Are we manufacturing a drug or giving young girls the incentive to be promiscuous and the young boys more reasons to not worry. I think our youngsters are the true victims here.




To market a drug
Financing a vaccine against cervical cancer may be the right thing to do, but a multinational giant's aggressive campaign has muddied the debate
CanWest News Service
Published: Monday, May 14, 2007
When Finance Minister Jim Flaherty announced $300 million in federal money for a program to vaccinate girls and young women against the human papilloma virus, it was hailed as the most important development in women's reproductive health since the pill.

This vaccine promises to tackle more than the warts caused by certain strains of HPV. It is billed as the first anti-cancer vaccine designed to prevent the vast majority of cervical cancer cases.

But it's too early to tell whether this is just a victory for women's health or also the triumph of an aggressive, multimillion-dollar marketing campaign that has infiltrated our living rooms and the political backrooms. Probably it's both.


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Merck is keen to see a government program to finance a wide-scale vaccination program while its drug Gardasil is the only one on the market.
AFP, Getty Images, Vancouver Sun Files

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Font: ****The process has been so tainted by one drug company pursuing its own commercial interests that it's difficult to know whether financing the HPV vaccine is the right decision from a public health perspective. It might well be, but the heavy lobbying effort, from a former aide to Prime Minister Stephen Harper on down, muddles the debate.

In coming weeks, the Ontario government is expected to announce its financing of the vaccine, which in partnership with federal funds, is crucial to the establishment of an HPV vaccine program. The province, like Harper's Conservatives, has come under intense drug company lobbying.

Meanwhile, we have seen health officials and women's groups debate the merits of this vaccine on the front pages of newspapers.

Many are in favour of the vaccine, calling it a revolution in health care, while others aren't so sure it's necessary and wonder if other health care needs are more pressing, such as reducing waiting times for cancer surgery, or the doctor shortage.

Parents have weighed in, admitting they don't know whether they want their preteens and teens vaccinated. Many people are confused. No wonder. This isn't just a health story, it's a business story, and when we look at it in that light, the urgency around the issue makes more sense.

The multinational drug giant Merck Frosst makes Gardasil, the only approved HPV vaccine available, and it has a lot riding on a successful launch of the vaccine.

According to the Wall Street Journal, Merck faces patent expirations on other bestsellers, and legal costs related to Vioxx, the withdrawn painkiller linked to heart attacks and strokes. Some analysts believe Gardasil's annual sales could reach $2 billion US or more by 2010.

Until its competitors can get their own versions of an HPV vaccine approved (GlaxoSmith Kline has one in the pipe), Gardasil is the only vaccine on the market. And that makes Merck keen to see a government program to finance wide-scale vaccination while it is.

But to create a public appetite for the vaccine, it must convince us our daughters need this vaccine. It also has to deal with our lapses in medical knowledge (who knew a virus caused cancer?), as well as our squeamishness around an issue most of us don't want to think about -- our preteen girls one day having unprotected sex.

Sheila Murphy, spokeswoman for Merck, detailed in an e-mail how difficult it is to explain Gardasil to the masses.

"The fact that a virus causes cancer, in this case anogenital cancers, is a big paradigm shift for many people," she wrote, adding, "when I started working on the Gardasil team, I didn't know that HPV was the reason I was having a Pap test."

She said it's equally challenging to communicate to people that a vaccine exists to prevent those cancers. "We are working with individuals and groups who share our desire to improve the wellness of Canadian women by communicating information on HPV.

"We are using all the channels of communication open to us to get the message about our cancer-preventing vaccine out."

Gardasil is a three-course vaccination that prevents four strains of the human papilloma virus, including HPV 16 and 18, thought to cause 70 per cent of cervical cancer cases. While cervical cancer is common in developing countries, it's relatively rare in North America. About 400 women will die of cervical cancer each year in Canada. Women already have an effective method of prevention -- regular Pap tests. During the past five decades, this exam has contributed to an 80 per cent reduction in cervical-cancer deaths. However, some critics argue the $300 million would be better spent ensuring Pap tests for immigrants, aboriginals and women who live in poverty -- all disproportionately represented among cervical cancer cases.

It's expected the vaccine will not only reduce cancer deaths but also the number of infections, the development of precancerous lesions and the need for biopsies.

In Canada and the U.S., even before the vaccine was approved, Merck financed information campaigns that linked the little-talked-about human papilloma virus with cancer.

Last April in the U.S., Merck began the "Tell Someone" advertising campaign featuring girls (actresses), in interview style, expressing surprise about the cause of cervical cancer and promising to tell other women.

These ads didn't mention the vaccine -- Merck wasn't allowed because it hadn't been approved by the Food and Drug Administration -- but represented a first step in linking cancer with a virus. At the time, a Merck spokesperson denied the campaign had anything to do with the vaccine.

In Canada, women can consult www.tellsomeone.ca, which describes the link. It also tells readers about a vaccine against HPV but, of course, Merck's name isn't mentioned because direct-to-consumer advertising for cancer therapies is not allowed.

Once the FDA granted approval in the U.S. last June, a full-scale ad campaign began, one which Canadians are generally exposed to because these advertisements show up in our homes on American TV channels.

In one TV spot, girls skipping ripe on a sidewalk are chanting: "O-N-E-L-E-S-S. I want to be one less. One less." In another, a young women skateboarder faces the camera and says, "I could be one less. One less statistic." The ads are poignant and gripping.

In Canada, we won't be seeing the "One Less" advertising. While direct-to-consumer advertising is generally allowed for vaccines, in the case of Gardasil, Merck cannot mention cancer in any ads. This has to do with the classification of the disease.

In the absence of the TV ads, Merck has to rely on various doctors' and women's groups to promote the product. It hasn't been difficult.

A spokeswoman for the Society of Obstetricians and Gynecologists of Canada told the Ottawa Citizen that Merck gave the society a $1.5-million grant to educate people about HPV. The SOGC's website on the issue (www.hpvinfo.ca) does not mention Merck, but serves the larger purpose of educating people about the cancer/viral link.

The society, which has come out strongly in favour of the vaccine, was only too happy to oblige when asked by Merck to educate the public about HPV. One of its main mandates is public education, said SOGC spokeswoman Kelly Nolan.

Dr. Vyta Senikas, the executive vice-president of the SOGC, said that aggressive marketing of products is a fact of life. She likened Merck's marketing of Gardasil to Microsoft's marketing of the video game system Xbox.

She said physicians are smart enough to withstand any undue pressure and believes Canadians will receive unbiased information about a new product she thinks is revolutionary. She stressed that, despite Merck financing, all information coming from the SOGC is peer-reviewed and fact based.

In Canada, the campaign to make the vaccine a must-have for every preteen is more of a backroom affair.

Shortly before Flaherty announced funding for vaccination in the budget, Merck hired Ken Boessenkool, a former aide to the prime minister, to lobby the federal government. Boessenkool works for Hill & Knowlton, a giant public relations and lobbying firm. After his hiring was revealed by the Citizen, a Merck spokesperson said Hill & Knowlton would help explain the importance of the new vaccine to policy-makers.

Now, with the federal money committed, Merck is lobbying the individual provinces for matching funding and the establishment of vaccination programs.

So there you have it: A glimpse into the lengths Merck has gone to convince politicians and the people that millions of Canadian girls and young women need this vaccine.

here is a link to another thread here on nt about this subject.

http://neurotalk.psychcentral.com/sh...ad.php?t=12577