title: Drugs, sex, money and power: an HPV vaccine case study.
abstract: In this paper we compare the experiences of seven industrialized countries in considering approval and introduction of the world's first cervical cancer-preventing vaccine. Based on case studies, articles from public agencies, professional journals and newspapers we analyse the public debate about the vaccine, examine positions of stakeholder groups and their influence on the course and outcome of this policy process. The analysis shows that the countries considered here approved the vaccine and established related immunization programs exceptionally quickly even though there still exist many uncertainties as to the vaccine's long-term effectiveness, cost-effectiveness and safety. Some countries even bypassed established decision-making processes. The voice of special interest groups has been prominent in all countries, drawing on societal values and fears of the public. Even though positions differed among countries, all seven decided to publicly fund the vaccine, illustrating a widespread convergence of interests. It is important that decision-makers adhere to transparent and robust guidelines in making funding decisions in the future to avoid capture by vested interests and potentially negative effects on access and equity.
authors.affiliation: Centre for Health Economics Research & Evaluation (CHERE), University of Technology Sydney, Level 4, 645 Harris St, Ultimo NSW 2007, Australia. marion.haas@chere.uts.edu.au
authors.forename: Marion
authors.initials: M
authors.lastname: Haas
authors.forename: Toni
authors.initials: T
authors.lastname: Ashton
authors.forename: Kerstin
authors.initials: K
authors.lastname: Blum
authors.forename: Terkel
authors.initials: T
authors.lastname: Christiansen
authors.forename: Elena
authors.initials: E
authors.lastname: Conis
authors.forename: Luca
authors.initials: L
authors.lastname: Crivelli
authors.forename: Meng Kin
authors.initials: MK
authors.lastname: Lim
authors.forename: Melanie
authors.initials: M
authors.lastname: Lisac
authors.forename: Margaret
authors.initials: M
authors.lastname: Macadam
authors.forename: Sophia
authors.initials: S
authors.lastname: Schlette
mesh_terms: D003132:Commerce; D003362:Cost-Benefit Analysis; D019049:Developed Countries; D017277:Drug Approval; D004345:Drug Industry; D005260:Female; D006291:Health Policy; D006801:Humans; D008119:Lobbying; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000191:economics; D011057:Politics; D011209:Power, Psychological; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines