Date:   4/6/2005 6:08:36 PM ( 20 y ago)
Hits:   3,130
URL:   https://www.curezone.org/forums/fm.asp?i=62734

0 of 0 (0%) readers agree with this message.  Hide votes     What is this?

Cancer vaccine will be a hard sell
Parents balk at idea of STD drug for kids

BY ED SILVERMAN
Star-Ledger Staff

At first blush, a vaccine that prevents a deadly form of cancer would seem
like a no-brainer for parents.

But as two major drug makers prepare to introduce such a product, sides are
already being drawn in what promises to be an all-out culture clash.

Within two years, Merck and GlaxoSmithKline hope to market a pair of
groundbreaking vaccines to prevent a sexually transmitted disease. Known as
the human papillomavirus, or HPV, the disease is a leading cause of cervical
cancer.

About 5,000 women in the United States die each year from cervical cancer,
and the drug makers expect to use this as a rallying cry to make their
vaccines widely available and generate billions of dollars in sales.

One drug maker, Merck, says it will try to convince states to require
vaccination before children as young as 12 can enter school.

"The best way to prevent infection is to vaccinate the population just
before they become sexually active, which is when they're young," Eliav
Barr, Merck's senior director of biologics clinical research, said. "This
way, it can be folded into routine medical care."

But the rollout of the vaccines promises be anything but routine.
Vaccinating children for a disease caused by sexual activity will be a tough
sell, especially for parents who fear children will take it as a green light
to have sex.

The HPV vaccine is likely to become a flashpoint for the pharmaceutical
industry, public health officials and parents, who are gearing up for a
heated debate about the finer points of cancer prevention, health-care costs
and teenage sex.

The vaccines are still in the final stages of testing, but some groups are
already concerned.

"The best way to prevent HPV is through abstinence," said Bridget Maher, an
analyst at the Family Research Council, a conservative group that expects to
campaign against making the vaccines mandatory for entering school. "I see
potential harm in giving this vaccine to young women."

She isn't alone.

A Merck study of 2,053 parents released last year found 11 percent of
parents with 13-year-old girls probably or definitely wouldn't want them
vaccinated before their 18th birthday. Another 27 percent were undecided.

A separate study last year in the Journal of Lower Genital Tract Disease
found 24 percent of 575 parents opposed a vaccine and believed it would lead
children to engage in sexual activity sooner than they would otherwise.

At the same time, though, these studies suggest most parents do support
vaccinating their children. The results also indicate some parents become
supportive after learning about the health benefits or hearing doctors
recommend vaccination.

Some doctors believe parents may become more supportive when they learn HPV
can be transmitted through sexual contact, and not necessarily intercourse,
according to a study in the American Journal of Epidemiology.

"This will be an arduous educational mission," said Daron Ferris, a
professor of family medicine and obstetrics/gynecology at the Medical
College of Georgia, who also ran trials for the Merck vaccine. "But once
they realize we have a vaccine to prevent cancer, I'd expect parents will
want to protect their loved ones."

Convincing parents may be harder for Merck than Glaxo, a British drug maker.

Unlike Glaxo, Merck will also target genital warts with its vaccine. Doctors
caution this may fuel more controversy if teenagers see a vaccine as an easy
way to combat yet another increasingly common sexually transmitted disease.

This is why some experts see trouble ahead. They point to the heated battle
concerning an over-the-counter, morning-after pill a federal panel in 2003
recommended for girls as young as 16. Anti-abortion groups opposed the
contraceptive pill, and the Food and Drug Administration has still not
approved it.

"Sex is a scary thing in this culture, and the age of the girls to be
vaccinated will really be an issue," said Janice Irvine, a University of
Massachusetts sociology professor and author of "Talk About Sex," a book on
sex education. "You can expect opposition to this vaccine."

These predictions worry the drug makers. As some best-selling drugs face
competition from cheap generic rivals, vaccines will become a source of
much-needed revenue. This is especially true for Merck. The Whitehouse
Station-based drug maker next year loses patent protection on its cash cow,
the Zocor cholesterol pill.

As Wall Street sees it, an HPV vaccine holds tremendous promise.

The global market could hit $4.3 billion in revenue by 2010, according to a
recent report by Richard Evans, an analyst at Sanford C. Bernstein. His
projection anticipates adolescent girls and boys, as well as women in their
20s and 30s, will be vaccinated.

The heady forecasts stem from data showing cervical cancer is widespread:
About 500,000 women worldwide are diagnosed each year, leading to 230,000
deaths, according to the World Health Organization. In the United States,
about 15,000 women are diagnosed annually.

For the companies to realize the billions of dollars in annual revenue, they
are expected to advertise widely and charge a lot. Merck will likely charge
$100 for each of three needed doses, Evans said, while Glaxo may place an
$80 price tag on each dose.

At those prices, an HPV vaccine would cost more than other childhood
vaccines, according to an article in Clinical Infectious Diseases, which was
written by officials at the Centers for Disease Control and Prevention. An
average dose of vaccine for measles, mumps and rubella cost $34.73 in 2003,
while a dose of chickenpox vaccine was $58.11.

The HPV vaccines would be "fairly expensive for this country," said Lauri
Markowitz, chief of epidemiology research in prevention of sexually
transmitted diseases at the CDC, which believes a vaccine would help prevent
cervical cancer.

An official CDC endorsement would not only influence doctors to recommend
vaccination, but health plans would also be spurred to cover the cost.

The drug makers are unwilling to discuss prices, but note diagnosing and
treating HPV is expensive. Related health costs were estimated to be at
least $1.6 billion annually, according to a 1999 CDC study. The costs
include doctor visits, Pap tests to detect cervical cancer and follow-up
procedures.

"A vaccine would be a more efficient use of health-care dollars," said Evan
Myers, an associate professor of obstetrics and gynecology at Duke
University and a consultant to Merck, who has studied the economic impact of
an HPV vaccine.

The best way to maximize savings, the companies maintained, is to vaccinate
children as young as possible. Glaxo plans to push for vaccinating girls as
young as 10, according to David Pernock, senior vice president for
pharmaceuticals and vaccines.

"Anyone who thinks a lot of teenagers aren't sexually active has their head
in the sand," said Cody Meissner, a pediatrics professor at Tufts New
England Medical Center and vice chair of the American Academy of Pediatrics'
infectious disease committee.

"No one's pleased about that, but it's a fact of life. And if the results of
the final-stage clinical trials for these vaccines are consistent with
what's known so far, they will be a wonderful contribution to public
health."

But convincing doctors may prove much easier than swaying state officials to
require vaccination before youngsters can attend school, as Merck intends to
do. The potential for controversy is so great that one New Jersey health
official said he does not want to get involved.

"I don't think we'd require the schools to mandate something like this,"
said Eddy Bresnitz, deputy commissioner of the state Department of Health
and Senior Services. "I'm sure the battle will be huge, and I'm not sure
it's a battle we should be fighting."

http://www.nj.com/business/ledger/index.ssf?/base/business-0/111251...

<< Return to the standard message view

fetched in 0.02 sec, referred by http://www.curezone.org/forums/fmp.asp?i=62734