money (mostly from the National Institutes of Health). Merck and GlaxoSmithKline already made a handsome profit from their HPV vaccines. Bashing Big Pharma as greedy bastards is a popular thing to do, and it's often true. I like to think that the $700 I paid to Merck helped pay for-well, let's see... 137 girls in developing countries to be vaccinated against cancer.

But I suspect that I really picked up a hotel room's booze tab for some doctor attending a lavish Merck sales gala pushing their latest designer drugs. I'll probably think twice about getting another similar vaccination, which does no one any good.