Healthy Skepticism Library item: 11220

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Talaga T.
Lobbyists boosted vaccine program
Toronto Star 2007 Aug 16
http://www.thestar.com/News/article/246824

Full text:

Ex-government advisers worked on drug firm’s campaign to push immunization program

The speed with which the HPV vaccine Gardasil got onto both the federal and provincial political agendas was no accident.

Only eight months after Gardasil was approved for sale in Canada, Ottawa agreed in March to fund $300 million over three years for a human papillomavirus vaccination program. And on Aug. 2, Ontario announced that all Grade 8 girls will have free access to Gardasil.

Merck Frosst Canada Ltd., the maker of Gardasil, hired public relations giant Hill & Knowlton to push the immunization strategies using some well-connected lobbyists: Ken Boessenkool, a former senior policy adviser to Prime Minister Stephen Harper; Bob Lopinski, formerly with Premier Dalton McGuinty’s office; and Jason Grier, former chief of staff to Health Minister George Smitherman.

According to Ontario consultant registration documents, Lopinski and Grier’s lobbying activities include: “Proposed policy decision to support a childhood immunization program for HPV and funding related thereto.”

Combine that with a catchy TV ad campaign urging young women to “Tell Someone,” as well as backing from medical groups like the Society of Obstetricians and Gynaecologists of Canada and a national vaccine program was born.

The medical community has largely lauded Gardasil, a $400 three-shot vaccine that can prevent HPV types 16 and 18, which are responsible for 70 per cent of cervical cancer cases. Nearly 400 Canadian women die of the disease each year.

The ads worked for Christina Leighton, 31, who had an abnormal Pap smear last year and was later diagnosed with cervical cancer. She didn’t know HPV caused the disease until she saw the TV ads.

While Leighton is aware the vaccine is still in its early stages, she will have her daughter, Emma, vaccinated. “It’s great, knowing there is something out there that can protect young women. I wish there had been one for me 14 years ago.”

Some critics say the vaccine’s long-term effects are unknown. Also unclear is if, or when, a future booster shot will be needed.

This is “not a public health crisis,” said Abby Lippman, chair of the Canadian Women’s Health Network and an epidemiologist at McGill University. “I want that data out there for discussion before we go and spend money when we don’t have a lot of money in the health-care system already.”

Advertising and savvy marketing shouldn’t set the public health agenda, said Lippman, who was the lead author on an online commentary in the Canadian Medical Association Journal. “It wasn’t a vaccination program that was launched. It seems to have been a program with this product.”

The Society of Obstetricians and Gynaecologists of Canada says it is “disappointed” with the CMAJ’s publication of the commentary. “The arguments expressed in this commentary lack grounding in scientific evidence,” a news release says, adding that “Canadian governments have made exactly the right decision in moving quickly to provide immunization against the (HPV) for young girls and women.”

Cervical cancer is the second most common cancer in Canadian women aged 20 to 44, the group says.

But Lippman wonders how the $300 million figure to support the HPV program was arrived at (Ontario’s portion is $117 million), and if there was any bargaining on price.

By comparison, the chicken pox vaccine Varivax costs $75 per shot and had Health Canada approval for six years before Ontario covered the costs of a vaccination program.

Sheila Murphy, spokesperson for Merck, makers of both vaccines, defended the high price of Gardasil. “Vaccines are getting more expensive. The technology is getting more sophisticated. These are huge, extensive, clinical studies.”

British Columbia health economist Hans Krueger did some number crunching recently for a report on the HPV vaccine for the B.C. Cancer Agency. British Columbia has not yet adopted a provincial program. He found it would cost the government $373.6 million over 26 years to offset the $54 million in medical treatment costs saved from using the vaccine.

Exactly what role the lobbyists played is equally unclear.

Duff Conacher, of Democracy Watch, an Ottawa-based citizen’s group aimed at keeping government accountable, said the quick adoption of Gardasil onto the public health agenda is a “horrendous” example of the power of lobbyists.

Boessenkool, who was responsible for message management for the Conservative campaign during the 2004 federal election, became a vice-president at Hill & Knowlton in October 2004. According to the federal lobbyist registry, his client is Merck with an effective date of Feb. 16, 2007. The vaccination program was announced in the March budget. He did not return calls.

Jeff Connell, director of public affairs for the Canadian Generic Pharmaceutical Association, doesn’t oppose lobbying but says the public should be aware of it. “If we are being advised to vaccinate huge populations of Canadian women with the vaccine, I think it’s important Canadians know who is being paid to do the advising.”

Merck’s Murphy sees nothing wrong with spreading the message about an anti-cancer vaccine.

“We are talking about a huge amount of disease that can be prevented,” she said. “Communicating this information to people has really been a huge challenge to us.”