Drugmakers Merck and GlaxoSmithKline joined the GAVI Alliance in a new agreement to supply HPV vaccine at lower prices to developing countries to help girls and women in those nations avoid cervical cancer.
GAVI stands for the Global Alliance for Vaccines and Immunization and is based in Geneva. It is a public-private partnership, funded by governments and non-profit organizations, with for-profit drug companies contributing medicine at lower prices than they charge in developed countries.
Human papillomavirus can contribute to cancer of the cervix, anus and other parts of the pelvis. Both girls and boys have begun to be treated with the vaccine in the United States and other developed countries.
"A vast health gap currently exists between girls in rich and poor countries. With GAVI's programs we can begin to bridge that gap so that all girls can be protected against cervical cancer no matter where they are born," GAVI chief executive officer Seth Berkley said in a statement. "By 2020 we hope to reach more than 30 million girls in more than 40 countries. This is a transformational moment for the health of women and girls across the world. We thank the manufacturers for working with us to help make this happen."
Merck is based in Whitehouse Station, N.J., and has a big operation in West Point, Montgomery County. Merck's HPV vaccine, Gardasil, is made at the West Point facility.
Glaxo is based in London, has 1300 employees at the Navy Yard in Philadelphia and thousands others in facilities in Pennsylvania and New Jersey.
Under the program, vaccines that drug companies charge more than $100 for in developed countries, will be available to poor countries for as low as $4.50 and $4.60 per dose, though three doses is the usual regime. The previous public sector low price was $13 per dose.
GAVI said of the 275,000 women in the world who die of cervical cancer every year, more than 85% are in low-income countries. The United Nation's UNICEF will administer the program.
"It is essential that every young girl around the world have access to HPV vaccines. Today's decision by UNICEF is an important step forward," Julie L. Gerberding, president of Merck's vaccines unit, said in a statement. "This partnership highlights Merck's commitment to working closely with GAVI to ensure broad and sustained access to Gardasil in the world's poorest countries, where the burden of cervical cancer is greatest."
Christophe Weber, president of GSK's vaccine unit said: "Cervical cancer is a significant issue especially in poorer countries where the availability of screening is limited. We are pleased to be expanding our commitment to GAVI by delivering our Cervarix vaccine to help protect girls in the developing world. This continues our significant commitment to make our vaccines accessible to as many people as possible, no matter where in the world they live. We hope that this will help reduce the burden of cervical cancer and positively impact future generations."
Lest anyone think vaccines are all about charity, both companies are profit-oriented enterprises.
Gardasil had $1.6 billion in sales in 2012, according to Merck's annual report. Merck CEO and Philadelphia native Ken Frazier said prices have to be higher for the same drug in developed countries such as the U.S. in order to be cheaper for poorer countries. In a recent interview with the Inquirer, GSK chief executive Andrew Witty said that to keep shareholders happy, for-profit companies can't give away all vaccines all of the time. And giving it away one year, but withdrawing it in the next year because of other financial pressures puts poor countries, non-governmental organizations and, ultimately, patients, in a bad position.
Doctors Without Borders/Médecins Sans Frontières (MSF), a non-governmental organization that provides medical care in some of the world's poorest and most-troubled spots, issued a statement expressing disappointment that the price was not lower, given the revenue that Merck and GSK made from their medicines.
"It's really disappointing that pharmaceutical companies haven't offered GAVI a much better deal on the HPV vaccine," Philadelphia native Kate Elder, the vaccines policy advisor for the MSF Access Campaign, said in a statement. "This vaccine is critical for millions of girls in developing countries, where cervical cancer is the main cause of cancer deaths among women. The price is unjustifiably high and will add to the already spiraling vaccination costs faced by low-income countries. While this deal is a reduction from the prices paid by developed countries, it will still cost nearly $14 to fully protect a girl against HPV – a price that is too high for the world's poorest countries. This adds more than 35 percent to the cost of the basic package of vaccines for girls and young women."
The $14 price she referred to factored in the need for the vaccines to be delivered in three doses.
In a conference call with reporters, GAVI's Berkley was asked about the MSF criticism. He said he would love a lower price, but turned the question back to MSF.
"Now that we got these price reductions, should we not roll out the vaccines to these girls?" Berkley asked.
Elder told the Inquirer recently that she agreed with Witty's comment about one-time or uncertain donations not being a sustainable model. But she would like lower prices on a consistent basis.
Asked about Berkley's question to MSF, Elder said in an email to the Inquirer, "To be absolutely clear: as a medical organization that vaccinates millions of people across the poorest countries, we fully support the introduction of these newest vaccines, including HPV. The point is that we want to vaccinate more, but MSF and country governments will not be able to reach as many children as needed in these countries if prices continue to skyrocket. To ask this of a medical organization that vaccinates millions of kids every single year is a deliberate attempt to divert attention from the discussion we're trying to have - why are prices so high?"