February 1, 2012

Personal Anecdote: Practically speaking, Cervarix is no longer on the market.

This is really more GlaxoSmithKline sales rep bait than a normal post, but truly:

Is Cervarix, Glaxo's HPV 16/18 vaccine with cross-protection for HPV 31 (and 45 and 33), still on the market?

From the patient perspective, it would seem the answer is "No."

I am in my 40s. Cervarix seems to induce stronger immunity in older women than Gardasil does. I am not positive for either HPV 16 or HPV 18, the two strains Cervarix primarily covers. I also don't have HPV 33 or 45, two fairly dangerous strains for which Cervarix, according to various studies, offers much better cross-protection than Gardasil. I would prefer to get Cervarix rather than Gardasil.

Yay Glaxo! I'm a sale, right?


I live in a large US city, with major hospitals, a research university, cancer research institutes, the works. I asked my doctor for Cervarix. He was willing to administer it off-label even though I'm over 25, but then...

No one can get me the vaccine.

The clinic can order it directly from their drug distributor. (Note: I don't really know how pharmaceutical distribution works in the US. Should I have to? I'm just a patient.) However, the distributor will only sell it to the clinic in a pack of 5 pre-filled syringes. Since it's a 3-dose vaccine and the clinic doesn't want to eat the other 2 doses at $125 a pop, they won't order it for me. (This 5-pack decision seems to be Glaxo's, and if so, they're doing a great job of un-selling their own drug. It ain't hot dogs and buns, people. If your market penetration is so lousy that your product is special order, you need to at least package it so that special orders work.)

My doctor will write me a prescription so I can buy it myself, and I might pay to do that. But I can't find a retail pharmacy that can get it for me AT ALL. (And then if it's only sold in a 5-pack, what the hell am I supposed to do with the other 2 doses--Craigslist 'em? I'm pretty sure that would be illegal. Maybe I'm supposed to find 4 other women and form a co-operative of some kind so we can purchase 3 5-packs and have 15 doses to split between the 5 of us? Hmm. There's research that 2 doses are effective. Maybe I can take 2 and find someone who wants the other 3 as a set?)

I contacted Glaxo to see if they could put me in contact with their regional distributor so I could find out whether there are any clinics or hospitals in my city that regularly order Cervarix, on the theory that maybe then I could get Cervarix there. The person who called me back from Glaxo referred me to a chain of urgent care clinics that does not order Cervarix at all--they order Glaxo vaccines, but only for the flu.

I called the large women's health clinics in my city. Nada. Not at Planned Parenthood, not at the hippie/lesbian place, nowhere.

I have an appointment next week at a clinic associated with a research university and with the largest hospital in town. We'll see if they can do this. And if they can't, I'd say that there's really only one HPV vaccine actually on the market now.

UPDATE 2/20: And in fact, the university clinic can't get me 3 doses of Cervarix either. They can give me a prescription for a box of 5, which I can then order online (at at cost of $720) because no pharmacy in town will order it. I'm not sure if I'll be doing this or not. On the one hand, I would prefer to get Cervarix rather than Gardasil. On the other hand, as a consumer I really believe this kind of idiocy on Glaxo's part shouldn't be rewarded. And it especially shouldn't be rewarded by my spending $288 of my hard-earned dollars on two vaccine doses I will never use. Morons.