Fwd: Merck lobbies states to require cervical-cancer vaccine for schoolgirls

[Guest guest]

This is not purely an EMS topic, but I hope that the moderators will indulge

me for posting this link to articles about Governor 's executive order to

give the vaccine to students.

I think it is important for all medical professionals to know, so I posted

it.

Reactions?

Gene G.

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> Associated Press    2007-02-03

>  

> Texas Requires Anti-Cancer Vaccine for Girls

>

> By LIZ AUSTIN PETERSON

> AP

> AUSTIN, Texas (Feb. 2) - Bypassing the Legislature altogether, Republican 

> Gov. Rick issued an order Friday making Texas the first state to

> require that schoolgirls get vaccinated against the sexually transmitted virus

that

> causes cervical cancer.

>

> Mandatory Vaccination

>

>

>  

>

>

>

> By employing an executive order, sidestepped opposition in the

> Legislature from conservatives and parents' rights groups who fear such a

> requirement would condone premarital sex and interfere with the way Texans

raise their

> children.

>

> Beginning in September 2008, girls entering the sixth grade - meaning,

> generally, girls ages 11 and 12 - will have to receive Gardasil, Merck & Co.'s

new

> vaccine against strains of the human papillomavirus, or HPV.

>

> also directed state health authorities to make the vaccine available

> free to girls 9 to 18 who are uninsured or whose insurance does not cover

> vaccines. In addition, he ordered that Medicaid offer Gardasil to women ages

19

> to 21.

>

> , a conservative Christian who opposes abortion and stem-cell research

> using embryonic cells, counts on the religious right for his political base.

> But he has said the cervical cancer vaccine is no different from the one that

> protects children against polio.

>

> " The HPV vaccine provides us with an incredible opportunity to effectively

> target and prevent cervical cancer, " said.

>

> Merck is bankrolling efforts to pass state laws across the country mandating

> Gardasil for girls as young as 11 or 12. It doubled its lobbying budget in

> Texas and has funneled money through Women in Government, an advocacy group

> made up of female state legislators around the country.

>

> has ties to Merck and Women in Government. One of the drug company's

> three lobbyists in Texas is Mike Toomey, 's former chief of staff. His

> current chief of staff's mother-in-law, Texas Republican state Rep. Dianne

> White Delisi, is a state director for Women in Government.

>

> The governor also received $6,000 from Merck's political action committee

> during his re-election campaign.

>

> The order is effective until or a successor changes it, and the

> Legislature has no authority to repeal it, said spokeswoman Krista

Moody.

> Moody said the Texas Constitution permits the governor, as head of the

executive

> branch, to order other members of the executive branch to adopt rules like

> this one.

>

> Legislative aides said they are looking for ways around the order for

> parents who oppose it.

> " He's circumventing the will of the people, " said Dawn , president

> of Parents Requesting Open Vaccine Education, a citizens group that fought

> for the right to opt out of other vaccine requirements. " There are bills

> filed. There's no emergency except in the boardrooms of Merck, where this is

> failing to gain the support that they had expected. "

>

> Texas allows parents to opt out of inoculations by filing an affidavit

> objecting to the vaccine on religious or philosophical reasons. Even with such

> provisions, however, conservative groups say such requirements interfere with

> parents' rights to make medical decisions for their children.

>

> The federal government approved Gardasil in June, and a government advisory

> panel has recommended that all girls get the shots at 11 and 12, before they

> are likely to be sexually active.

>

> The New Jersey-based drug company could generate billions in sales if

> Gardasil - at $360 for the three-shot regimen - were made mandatory across the

> country. Most insurance companies now cover the vaccine, which has been shown

to

> have no serious side effects.

>

> Merck spokeswoman Janet Skidmore would not say how much the company is

> spending on lobbyists or how much it has donated to Women in Government.

> Crosby, the group's president, also declined to specify how much the drug

> company gave.

>

> A top official from Merck's vaccine division sits on Women in Government's

> business council, and many of the bills around the country have been

> introduced by members of Women in Government.

>  

>

>

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>  

> Associated Press    2007-02-021

>  

> Cancer Vaccine Faces Cost Hurdles

> AP

> TRENTON (Feb. 2) - Girls jumping rope chant " one less, one less, " in TV

> commercials for the new cervical cancer vaccine Gardasil, vowing they will be

> one less cancer patient.

>

> But in the real world, Gardasil is getting used less than doctors would

> like. Pediatricians and gynecologists from Arizona to New York are refusing to

> stock Gardasil because of its $360 price for the three doses required and

> " totally inadequate " reimbursement from most insurers.

>

> Pediatricians, in particular, are rebelling, fed up after years of declining

> insurance reimbursement for vaccines, an explosion of new vaccines and

> fast-escalating vaccine prices.

>

> Many practices must tie up $50,000 or more in vaccine inventory, run

> multiple refrigerators, insure the vaccines and spend lots of time on

inventory

> management. They also must absorb the cost of broken or wasted vials, and say

> that's not possible with most insurers reimbursing at just $2 to $15 over the

> $120 per dose charged by Gardasil's developer, Merck & Co. of Whitehouse

> Station, N.J.

>

> " Doctors are drawing a line in the sand on this. They're either not giving

> it or requiring a surcharge, " said Dr. Schwartz of Broadway Pediatrics

> Associates in Westport, N.J., which charges patients a $25 surcharge per

> shot.

>

> Dr. Jill Stoller of Chestnut Ridge Pediatric Associates in Woodcliff Lake,

> N.J., said the inadequate insurance reimbursement for Gardasil is keeping " a

> wonderful new vaccine " from many patients.

>

> " It really is a shame, " said Stoller, who also assesses a surcharge.

>

> Pediatricians and gynecologists at solo and large group private practices

> contacted by The Associated Press said they would, at best, break even if they

> stocked the vaccine. Most will give patients a prescription to get filled and

> bring back, but that could cost patients far more.

>

> " I don't know where to turn, " said Falco, a Marlboro, N.Y., elementary

> school teacher trying to get her 13- and 15-year-old daughters vaccinated.

>

> Her pediatrician, Dr. Herschel Lessin told her his 20-doctor Children's

> Medical Group in Poughkeepsie, N.Y., can't afford to stock Gardasil.

>

> Lessin said insurers paying their executives millions won't give him $25 to

> cover his costs, but will spend tens of thousands if a patient develops

> cervical cancer.

>

> His practice will provide prescriptions but warned Falco her insurer might

> not reimburse her and pharmacies might mark each dose up to $200. Falco then

> tried her gynecologist, who sent her back to the pediatrician.

>

> " I still don't have the shot and now I have to decide whether I want to make

> a $1,200 investment to get them vaccinated, " she said. " I really don't want

> to deny them what I think is right. "

>

> Dr. Blum, senior partner in a big pediatric practice in suburban

> Kansas City, said it only provides Gardasil to patients who pay $450 up front,

> then tries to get insurance reimbursement for them. Only a half-dozen patients

> have done so.

>

> Dr. Kathleen of AppleTree Pediatrics in Tyler, Texas, said as a solo

> practitioner she not only can't stock Gardasil but can't afford it for her own

> 12- and 13-year-old daughters. When she explains the situation to patients,

> " they all say 'We'll be happy to wait,' because they can't afford to pay for

> it either. "

>

> Girls should get the vaccine before they are sexually active, say medical

> groups representing pediatricians, gynecologists and cancer specialists.

That's

> because Gardasil, launched last June, prevents cervical cancer by blocking

> infection from the two strains of human papilloma virus - a common sexually

> transmitted disease - that cause most cervical cancer. It also protects

against

> genital warts.

>

> Experts recommend routinely vaccinating 11- and 12-year-old girls, who get

> other shots then, and say Gardasil can be given to girls as young as 9 and as

> a catch-up for those 13 to 18.

>

> The Food and Drug Administration has approved it for females up to age 26.

> Merck is conducting tests on older women and boys.

>

> Some pediatricians say many gynecologists just don't want to deal with

> Gardasil.

>

> Dr. ph Piacente of Mesa Pediatrics in Arizona said his practice hopes to

> be able to afford to start stocking Gardasil by summer, but two gynecology

> practices nearby tell him they won't handle it.

>

> With many 18- to 26-year-old women uninsured, gynecologist Dr. Rhoda

> Sperling at Mount Sinai Medical Center in New York said only about half her

patients

> who are not in long-term monogamous relationships are getting Gardasil.

>

> Only a few of Planned Parenthood's 860-plus U.S. health centers offer

> Gardasil so far, but the federal Vaccines for Children program recently sent

just

> over 1.3 million doses to states for girls covered by Medicaid or

> state-subsidized children's health insurance.

>

> Doctors say manufacturer Merck should do more to help, given that Gardasil

> is the most expensive vaccine ever. They say it gives them a couple months to

> pay but not the customary discount for ordering multiple vaccines.

>

> Merck, which notes Gardasil is covered by 96 percent of insurance plans,

> recently added Gardasil and its other adult vaccines to its patient assistance

> program, but only about 800 doses total were given away in the last three

> months of 2006.

>

> The American Academy of Pediatrics says insurers should be paying at least

> 17 percent over a vaccine's price to cover all costs, and it is talking with

> insurers to win higher reimbursements.

>

> Two have agreed.

>

> Horizon Blue Cross Blue Shield, New Jersey's biggest insurer, now gives $150

> per dose plus a $21.50 administration fee - for staff time and office

> overhead, plus supplies and syringe disposal.

>

> Cigna HealthCare said it raised reimbursement " significantly " on Jan. 15 in

> most markets but would not disclose any figures. Doctors said it had been

> paying only $120 per dose.

>

> A spokesman for the trade group America's Health Insurance Plans said

> patients whose doctors aren't stocking Gardasil should check with their

insurer to

> see if there's another way to get it.

>

>  

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>

> Associated Press    Tuesday, January 30, 2007

>

> Merck lobbies states to require cervical-cancer vaccine for schoolgirls

>

> AUSTIN, Texas - Merck & Co. is helping bankroll efforts to pass state laws

> requiring girls as young as 11 or 12 to receive the drugmaker's new vaccine

> against the sexually transmitted cervical-cancer virus.

>    

>     Some conservatives and parents'-rights groups say such a requirement

> would encourage premarital sex and interfere with the way they raise their

> children, and they say Merck's push for such laws is underhanded. But the

company

> said its lobbying efforts have been above-board.

>    

>     With at least 18 states debating whether to require Merck's Gardasil

> vaccine for schoolgirls, Merck has funneled money through Women in Government,

> an advocacy group made up of female state legislators around the country.

>    

>     A top official from Merck's vaccine division sits on Women in

> Government's business council, and many of the bills around the country have

been

> introduced by members of Women in Government.

>    

>     " Cervical cancer is of particular interest to our members because it

> represents the first opportunity that we have to actually eliminate a cancer, "

> Women in Government President Crosby said.

>    

>     Gardasil, approved by the federal government in June, protects girls and

> women against strains of the human papillomavirus, or HPV, that are

> responsible for most cases of cervical cancer. A government advisory panel has

> recommended that all girls get the shots at 11 and 12, before they are likely

to be

> sexually active.

>    

>     But no state has yet to add Gardasil to the list of vaccinations

> youngsters must have under law to be enrolled in school.

>    

>     Merck spokeswoman Janet Skidmore would not say how much the company is

> spending on lobbyists or how much it has donated to Women in Government.

> Crosby also declined to specify how much the drug company gave.

>    

>     But Skidmore said: " We disclosed the fact that we provide funding to

> this organization. We're not in any way trying to obscure that. "

>    

>     The New Jersey-based drug company could generate billions in sales if

> Gardasil _ at $360 for the three-shot regimen _ were made mandatory across the

> country. Most insurance companies now cover the vaccine, which has been shown

> to have no serious side effects.

>    

>     Cathie , president of the conservative watchdog group Texas Eagle

> Forum, said the relationship between Merck and Women in Government is too

> cozy.

>    

>     " What it does is benefit the pharmaceutical companies, and I don't want

> pharmaceutical companies taking precedence over the authorities of parents, "

> she said.

>    

>     said Merck's method of lobbying quietly through groups like Women

> in Government in addition to meeting directly with legislators are common in

> state government but still should raise eyebrows. " It's corrupt as far as I'm

> concerned, " she said.

>    

>     A mandatory vaccine against a sexually transmitted disease could be a

> tough sell in the Lone Star State and other conservative strongholds, where

> schools preach abstinence and parents' rights are sacrosanct.

>    

>     But Merck has doubled its spending on lobbyists in Texas this year, to

> between $150,000 and $250,000, as lawmakers consider the vaccine bill for

> girls entering the sixth grade.

>    

>     Also, the drugmaker has hired one of the state's most powerful

> lobbyists, Mike Toomey, who once served as Republican Gov. Rick 's chief

of staff

> and can influence conservatives who see him as one of their

> own.

>    

>     " What we support are approaches that achieve high immunization rates, "

> said Skidmore, the Merck spokeswoman. " We're talking about cervical cancer

> here, the second-leading cancer among women worldwide. "

>    

>     The legislation already has the enthusiastic support of the conservative

> governor.

>    

>     " I look at this no different than vaccinating our children for polio, "

> said. " If there are diseases in our society that are going to cost us

> large amounts of money, it just makes good economic sense, not to mention the

> health and well being of these individuals to have those vaccinesavailable. 

>    

>     Proposals for mandates have popped up from California to Connecticut

> since the first piece of legislation was introduced in September in Michigan.

> Michigan's bill was narrowly defeated last month. Lawmakers said

> the requirement would intrude on families' privacy, even though, as in most

> states' proposals, parents could opt out.

>    

>     Even with such opt-out provisions, mandates take away parents' rights to

> make medical decisions for their children, said Klepacki of the

> Colorado-based evangelical organization Focus on the Family. The group

> contends the vaccine should be available for parents who want it, but not

> forced on those who don't.

>    

>     But Texas Rep. Farrar said her proposal is aimed at protecting

> children whose parents are less informed about or less interested in

> preventive care.

>    

>     " Not everybody has equal sets of parents, " said Farrar, a Houston

> Democrat who had precancerous cells removed from her cervix several years ago.

" I

> think this is a public health issue and to not want to eradicate

> cervical cancer is irresponsible.ce

>    

>     Drug-industry analyst Steve Brozak of W.B.B. Securities has projected

> Gardasil sales of at least $1 billion per year _ and billions more if states

> start requiring the vaccine. " I could not think of a bigger boost, " he said.

>

>

>

[Guest guest]

>>This is not purely an EMS topic, but I hope that the moderators will indulge

me for posting this link to articles about Governor 's executive order to

give the vaccine to students.

I think it is important for all medical professionals to know, so I posted

it.

Reactions?<<

I think Rick has a serious case of craniorectal inversion, or he's in

cahoots with Merck, that's my reaction.

I'm not anti-vaccine by any means, and I applaud the development of the HPV

vaccine. But REQUIRING school girls to have the vaccine? Hell no, and not just

for the financial reasons. This kind of government mandate flies in the face of

Texas' independent spirit, does it not?

From what I've read, most physicians don't even carry it because it's

prohibitively expensive, and the reimbursement is substantially less than the

cost. Evidently Gov. did not seek the input of physicians before he issued

his executive order.

--

Grayson, CCEMT-P, etc.

MEDIC Training Solutions

http://www.medictrainingsolutions.com/

[Guest guest]

I have a daughter who would be one of those who would be required to

have one if something like this passes. So this is my own opinion, but

I believe if this vaccine would prevent cervical cancer in women period.

Then by all means make it so. Okay, so has gone about it all

wrong, and that the pharmacuetical companies need to lower the cost of

the vaccines period. (and I also believe that pharmaceutical companies

are some seriously price gouging money hogs who seriously need to have

some contraints placed on them! ) I step down from my soap box. Of

course this is my opinion.

Re: Fwd: Merck lobbies states to require

cervical-cancer vaccine for schoolgirls

>>This is not purely an EMS topic, but I hope that the

moderators will indulge

me for posting this link to articles about Governor 's

executive order to

give the vaccine to students.

I think it is important for all medical professionals to know,

so I posted

it.

Reactions?<<

I think Rick has a serious case of craniorectal inversion,

or he's in cahoots with Merck, that's my reaction.

I'm not anti-vaccine by any means, and I applaud the development

of the HPV vaccine. But REQUIRING school girls to have the vaccine? Hell

no, and not just for the financial reasons. This kind of government

mandate flies in the face of Texas' independent spirit, does it not?

From what I've read, most physicians don't even carry it because

it's prohibitively expensive, and the reimbursement is substantially

less than the cost. Evidently Gov. did not seek the input of

physicians before he issued his executive order.

--

Grayson, CCEMT-P, etc.

MEDIC Training Solutions

http://www.medictrainingsolutions.com/

<http://www.medictrainingsolutions.com/>

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