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Vaccine revenue streams are only in your dreams

November 21, 2011

One of the constant refrains of the anti-vax crowd is that no one in “mainstream”  medicine functions for any reason other than to feather their luxurious nests of science, as spoofed by the Daily Show sketch “Science: What’s it up to?” (1), a video that was brought to my attention recently by the Facebook page “Chillin’ Out Vaxin’ Relaxin’ All Cool” (2). The general idea perpetuated by the anti-vaxxer is that pediatricians exist to make bank on Well Baby visits and the dollars just rain down upon them each time they administer a vaccination. This assertion is hard to kill even with obvious evidence to the contrary [(3; again, via (2)]. In short, this paper by Coleman et al. presents the results of a  survey of pediatricians designed to assess the net profit from administering vaccinations. The authors found that pediatric practices which administer vaccines garner “little to no profit” from this critical healthcare measure, even when most patients have private health insurance. But the anti-vaxxers rarely let science get in the way of their portrait of MDs as pathologically greedy Big Pharmabots.

Along these lines, one of the many ill-informed arguments against HPV vaccine is that physicians are pushing it because they are in Big Pharma’s back pocket. But, in fact, it appears that many doctors may be in jeopardy of losing a huge revenue stream at the hands of the dreaded HPV vaccine. Thus, as usual, the arguments of the anti-vaxxers make no sense. So let’s begin at the beginning. Right now, there is no person in their right mind who would argue with the need for a woman who has been sexually active to keep up with her Pap smears, whether following guidelines for yearly exams or the newer “every 2-5 years” schedule.  We need these screenings to continue during the transition period until such a time as my fantasy comes true and everyone has been vaccinated for HPV. Further, until the vaccine has been engineered enough to prevent all HPV strains, the Pap smear will be necessary. However, it’s not going to be too terribly long before this occurs. At that time scientific organizations will revisit the need for Pap smears and will, at some point, find that they are no longer necessary, and women the world over will rejoice.

However, this may have a massive impact on the specialty of gynecology, not to mention several other aspects related to the Pap smear, as described in a bit more detail below. As of 2010, there were an estimated 114,078,439 women age 21 and over in the United States (4), most of whom meet the criteria for regular Pap smears. While it is difficult to gauge the exact cost of a Pap smear, Planned Parenthood offers them for prices ranges from $25.00 to approximately $90.00 (5). Goldmine, baby! Then, of course, we have the revenue stream of the approximately 3 million women who receive the worrisome news of an abnormal Pap smear each year and thus require follow-up of more invasive (and expensive!) procedures (6).

As mentioned above, the gynecologist isn’t the ony one who “benefits” from the yearly Pap. We also have everyone from cytotechnologists required to read the slides to the manufacturers of the disposables needed for this wondrous examination…not to mention all of the women who avoid getting cervical cancer because of their Pap, but for the purposes of the anti-vaxxer, this is irrelevant because surely the gynecologist is just in it for the money. It should be noted, however, that there are only two companies that currently manufacture HPV vaccine, while there are approximately 20,000 gynies who stand to lose a boatload of bucks, to say nothing of the thousands of others who provide support goods and services for Pap smears (7). So, to finally get to the point of this post, to those who take the stance that HPV vaccine is just a giant revenue-generator for Big Pharma and physicians, I ask a simple question:

Why would such organizations as the American College of Obstetricians and Gynecologists and the  International Federation of Gynecology and Obstetrics support HPV vaccination when essentially they will be severly curtailing their profits as well as subjecting their own discipline to some severe pruning, if not total extinction? Why are these people not running around screaming about the “dangers” of the HPV vaccination in an effort to protect their revenue stream?

Someone needs to alert these crazy gynies that they are going to lose some serious dough if they keep up this nonsense of supporting the HPV vaccine. Just a little something to think about as you stuff your turkey, reader. Happy Thanksgiving!

(1) http://www.thedailyshow.com/watch/wed-october-26-2011/weathering-fights—science—what-s-it-up-to-?xrs=share_fb

(2) http://www.facebook.com/home.php#!/COVRAC

(3) Coleman et al. Net Financial Gain or Loss From Vaccination in Pediatric Medical Practices. Pediatrics, Vol. 124, December 1, 2009, pp. S472 -S491.

(4) http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=DEC_10_DP_DPDP1&prodType=table

(5) http://www.ppgmv.org/ppswcf/annual-exams-only-8500-29150.htm

(6) Sirovich and Welch, The Frequency of Pap Smear Screening in the United States. J Gen Intern Med. 2004 March; 19(3): 243–250.

(7) http://www.bls.gov/oes/current/oes291064.htm

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