CDC Panel Says No to Routine Use of Gardasil for Boys

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Vaccination was considered a good value if cost-effectiveness ratios ranged from $50,000 to $100,000 per quality-adjusted life year, meaning the cost of the vaccine vs. the number of added years someone would gain by getting the vaccine.

Assuming 75 percent coverage and lifelong protection, the researchers found routine vaccination of 12-year-old girls was a good value at less than $50,000 per quality-adjusted life year. However, adding preadolescent boys increased the cost-effectiveness ratio to more than $100,000 per quality-adjusted life year. The researchers considered treatment for conditions caused by HPV, including anogenital and oral cancers, genital warts, and juvenile-onset recurrent respiratory papillomatosis.

"Only under optimistic assumptions of high, lifelong vaccine efficacy against all HPV-related health conditions, or lower vaccine efficacy accompanied by lower coverage or vaccine costs, did vaccinating both girls and boys fall below $100,000 per quality-adjusted life year," Kim said.

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Debbie Saslow, director of breast and gynecologic cancer at the American Cancer Society, agreed with the findings.

"If we can vaccinate a high enough proportion of young girls, then vaccinating boys is not cost-effective," she said.

Reacting to the panel's vote on Wednesday, Gardasil's maker, Merck & Co, took issue with the ruling.

"Approximately 75 to 80 percent of males and females will acquire one or more types of HPV in their lives and HPV-related diseases cause significant personal and public health burden for both men and women," Merck spokeswoman Pam Eisele told Bloomberg. "As such, we believe there is value in vaccinating both young men and women with Gardasil to help protect them from certain diseases caused by HPV."

Since Gardasil's approval, studies have found it safe and nearly 100 percent effective in preventing precancerous cervical lesions from the four HPV strains targeted by the vaccine.

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