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HPV vaccine marketing practices questioned.

Women at the highest risk for human papillomavirus infection were among the least likely to get the message that there is a vaccine that can protect them, editorialists said in a special communication published in JAMA.

Sheila M. Rothman, Ph.D., and David J. Rothman, Ph.D., of Columbia University, New York, contend that Merck & Co. promoted its quadrivalent human papillomavirus vaccine Gardasil as an anticancer agent, maximizing the threat of cervical cancer and minimizing the sexual transmission of the virus.

"Rather than concentrating on populations in geographic areas with excess cervical cancer mortality, including African Americans in the South, Latinos along the Texas-Mexico border, and whites in Appalachia, the marketing campaign posited that every girl was at equal risk," Dr. Rothman and Dr. Rothman wrote (JAMA 2009;302:781-6).

Further, Merck's marketing strategy included awarding "'sizeable educational grants" to professional medical associations in adolescent and women's health and oncology to encourage these organizations to undertake or intensify vaccination activities, according to the authors.

In an interview, Pamela Eisele, a spokeswoman for Merck, denied the claims. "'We did not require any reporting or review of any materials developed," Ms. Eisele said. "Merck provides independent grant support to professional medical associations that develop and distribute their own educational information about HPV and cervical cancer to broad audiences."

"We value our relationships with these groups and [strictly adhere] to the Pharmaceutical Research and Manufacturers of America Code on Interactions with Healthcare Professionals," she said. In addition, "Merck closely follows the standards for commercial support of continuing medical education established by the Accreditation Council for Continuing Medical Education."

Dr. Rothman and Dr. Rothman said that the role of several professional medical associations in the marketing of the HPV vaccine "is cause for concern."

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One recipient of Merck funding, the American Society for Colposcopy and Cervical Pathology (ASCCP), used the grant money to create a program to educate its members on vaccine use. Further, the society developed a Gardasil-specific speaker support center that included a registry of members who completed the educational program and a database of when and where they presented, Dr. Rothman and Dr. Rothman said.

Given the potential for conflicts of interest associated with an industry-supported educational program, "'we set up internal systems to evaluate the materials for bias, and I reviewed all of the materials independently," said Dr. L. Stewart Massad, chair of ASCCP's Practice and Ethics committees, noting that he accepts no financial support or grant money.

The American College of Obstetricians and Gynecologists (ACOG) also received grant money for HPV vaccine education.

In an interview, Dr. Hal C. Lawrence III, vice president of practice activities for ACOG, emphasized that the college "'thoroughly reviewed the evidence before making any recommendations about the HPV vaccine."

"We wouldn't make any recommendations if we didn't feel strongly about the importance of the vaccine, both in the prevention of cervical cancer but also in other HPV illnesses," he said.

Dr. Rothman and Dr. Rothman concluded that professional medical associations should refrain from promoting product-specific speakers bureaus and refuse funding that requires reporting activity to the donor. Neither reported having relevant financial disclosures.
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Title Annotation:INFECTIOUS DISEASES
Author:Mahoney, Diana
Publication:Family Practice News
Date:Sep 15, 2009
Words:521
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