Merck and insurance companies at cross-purposes over Gardasil

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Although some states are making the HPV vaccination Gardasil mandatory for young girls, those who seek the vaccine in states where it is not provided by the government may have a difficult time finding it at all.

According to howstuffworks, the medical reinbursement system currently in use is failing. Normally doctors purchase a vaccine themselves, then charge the patient’s insurance company for the cost of the medication plus an additional 10 to 17 percent over retail (to cover costs from stocking and administering the medicine). Gardasil, however, is so expensive that some insurance companies are refusing to pay the $171.50 per dose.

Howstuffworks states:

So doctors — pediatricians in particular, who tend to stock the most vaccines of all medical specialists — and insurance companies appear to be in a deadlock. Pediatricians claim they simply can’t afford to stock Gardasil since they’re not getting reimbursed for all of their expenses. For some, stocking the drug would mean operating at a loss or barely breaking even. And most insurance companies, who have been trying to change the biologics-reimbursement situation for years now, are standing their ground at $132 per dose (called “ASP+6,” or “average selling price plus 6 percent”), saying that doctors are demanding over-reimbursement. And in the meantime, many people who can’t afford to shell out up to $400 to get their daughter(s) vaccinated are left running from pediatrician’s office to public health clinic to gynecologist’s office and back again trying to find someone who has Gardasil.

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This in the wake of Texas Gov. Rick Perry melodramatically claiming that he “can’t look a young woman in the eye” who contracted cervical cancer because she didn’t have access to Gardasil. If that’s really the case, get off your duff and start fixing our broken healthcare system instead of settling for self-serving photo ops.

About Cary Byrd

eDrugSearch founder, Cary Byrd, has been called an “e-health innovator” by MarketIntellNow, interviewed by top pharmaceutical industry journalists, invited to Matthew Holt’s Health 2.0 Conference and a Consumer Report's health summit, and highlighted on numerous health blogs. - Search. Compare. Save.

0 thoughts on “Merck and insurance companies at cross-purposes over Gardasil

  • Just want to comment on the “new wonder drug” Gardisil, the vaccine against cervical cancer. I think it’s interesting that, first of all, we are inundated with the news that, GASP, HPV can cause cervical cancer, the key word being “can”, not “does definitely” cause. Then, all of a sudden! A wonder drug looms on the horizon that MAY prevent cervical cancer. Key word MAY. What a crock! Anybody with any sense at all knows Merck has been working on this apparently “new” vaccine as a money maker to make up for their loss with Vioxx. And 2 states are going to make it a mandated vaccine? Stupid, stupid! Play right into Merck’s hands, stupid people. I don’t buy it, and the public ought to know this.

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