High Vaccine Costs Block Cervical Cancer Prevention

Hyderabad: Cervical cancer is the second leading cause of cancer-related deaths among women in India, after breast cancer. According to the National Cancer Registry Programme, cervical cancer accounts for nearly a third of all cancers reported among Indian women, which disproportionately affects low and middle-income countries. Globally, cervical cancer is the fourth most common cancer in women.

Nearly 90 per cent of cases of cervical cancer are caused by the human papillomavirus (HPV), which spreads primarily through sexual activity. HPV vaccines have been available since 2008. In 2023, India introduced its first indigenously-produced HPV vaccine. The Centre had also planned to roll out the vaccine as part of its national immunisation programme but it has not commenced so far.

One of the biggest barriers to widespread HPV vaccination is its cost. Three main vaccines are currently available: Gardasil, Cervarix, and Cervavac. Gardasil, a quadrivalent vaccine, protects against HPV types 6, 11, 16, and 18, and costs approximately Rs 9,000 for the nonavalent and Rs 4,000 for the quadrivalent version. Cervarix and Cervavac, an indigenously developed vaccine by the Serum Institute of India (SII), are priced around Rs 2,000 per dose. It is hoped that with bulk government procurement, the price of Cervavac may fall to Rs 300-400 per dose.

The high cost of vaccines has been a significant hurdle. However, the development of Cervavac offers a promising solution. "The vaccine is designed to be highly affordable, with SII making it a fraction of the cost of existing vaccines. This would be a game-changer for lower-income populations, as the vaccine has shown to produce a strong immune response," said Dr Geetha Nagasree, senior consultant surgical oncologist.

For the vaccine to have maximum impact, it should be administered to adolescents between the ages of 9 and 15. "The challenge lies in mobilising the workforce to administer vaccines and generating awareness, especially in rural areas,” Dr Geetha added.

Drawing lessons from the Covid-19 vaccination drive, experts stress the importance of awareness campaigns and coordinated vaccination efforts, such as school-based programmes. Alongside vaccination, robust screening programmes are essential to detect cervical cancer early and improve survival rates, Dr Geetha said.

Dr Vasundara Cheepurupalli, a senior consultant gynaecologist, said, "HPV is responsible for over 95 per cent of cervical cancer cases, and affordable vaccines could significantly reduce healthcare disparities. Widespread vaccination would also contribute to herd immunity, lowering overall HPV transmission. Lowering the vaccine's cost would not only save lives but also be more cost-effective than treating cancer."

The limited competition is another factor driving high prices. "If the local companies are given the know-how and more people opt to get vaccinated, the demand would increase and price would automatically come down," she added.

Dr Ranga Reddy Burri, the president of Infection Control Academy of India, highlighted successful case studies like the Hepatitis B and the Covid-19 vaccines, where public-private partnerships helped reduce prices and improve accessibility. "These successes were driven by indigenisation, technology transfer through public-private partnerships, advance market commitments, economies of scale, and targeted grants to stimulate innovation. The government can adopt these proven approaches to optimise costs and ensure large-scale availability of complex vaccines including HPV without compromising on quality," he said.