The Cost of (Not Getting) Cancer

Undergraduates who rush out to inoculate themselves with Gardasil, the new HPV or “cervical cancer” vaccine, are in for an unpleasant surprise. Through Harvard University Health Services (UHS), each Gardasil shot costs $154—and the full-course vaccination requires three of them. The total cost of the vaccination, $462, is prohibitively high. The University, through UHS, should follow the Massachussetts state government’s lead in fighting cervical cancer and subsidize the vaccination’s costs for women who want it.

HPV is a common, sexually-transmitted disease caused by strains of the human papillomavirus group of viruses. The Center for Disease Control estimates that genital strains of HPV will infect over 50 percent of sexually active men and women at some point in their lives. Once someone is infected with the virus, he or she may remain asymptomatic or may develop genital warts. The greatest danger that HPV poses is that it may cause pre-cancerous changes in the cervix, vulva, anus, or penis. Pre-cancerous cervical changes (by far the most common among these four) can be detected by a pap smear; medical follow-up can ensure that pre-cancerous changes do not develop into actual cancer. Nevertheless, despite the potential for prevention, each year about 14,000 women are diagnosed with cervical cancer and more than 3,900 women die of the disease.

The new vaccine Gardasil—for women only—protects against four strains of HPV that together are responsible for 70 percent of cervical cancers and 90 percent of genital warts. In order for it to be effective, it must be administered before a woman has been exposed to the disease; ideally, before she becomes sexually active, although the vaccine will still work for women who are sexually active but have not yet been infected with HPV.

UHS does offer the vaccine, which is advertised on UHS’s web site as “recommended for females between the ages of 11-26.” At $462, however, the vaccine is simply too expensive to be a realistic option for most students. Admittedly, it would be unusual for Harvard to completely fund a vaccination. Immunizations are explicitly excluded from the benefits covered by the Student Health Fee—a good policy, since students who do not need immunizations should not have to cover the costs of immunizing students in need of (often travel-necessitated) unusual, circumstantial immunizations or vaccinations.

Beyond the student health fee, there is wide variability in coverage for the vaccine among secondary insurance plan providers. Because of this variability, as well as the efficacy of the vaccine and the seriousness of the diseases it protects against, UHS should treat Gardasil as it does many name-brand pharmaceuticals and subsidize costs so that students pay only a $30 co-pay per shot.

Other institutions have recognized the benefit of subsidizing Gardasil. Massachusetts governor Deval Patrick’s budget for 2008 increases the state’s universal immunization program by $24.8 million; a good portion of this money will go towards paying for HPV vaccination for females ages nine to 18. Harvard can help in furthering this important women’s health issue by cutting the cost of the vaccination for women who are too old to get the vaccine through the state (19), but still young enough that vaccination is recommended for them (through age 26).

An ounce of prevention is worth a pound of cure; women who are vaccinated against HPV will avoid both the costs and the suffering associated with getting cervical cancer. UHS should recognize this and make Gardasil a feasible option for students by subsidizing its impossibly high cost.