Florida Health News

Cervical-cancer vaccine: a pain in the pocketbook

By Whitney Sessa
5/8/2008 © Florida Health News

GAINESVILLE -- When Erica Lipner-Bernstein paid $500 for her Gardasil vaccine, she couldn’t help but think of its “one less” commercials, which urge women to take the shots so they’ll be “one less” possible victim of cervical cancer. She also couldn’t help but wish it were “one less” bill she had to pay.

Her family’s health insurer covers treatment for infection with human papillomavirus, which can cause genital warts or cervical cancer. But it doesn’t pay for Gardasil, the vaccine that can prevent the infection, the 19-year-old University of Florida freshman said.

“Not only did my insurance not cover it,” said Lipner-Bernstein, but “I had to pay in cash.”

Since the anti-cancer vaccine was released in June 2006, millions of young women like her have raced to their doctors to get the three-shot series. Millions of others have not, however, because of the price tag.

College women fall in the high-risk age group --15 to 24 -- for contracting the virus that Gardasil protects against. But many insurers don’t cover it at all, or only up to age 16. It’s a dilemma that Florida universities are starting to address.

The vaccine, sold by Merck and Co. in collaboration with Sanofi Pasteur, carries a suggested retail price of $120 per dose. “I paid $360 for the three shots, and my insurance didn’t cover any of it,” said Brooke Oropeza, 19, a UF freshman who received the shots from a health clinic in her hometown.

A lot of medical offices and clinics charge more than the suggested retail price – including student health centers at most of the state’s universities. They say they have to make up for the negotiated discounts that some insurers pay and must cover costs of refrigerated storage.

The federal Vaccines for Children Program provides the Gardasil series free to patients under 19 who are uninsured and have incomes low enough to meet guidelines for Medicaid. But the program does nothing to aid college-age women.

About 1,000 women have been vaccinated with Gardisil at the UF Student Health Care Center, where the cost for the series is $495. “The price is prohibitive for many people,” said Jane Cullen, the associate director for nursing there.

In August, UF will change its student insurance policy to include a $500 wellness benefit, which can be used for immunizations, including Gardasil. It can also be used for gynecological exams and lab fees, Cullen said.

Other colleges in Florida also have been charging more than the suggested retail price per dose: University of Miami, $140; Florida Atlantic University, $146; the University of Central Florida, $135; Florida State University, $142.50; and University of South Florida, $125. Two of these schools – FSU and UM – have begun discounting the cost 50 percent to women who are on the student health insurance plan.

Human papillomavirus, or HPV, is quite common, with 6 million new cases in the United States each year. Three-fourths of them are diagnosed in 15-to 24-year-olds.

The vaccine is approved for females ages nine to 26 and protects against the four most common types of HPV (6, 11, 16 and 18). Together they are responsible for 70 percent of cervical cancers and 90 percent of genital warts.

“I strongly encourage all young women to get this vaccine,” Cullen said. “It’s the only vaccine out there that prevents a cancer. It’s hugely exciting.”