Cervical cancer is diagnosed in almost half a million women each year. Genital warts and cervical cancer are caused by the Human Papillomavirus, also known as HPV, one of the most common sexually transmitted viruses in the world. In the United States alone, over 20 million people are currently infected with HPV. The CDC estimates that up to half of these infections are in adolescents and young adults ages 15-24. HPV is so common nearly all sexually active adults will be infected with some type of this virus at some point in their lives. There are over 40 strains of HPV, most causing transient and/or asymptomatic presentations, However; certain strains persist and develop into cancers, leading to cervical, anal, penile and other cancers of the genitalia. Merck and Company, the fourth-biggest U.S. drug maker, developed a product which aims to prevent genital cancers by preventing the transmission of the four types of Human Papillomavirus, two of which cause nearly 70% of cervical cancers, and two stands which cause 90% of genital warts. This product, an intramuscular vaccine named Gardasil, was approved in 2006 by the FDA and widely available in 2007. The FDA permitted Gardasil to be used on girls ages 9-26, with intent of vaccinating girls before they become sexually active, thereby greatly reducing their chance of contracting HPV and developing cervical cancer. Nearly half a million women are diagnosed with cervical cancer each year. Some health care experts envision that Gardasil might be able to eliminate cervical cancer within one generation.
Gardasil is extremely important from a public health perspective. It is required to be given in 3 doses over a period of 6 months. Each dose cost over $120. Cervical cancer has hit the hardest in the world’s poorest countries. These are the places that need it most, but affordability may hinder access.
There remains, to date, significant controversy over this vaccine. While it may prevent a serious and often fatal medical condition, many conservative opponents believe that giving young girls and women the vaccine permits them to engage in sexual activity. Both the CDC as well as the American Academy of Pediatrics recommends that all young females receive the HPV vaccine in much the same way as other childhood immunizations required for public school enrollment, with routine immunization at ages 11-12.
A few years ago, the State of Texas mandated that this vaccine be given to girls in order to be admitted to school. This sparked a major controversy as people considered the requirement of a drug and the implications it may have on sexual activity of the students. Company officials from Merck worked with governmental agencies and other groups to reduce concerns. In 2008 Merck advertised Gardasil in television commercials entitled, “One Less” and “Guard Yourself”, implying that by taking the vaccine, you are protecting yourself and preventing one less case of cervical cancer.
Stakeholders in this case include; the government, public interest groups, Merck employees, stockholders, current and future recipients of this drug and their parents, and society as a whole. This includes advocates and opponents of product recommendations, both within and outside of the State of Texas. Also included are medical professionals and medical professional groups. Currently the CDC and its partners, including the CDC has recommended that young men and adolescent boys be vaccinated with Gardasil. Gardasil has been shown to be effective in preventing penile cancer and male genital warts. Currently we would consider young men and adolescent boys as well as their parents, stakeholders as well.
The following includes the positions of each stakeholder in the discussed case study:
Internal Stakeholders including employees and executives of Merck & Company...