The Pharmaceutical Benefits Advisory Committee have rejected a submission requesting that they add the human papillomavirus (HPV) vaccine Gardasil to the Pharmaceutical Benefits Scheme (PBS) for administration to boys.
Is it because they are attempting to not add anything to the PBS for the time being? Is it because they reject nearly all submissions on first attempt? Or, is it because of the “unacceptably high and uncertain cost-effectiveness” reported in their response?
It begs the question, why is it not cost-effective to prevent men from developing cancers associated with the HPV when it IS cost effective to treat women?
You have to question whether or not the fact that preventing oral and anal cancers associated with HPV would benefit the community of men who have sex with men (MSM) more than the rest of the male population and whether this is what the PBAC are talking about when they refer to “uncertain cost-effectiveness”. So does this mean that MSM are less important than other men? Or, does it mean that there is a level of questioning within the PBAC about how culpable these people are? It seems to me that it’s entirely unacceptable to offer a vaccine to one half of the population and not the other, based on assumptions about their risk factors, particularly when the risk factors in question are associated with sexual practices.
The image of a young woman developing and dying of cervical cancer is one that we would all like to see flicked into the past, but does a man dying of anal cancer illicit the same response? Is there an inherent value judgement placed on how these two individuals developed their cancers? One in the pursuit of her God given responsibility to reproduce, and the other in an erotic and lust filled encounter with a person of the same sex. I realise I’m being provocative here but I can’t help wondering whether the fact that society as a whole doesn’t like thinking about men and women sucking and licking each others genitals (despite the fact that it’s something most of us do from time to time) is impacting decisions made which will cause unnecessary illness and potentially deaths.
As a health professional, my understanding is that preventative health care (such as the use of vaccines) is about saving lives from the earliest possible vantage point. Vaccines being the absolute gold standard of public health care as they are low effort, low responsibility and highly effective. Yes, sometimes they are expensive, however how would we react if a decision making body declared that measles vaccines were not cost-effective or that parents shouldn’t be offered polio vaccines any more because polio has become a rare disease and it’s not worth the cash to prevent the small number of cases which might occur. What if it were your child who was one of those cases? Don’t you think you might feel let down by a system that decided that your child’s health wasn’t worth the cost? The difference here of course is that polio is not contracted because of any particular activity which increases you risk, or when it is (in the case of traveling to a high-prevalence area) it’s a non offensive activity. It must be tough for the parents of young boys to think “well if little Johnny turns out to be gay then he’ll thank me for allowing him to have this vaccine” but that is what parents should be thinking. They should be thinking that they don’t want to see their sons dying of throat cancer because he liked sucking cock (or pussy for that matter) and as unpleasant as that thought is, the PBAC should be protecting boys from these diseases as much as possible, not matter how they might contract them.