Research, Develop, and Sell, Sell, Sell: Part Two in a Series on the Politics and PR of Cervical Cancer

As noted in part one of this series of four articles, Setting the Stage, in 2006, Merck captured worldwide attention with the introduction of what is often touted as the first ever vaccine against cancer. Effective against two strains of Human Papillomavirus (HPV) that account for 70% of cervical cancer cases, the vaccine shows real promise for reducing HPV infection in women.

These articles are not primarily about the efficacy of Merck's vaccine, Gardasil, or of GlaxoSmithKline's competing vaccine, Cervarix, which has not yet received FDA approval. Dr. Diane Harper, who has studied HPV for twenty years and worked on the drug trials for both vaccines, told me emphatically that "The vaccines are good and will indeed prevent cervical cancer." But Dr. Harper has serious concerns about Merck's marketing juggernaut, and the push for vaccine mandates for middle-school aged girls.

"I'll give Merck credit - there is absolutely nothing factually incorrect in Merck's advertisements. But the interpretation of the rock stars, and the media, and of everyone else is that this vaccine will completely eliminate cervical cancer. I've worked with ABC, with NBC, and even on their nightly news, their headline is 'HPV vaccine prevents cervical cancer.' It's true, that is a true headline, but it is not accurate."

Viral Marketing (Literally)

As discussed in the first article of this series, Merck is in the enviable position of having the first HPV vaccine on the market. Even without state governments making vaccination required through mandates, there is undoubtedly a robust market for a drug that is being heralded as one of the medical miracles of our time, especially with a 16 to 19 month lead on its closest competitor.

Merck used their deep pockets to make sure that even before the FDA had approved Gardasil, there was a growing awareness of and concern about -- one might even say fear of -- HPV among U.S. women. The marketing juggernaut was multifaceted and meticulously planned. In 2005 Merck started by funding a campaign called "Make the Connection," which was run by the Cancer Research and Prevention Foundation (CRPF) and the celebrity charity Step Up Women's Network. The national campaign was launched September 30, 2005, in Tampa, FL, with what would become the standard formula of a celebrity, a medical professional, and an opportunity for attendees to bead their own "Make the Connection" bracelets. Partnering with non-profits, especially non-profits that appears to have patients' health and women's issues as their primary concerns, helped Merck reach audiences that may have rightly been suspicious of the motivations of a pharmaceutical company. But with even cursory examination, CRPF looks like a drug industry funded group wrapped in non-profit clothing.

According to their website, CRPF was founded in 1985 by Carolyn Aldigé a year after she lost her father to cancer. As is often the case with patient groups, CRPF's 2006 annual report lists several pharmaceutical companies, including Merck, GlaxoSmithKline, Pfizer, Roche, Eli Lilly, and Sanofi-Aventis as funders. In fact, all of those and more gave in excess of $100,000 to the organization during 2006, with several others giving at only slightly lower levels. In addition, CRPF received more than $100,000 from the industry lobbying group Pharmaceutical Research and Manufacturers of America (PhRMA) in 2006. CRPF needs to be bringing in big grants: according to their 2006 IRS 990 filing, available at Guidestar, as President of CRPF, Aldigé makes $256,000 a year and has a total compensation package of more than $286,000 annually.