Merck and Your Legislator
We have written here before about the way in which Merck marketed Gardasil in order to maximize fear of cervical cancer – a disease that regular pap smears prevent anyway. Our previous post focused specifically on the ways in which Merck manipulated the information available to physicians. Now, an exceedingly interesting study just released in the American Journal of Public Health shows the extent of Merck’s involvement in influencing Gardasil vaccination policies through interviews of public health officials and legislators.
This new report focuses particularly on the effort to create HPV vaccine mandates in various states. As one interviewee in the study notes, these mandates are normally driven by the profit motive of the pharmaceutical industry: “Just about every vaccine mandate that we have lately has been the result, at least partially, of the drug industry’s efforts.”
It was no different in the case of the HPV vaccine. Merck worked to introduce legislation regarding the vaccine in a number of ways, particularly through Women in Government (WIG), a national nonprofit group of female state legislators who had already identified cervical cancer as a key issue. By contributing educational grants to WIG, Merck was able to get dozens of legislators to attend conferences on cervical cancer that were also attended by Merck representatives. This made sure the legislators received the most favorable information about the HPV vaccine while dramatizing the impact of cervical cancer – which is not as prevalent in developed countries to begin with.
According to the report, Merck lobbyists were extremely involved in all policymaking activities, even drafting bills for legislators to use. When they weren’t actually writing the policy, they often served as key sources of information to legislators, who were less likely to turn to public health officials for information regarding the vaccine. Unsurprisingly, as a result, almost all the policymakers interviewed thought that “in principle, a lobbying role for vaccine manufacturers was acceptable.”
Merck also reached out to public interest groups to market the vaccine. As the report notes, “One organization that had long worked in the area of cancer prevention reported that both Merck and GlaxoSmithKline, the manufacturer of a competing HPV vaccine, came forward with unrestricted donations for the first time after Gardasil was introduced.” Meanwhile, other clinics and prescribers who serve low-income populations received donations of the vaccine.
It is clear that the extent of Merck’s involvement with policmaking is definitely unethical, if not actually illegal. The report itself notes that “Companies depend on policymakers to stimulate demand for their products and provide for the financing and distribution of vaccines.” It is also clear that there is a serious disconnect between those who are responsible for our safety – public health officials – and legislators. If legislators rely solely on the pharmaceutical industry for safety information, as the study notes, “this lack of communication could lead to legislation that was logistically difficult to implement or scientifically unfounded.”
Reading the report, the one great take-away was that it takes an informed public to fight back against such underhanded marketing methods. The study looked at five states where Merck fought to put make the HPV vaccine mandatory prior to school enrollment. Only one of those succeeded, and even that one allowed parents to opt out without providing a reason. The only reason that Merck’s attempts failed is that ordinary people – like us – realized what they were trying to do and made their voices heard.