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Kaiser Daily Women's Health Policy

Public Health & Education | Detroit News Examines Cost of HPV Vaccine Gardasil
[Mar 29, 2007]

      Some health insurance companies are not covering Merck's human papillomavirus vaccine Gardasil and others only cover part of the vaccine's cost, the Detroit News reports. According to the News, many physician offices are requiring patients to pay for Gardasil up front or sign a waiver stating they will pay for the vaccine if their insurance company does not (Feighan, Detroit News, 3/28). Gardasil in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases, and about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases, among women not already infected with these HPV strains. Gardasil also protects against vaginal and vulvar cancers, two other gynecological cancers that are linked to HPV, according to a study presented in Atlanta at a meeting of the American Society of Clinical Oncology. FDA in July 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26. CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine. The ACIP recommendation also allows for girls as young as nine to receive the vaccine and recommends that girls and women ages 13 to 26 receive Gardasil (Kaiser Daily Women's Health Policy Report, 3/23). According to some Detroit-area physicians, the full cost of the vaccine, which is given in three injections during a six-month period, is about $450. Two of the largest insurance providers in southeast Michigan, Health Alliance Plan and Blue Cross Blue Shield of Michigan, provide coverage for the vaccine. BCBS only pays for the HPV vaccine when the plan has immunization coverage, which is included in most employer groups, an unnamed company spokesperson said. According to the News, some health insurance plans stop immunization coverage at age seven or 17. In addition, some insurance companies that cover Gardasil have annual limits on preventive care that might be lower than the cost of the vaccine. "The insurance issue is a nightmare," April Sarvis, a Bloomfield Hills, Mich.-based ob-gyn, said, adding that some physicians are not offering Gardasil because insurance plans are not paying the full cost (Detroit News, 3/28).


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