Opinion, arguments & analyses from the editors of Scientific American

Is an HPV vaccine for boys cost-effective?


gardasil hpv vaccine boys costAn advisory panel for the U.S. Food and Drug Administration (FDA) recently approved the use of Gardasil, a vaccine for the human papillomavirus (HPV), for use in males. A new study, published yesterday in the British Medical Journal, found, however, that a public health campaign to vaccinate boys—in addition to girls, who have been receiving the vaccine in the U.S. since 2006—would not be cost-effective.

"What our results imply is for the resources expended, there may be better uses and other health interventions that would increase health gains in the population," Jane Kim of the Harvard School of Public Health, and an author of the study, told Reuters.

The vaccine helps to prevent against cervical cancer and genital warts, linked to certain strains of HPV, in females ages nine to 26. By administering it to males (recommended by the FDA panel also for ages nine to 26), proponents of the vaccine argue, it could protect boys and men from rare anal and penile cancers as well as genital warts—and slow the spread of the sexually transmitted disease.

Clinical trials have shown the vaccine to be both safe and effective in males. But, as Kim told Reuters, "Even though it might be beneficial, whether or not the benefits are worth the investment is what we sought to evaluate." Their calculations, based on trial data, health care and awareness campaign costs, as well as quality of life figures, found that the cost of launching a massive public health campaign to reach just as many boys as girls outweighed the economic benefits.

The cost-effectiveness of vaccinating boys, however, might prove to be better, Kim noted, if less than three quarters of girls get the vaccine. "If coverage in girls ends up being low," she told Reuters, "vaccinating boys became much more attractive." The authors also noted that their findings need not weight into the FDA's decision to approve the drug or a family's decision to have their son vaccinated.

Merck, which makes the vaccine, stands to earn an additional $300 million a year if the vaccine is extended to boys, Forbes reported last month.

Image courtesy of Wikimedia Commons/Jan Christian

The views expressed are those of the author and are not necessarily those of Scientific American.

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