The NHS has changed its choice of vaccine for the prevention of HPV virus infection – the main cause of cervical cancer – to include prevention of genital warts, choosing MSD’s Gardisil as the new standard.
Gardasil vaccination – not formerly available on the NHS – will be offered to all girls aged 12 to 13 from September 2012, and is predicted to eradicate genital warts in the UK heterosexual population within 20 years.
The decision reverses the 2006 choice of GSK’s cheaper vaccine Cervarix, which is effective against HPV infection but not against genital warts.
Sexual health organisations that had criticised the 2008 decision as being based on price rather than value have praised the policy change.
The quadrivalent vaccine Gardasil targets four strains of HPV – two that cause 70% of cervical cancers and two that cause 90% of genital warts – whereas the bivalent Cervarix targets only the two cancer-causing strains.
A review of the impact of HPV by the Health Protection Agency led the NHS to place greater emphasis on the prevention of genital warts (which affect 160,000 new patients in the UK each year) than in the 2008 decision.
David Salisbury, Director of Immunisation for the NHS, said: “We looked at the science and we looked at the price. We have reflected the changes in scientific knowledge that has become available since last time.”
Salisbury noted that in Australia, Gardasil has been shown to greatly reduce the incidence of genital warts while being as effective as Cervarix in preventing cervical cancer.
Since 2008, HPV vaccination has been offered routinely to girls aged 12 to 13 years, with a catch-up programme covering girls up to 18. Take-up is at 77% for the younger group and 84% for the catch-up.
Gardasil is sold in Europe by Sanofi Pasteur MSD, a joint venture between Merck & Co (MSD in Europe) and Sanofi.
Dr Peter Greenhouse of the British Association for Sexual Health and HIV said the change in vaccine should see a reduction in the incidence of genital warts in teenage girls within five years, leading to their eradication in the heterosexual population within two decades. He recommended that the vaccine also be made available to young gay men.
For the pharma industry, the rethinking of the NHS cervical cancer strategy represents a triumph for the value-based pricing model.
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