Abstract

Human papillomavirus (HPV) is responsible for almost all of the 570,000 new cases of cervical cancer and approximately 311,000 deaths per year. HPV vaccination is an integral component of the World Health Organization’s (WHO) global strategy to fight the disease. However, high vaccine prices enforced through patent protection are limiting vaccine expansion, particularly in low- and middle-income countries. By limiting market power, patent buyouts could reduce vaccine prices and raise HPV vaccination rates while keeping innovation incentives. We estimate the global patent buyout price as the present discounted value (PDV) of the future profit stream over the remaining patent length for Merck’s HPV vaccines (Gardasil-4 and 9), which hold 87% of the global HPV vaccine market, in the range of US$ 15.6–27.7 billion (in 2018 US$). The estimated PDV of the profit stream since market introduction amounts to US$ 17.8–42.8 billion and the estimated R&D cost to US$ 1.05–1.21 billion. Thus, we arrive at a ratio of R&D costs to the patent value of the order of 2.5–6.8%. We relate this figure to typical estimates of the probability of success (POS) for clinical trials of vaccines to discuss if patent protection provides Merck with extraordinarily strong price setting power.

Highlights

  • A disease mainly caused by human papillomavirus (HPV), is the fourth most common type of cancer in women with approximately 570,000 new cases and 311,000 deaths per year globally [1,2,3]

  • The vast majority (95%) of deaths caused by cervical cancer and around half of the world’s new cases are in low-income countries (LIC) and middle-income countries (MIC) [6,7,8,9]

  • The U.S Food and Drug Administration (FDA) approved Gardasil-4 for immunization against human papilloma virus (HPV) in males and females aged between 9–26 years whereas Cervarix is approved only for females aged between 10–25 years [32]

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Summary

Introduction

A disease mainly caused by human papillomavirus (HPV), is the fourth most common type of cancer in women with approximately 570,000 new cases and 311,000 deaths per year globally [1,2,3]. Gardasil-4 was approved for both U.S and European markets in September 2006 whereas Cervarix was approved in September 2007 [30, 31] They target HPV L1 major capsid protein that assemble to form VLPs with a morphology similar to the HPV native virions and generate robust antibody responses against the targeted HPV types [32]. Both vaccines contain VLPs for HPV 16 and 18, which cause cervical cancer, but Gardasil-4 has VLPs for HPV 6 and 11, which cause benign genital warts. In addition to the four HPV types covered in Gardasil-4, the new vaccine provides protection against HPV types 31, 33, 45, 52 and 58 [33]

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