Cervical cancer vaccine too costly, say experts

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With one in every five South Africans infected with the cancer-causing human papillomavirus (HPV) and 5 743 women diagnosed with cervical cancer each year, pressure was mounting to find more ways to reduce the cost of the prevention vaccine, experts said last week.

During a seminar on HPV in Cape Town, which was hosted by global pharmaceutical firm MSD, medical experts said the prevalence of cervical cancer, which is the most deadly among women, could be overcome by vaccination.

HPV, a highly transmittable virus that can affect men and women, is the leading cause of cervical cancer.

The ministry of health began rolling out HPV vaccine to Grade 4 girls last month. Before this move, the vaccine was only available in the private sector. When the Health Department launched the campaign, it said it was paying about a fifth of the usual cost to GlaxoSmithKline.

MSD, whose HPV vaccine prevents other forms of cancer as well as certain sexually transmitted diseases, is looking at tender pricing. It holds 70 percent of the HPV vaccine market in the South African private sector. It slashed its price by 30 percent last month to R540 per dose. The price of other pharmaceutical firms is about R500 per dose, but because MSD’s is a fourth-tier vaccine, it has been priced above others.

“At the last tender, the government engaged us to see if we can provide them with a good price and we are having those negotiations,” said Pristish Jairam, the director of external affairs at MSD.

While increasing access to the vaccine in the private sector is the government’s focus, Jairam said a small percentage of medical schemes had started looking at funding the vaccine. Bankmed medical scheme was one. The country’s biggest scheme, Discovery Health, is giving Vitality points to members who take the vaccine even though the funding still comes from the patient’s savings and not the scheme’s risk funds.

“We must put pressure on medical aids to get these vaccines funded. This is something where a benefit will come a little bit later (for the scheme) but it is cost-effective to vaccinate against HPV,” Matthys Botha, a professor in the obstetrics and gynaecology department at Stellenbosch University, said. He said there was the potential of eradicating the disease in about 50 years if people were vaccinated properly.

A person on the HPV vaccine needs three doses for 98 percent effectiveness in preventing the virus. This puts the total cost at between R1 500 and R1 620 if vaccinating at a private doctor. But in its schools programme, the Health Department is offering two doses. Research has shown this to be effective.

Research results published last week showed that a single dose might be enough to prevent cervical cancer.

The research, by the division of cancer epidemiology and genetics at the National Cancer Institute in Maryland, were based on a study of about 7 500 women in the US.

Botha said one in 30 women in South Africa was estimated to develop cervical cancer in their lifetime. Globally, 80 percent of the sexuality active population is estimated to come into contact with the HPV virus at some point. But most are able to clear infections as their immune systems are strong enough to fight the virus. Only 10 percent of women get consistent HPV infection that causes the virus to linger long enough to develop cancer or other diseases.

Even with these statistics, the Western Cape Department of Health reported last week that 44 percent of the province’s Grade 4 girls were not vaccinated because their parents had safety concerns.

Joe Maila, a spokesman, said no such concerns were brought to the department’s attention but it was too early for an indication on how many parents had given consent. “We know it helps. It’s up to people to take advantage of this opportunity. We can only vaccinate if consent is given.”

The department needed 80 percent of girls to be vaccinated to ensure herd immunity. This occurs when there are enough people vaccinated against the virus to protect those who are not. - Business Report


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