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A new report in the British Medical Journal is bound to ruin the day of company officials (and shareholders) of the current human papilloma virus (HPV) vaccine manufacturer, Merck, who were undoubtedly pleased that an FDA committee recently recommended that the government agency okay the use of Gardasil in males against genital warts.

An economic analysis of the cost effectiveness of vaccinating boys for HPV in order to prevent cervical cancer caused by certain HPV variants in girls was done at the Harvard School of Public Health.  The researchers concluded that vaccinating girls resulted in a cost of $50,000 per quality adjusted life year (QALY), which means that for every additional year of perfectly healthy life that is gained via the vaccine, the cost is $50,000.00.  The cost for including boys in the HPV vaccination efforts raised the cost of one QALY to over $100,000, which “…exceeds conventional thresholds of good value for money,” the researchers said.

The researchers made the calculations assuming 75% vaccination coverage rate, and also assumed that the immunity to the cancer-causing variants of HPV that the vaccine is supposed to confer lasts a lifetime, which is of course unknown at this stage, since the vaccines in question have only been in use for a few years.

The immunity conferred by every other vaccine appears to wane over time, so until we have evidence to the contrary, it is rational to assume that any immunity conferred by Gardasil and Cervarix will wane as well.  If repeated vaccination is necessary, this will raise the cost of each QALY even further.

Nonetheless, it seems likely that the current push to recommend the use of HPV vaccines in males will continue with a simple shift in focus on genital warts instead of cervical cancer.

The two currently FDA approved vaccines for human papilloma virus are manufactured by Merck & Co.  (Gardasil, ) and GSK, GlaxoSmithKlein (Cervarix).

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