Merck’s HPV vaccine: Effective usage down but sales up

By Audrey Quinn

When the human papillomavirus (HPV) vaccine Gardasil arrived on the market in 2006, its producer Merck hailed it as an end to the spread of HPV and related cervical cancer and genital warts. Young women between the ages of 9 and 26 just needed three shots of the vaccine, Merck explained, and they’d be free of the most virulent strains of HPV for life.


 
The need for those three doses, priced around $100 each and spaced out over six months, may have hindered the drug’s overall success rate.
The New York Times reports that fewer and fewer young women are completing the required three vaccinations.
A recent study in the journal Cancer looked at insurance records of 271,976 American girls and women who received received the first dose of Gardasil between 2006 and 2009. In 2006, 50% of young women finished up the remaining two doses. But by 2009, less than 22% of those who started vaccine doses saw them to completion.
The Times’ Nicholas Bakalar relates:

Getting one shot is not enough, according to the senior author, Dr. Abbey B. Berenson, a professor at the University of Texas Medical Branch. “All the data is based on three injections,” she said. “Getting one shot does not protect, based on the data we have now.”

Berenson says that receiving one or two of the shots could give young women a false sense of protection against HPV.
Another study out last fall looked at nearly 10,000 young women across the Baltimore area. SmartPlanet’s Janet Fang reported:

Only 27% started the vaccination process, and only 31% of them completed all 3 doses.

Where did things go wrong? Why would vaccine that showed such promise not get used? In addition to the hassle of multiple doses, some blame misconceptions about the vaccine’s risk spread through the internet. Other’s look to social conservatives’ fears that HPV vaccines equate with sanctioning pre-maritial sex. Matthew Herper of Forbes has another theory:

A big part of the answer is politics. Drug safety, vaccines, antibiotics and reproductive medicine—all have become proxies for the culture war, often tripping up public health in the process.

Berenson, the study’s senior author, points out that Gardasil’s aggressive marketing campaign in 2006 glossed over the importance of getting all three shots.
In the financial markets, however, Gardasil continues to succeed. Sales rose 33 percent in the last quarter to $284 million. This increase in sales largely comes from its introduction to the Japanese market, and an increase in the vaccination of males. Analysts say that with 470,000 cases of cervical cancer worldwide, causing 250,000 deaths annually, it’s likely sales of the drug will continue to grow as it enters into new international markets.
I’ll be curious to see Merck’s response to Berenson’s study. Does the pharma giant care if effective Gardasil usage in the U.S. is down when overall sales are up?
Photo: Steven Depolo/Flickr

Read More

So you sequenced your genome. Now what?

By Janet Fang

In the last decade, a string of advances have made it relatively fast and cheap to sequence a human genome. But what are you supposed to do with all those data?



With about 20,000 full genomes already sequenced, it becomes a GATTACA alphabet soup… in many cases, it’s quicker and easier to sequence a genome than it is to analyze the resulting data. The trick is to turn those As, Ts, Gs, and Cs into a manageable description of disease risks and other genetic predispositions.
Two startups – DNAnexus and Bina Technologies – are helping to unravel the meaning of those letters, pushing personalized medicine forward. Technology Review reports.
For Mountain View, California-based DNAnexus, it’s about cloud computing. The startup positions itself between sequencing facilities and the researchers, doctors, and companies who need to manage and glean information from sequenced genomes.
“The more and more data you produce faster and cheaper, the more the bottleneck – which used to be the DNA sequencing itself – is actually now the data management,” says cofounder Andreas Sundquist.
He sees the company as an instant online genomics center, offering immediate access to vast stores of DNA data. After you upload yours to DNAnexus, they’re stored in your cloud-based account, and you can use DNAnexus’s analysis tools to make sense of it all.
Sundquist hopes DNAnexus will bring together lots of different genetic databases, which for now tend to exist on their own – aiding research efforts, drug discoveries, and development of diagnostic tests.
In the next several years, the number of genomes sequenced will rise to a million as the price and time required continue to fall (right now, the process takes about a day and costs roughly $4,000).
All that data could amount to more than an exabyte of data – one billion gigabytes – and hundreds of thousands of central processing units will be needed to analyze it all.
And that brings up another matter. While several companies use the cloud to process raw data into a genetic profile, the data files generated by sequencing machines are so massive, uploading them becomes an issue.



So Redwood City, California-based Bina Technologies has a slightly different strategy: divide and conquer.
They give their customers a data-crunching machine that will turn heaps of raw sequence into easily shared genetic profiles. Those profiles are then uploaded to their cloud-hosted site for management, sharing, and aggregation.
Specifically, the company plans to sell its “Bina Box” preloaded with software that can reduce the 300 gigabytes or so of raw data from a human genome into a few hundred megabytes of genetic information. The Bina Box, explains founder Bani Asadi, does the initial heavy lifting, making data small enough to send to the cloud.
Eventually, what these startups are doing could help researchers find better treatments and identify genetic links to diseases.
In 10 years, Sundquist believes, everyone in the developed world will have their genome sequenced as part of their medical records. He adds: “I’m sure the iPhone 10 will have a DNA-sequencing module.”
[Via Technology Review here and here]
Image by joyosity via Flickr

Read More