News
A new study suggests the prevalence of oncogenic strains of human papillomavirus (HPV) in young Australian women has fallen to the lowest level in high-income countries after a national human papillomavirus (HPV) vaccination programme was introduced in Australia in 2007. Only 1·6% of women studied were reported to have vaccine-targeted HPV genotypes—compared with a rate of about 18% before the vaccination programme began, according to findings from Osborne and colleagues reported in Vaccine. Self-collected vaginal swabs were obtained from 431 women aged 18–25 years living in Victoria, Australia, in response to a Facebook recruitment campaign between 2011 and 2013. HPV DNA genotyping showed that 24·6% of swabs were positive for HPV DNA. However, only seven samples (1·6%) were reported to
have HPV genotypes targeted by the quadrivalent vaccine used in the government-funded programme. All cases were HPV 16 and no cases of the other targeted genotypes—HPV 6, 11, or 18—were detected. Osborne and colleagues state that the prevalence of HPV 16 was the lowest reported in sexually active women aged between 16 and 25 years in any high-income population pre-vaccination. Julia Brotherton, a study author (Australia’s National HPV Vaccination Program Register, and University of Sydney, NSW, Australia), said the prevalence of vaccine-related HPV genotypes had fallen surprisingly quickly since the vaccination programme began 7 years ago. “The findings are consistent with what we are seeing with a dramatic decrease in genital warts and a decrease in high grade [cervical]
lesions in this group of women,” commented Brotherton. Karen Canfell (Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, NSW, Australia), agreed: “The study is another brick in what is becoming a very solid edifice in terms of evidence that HPV vaccination has had a significant and substantial effect very rapidly since it’s introduction.” Canfell said these findings supported plans to overhaul the country’s cervical screening programme to make it tailored around detecting HPV. In these plans, women aged 25–74 years are set to be offered a primary HPV DNA test every 5 years, and from 2016, those with positive results for HPV genotypes 16 or 18 will be referred directly for colposcopy.
P Marazzi/Science Photo Library
Australian HPV vaccination programme yields results
Published Online November 7, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)71039-3 For the study by Osborne and colleagues, see Vaccine 2014; published online Nov 1. DOI:10.1016/j. vaccine.2014.10.045
Megan Howe
US hospitals object to changes in Genentech drug distribution Genentech’s change in distribution of bevacizumab, trastuzumab, and rituximab to a specialty distribution system, represents a de-facto price hike that could cost US hospitals millions of dollars, as reported in Time. This change reduces the number of distribution centres for the drugs from 80 to five, resulting in “six-figure or seven-figure increases in drug expenditures” every year for hospitals across the country, says Michael Vozniak (Hematology/Oncology Pharmacy Association, Chicago IL, USA). The shift will deny hospitals standard industry discounts. “We do understand that hospitals will have to make some adjustments”, says Charlotte Arnold (Genentech, San Francisco CA, USA). “Our main concern is ensuring that patients can access these life-saving drugs. With this change, all six of our infused cancer drugs are distributed the same
way and allows us to better manage and track our supply.” However, according to a letter from the American Hospital Association and five other hospital advocacy groups to Genentech’s chief executive officer Ian Clark, Genentech’s distribution change could imperil supply, as “inclement weather or a natural disaster could compromise the entire nation’s ability to source these important drugs.” The letter states “...your surprise decision has sent a shockwave through the hospital community that will completely up-end pharmacy budgets”. “We are deeply concerned”, says José Baselga (Memorial Sloan Kettering Cancer Center, New York NY, USA). “Shifting away from wholesalers to a few specialty distributors is labour-intensive and expensive for hospitals”.
www.thelancet.com/oncology Vol 15 December 2014
“The timing is just awful”, says Roy Guharoy (Ascension Health, St Louis MO, USA). “We were given almost no notice. It’s going to hurt patient care.” Most hospitals already purchase some other cancer drugs from specialty distributors, Arnold points out. But wholesalers typically deliver drugs daily and at specified times to centres, whereas specialty distributors use unscheduled commercial carriers, which could force providers to increase inventory to avoid drug shortages or delays in patient care, hospital officials say. Guharoy has instructed that Genentech sales representatives should be barred from Ascension facilities—one of the USA’s largest nonprofit hospital systems. Arnold says Genentech will not reconsider its decision.
Published Online November 7, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)71040-X This online publication has been corrected. The corrected version first appeared at thelancet.com/oncology on November 24, 2014 For Time magazine’s coverage of hospital officials’ responses to Genentech’s decision see http://time.com/3541484/ cancer-drug-price-hikes/ For the letter to Genentech see http://www.aha.org/advocacyissues/letter/2014/141028-lethealthorgs-clark.pdf
Bryant Furlow e591
A new study suggests the prevalence of oncogenic strains of human papillomavirus (HPV) in young Australian women has fallen to the lowest level in high-income countries after a national human papillomavirus (HPV) vaccination programme was introduced in Australia in 2007. Only 1·6% of women studied were reported to have vaccine-targeted HPV genotypes—compared with a rate of about 18% before the vaccination programme began, according to findings from Osborne and colleagues reported in Vaccine. Self-collected vaginal swabs were obtained from 431 women aged 18–25 years living in Victoria, Australia, in response to a Facebook recruitment campaign between 2011 and 2013. HPV DNA genotyping showed that 24·6% of swabs were positive for HPV DNA. However, only seven samples (1·6%) were reported to
have HPV genotypes targeted by the quadrivalent vaccine used in the government-funded programme. All cases were HPV 16 and no cases of the other targeted genotypes—HPV 6, 11, or 18—were detected. Osborne and colleagues state that the prevalence of HPV 16 was the lowest reported in sexually active women aged between 16 and 25 years in any high-income population pre-vaccination. Julia Brotherton, a study author (Australia’s National HPV Vaccination Program Register, and University of Sydney, NSW, Australia), said the prevalence of vaccine-related HPV genotypes had fallen surprisingly quickly since the vaccination programme began 7 years ago. “The findings are consistent with what we are seeing with a dramatic decrease in genital warts and a decrease in high grade [cervical]
lesions in this group of women,” commented Brotherton. Karen Canfell (Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, NSW, Australia), agreed: “The study is another brick in what is becoming a very solid edifice in terms of evidence that HPV vaccination has had a significant and substantial effect very rapidly since it’s introduction.” Canfell said these findings supported plans to overhaul the country’s cervical screening programme to make it tailored around detecting HPV. In these plans, women aged 25–74 years are set to be offered a primary HPV DNA test every 5 years, and from 2016, those with positive results for HPV genotypes 16 or 18 will be referred directly for colposcopy.
P Marazzi/Science Photo Library
Australian HPV vaccination programme yields results
Published Online November 7, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)71039-3 For the study by Osborne and colleagues, see Vaccine 2014; published online Nov 1. DOI:10.1016/j. vaccine.2014.10.045
Megan Howe
US hospitals object to changes in Genentech drug distribution Genentech’s change in distribution of bevacizumab, trastuzumab, and rituximab to a specialty distribution system, represents a de-facto price hike that could cost US hospitals millions of dollars, as reported in Time. This change reduces the number of distribution centres for the drugs from 80 to five, resulting in “six-figure or seven-figure increases in drug expenditures” every year for hospitals across the country, says Michael Vozniak (Hematology/Oncology Pharmacy Association, Chicago IL, USA). The shift will deny hospitals standard industry discounts. “We do understand that hospitals will have to make some adjustments”, says Charlotte Arnold (Genentech, San Francisco CA, USA). “Our main concern is ensuring that patients can access these life-saving drugs. With this change, all six of our infused cancer drugs are distributed the same
way and allows us to better manage and track our supply.” However, according to a letter from the American Hospital Association and five other hospital advocacy groups to Genentech’s chief executive officer Ian Clark, Genentech’s distribution change could imperil supply, as “inclement weather or a natural disaster could compromise the entire nation’s ability to source these important drugs.” The letter states “...your surprise decision has sent a shockwave through the hospital community that will completely up-end pharmacy budgets”. “We are deeply concerned”, says José Baselga (Memorial Sloan Kettering Cancer Center, New York NY, USA). “Shifting away from wholesalers to a few specialty distributors is labour-intensive and expensive for hospitals”.
www.thelancet.com/oncology Vol 15 December 2014
“The timing is just awful”, says Roy Guharoy (Ascension Health, St Louis MO, USA). “We were given almost no notice. It’s going to hurt patient care.” Most hospitals already purchase some other cancer drugs from specialty distributors, Arnold points out. But wholesalers typically deliver drugs daily and at specified times to centres, whereas specialty distributors use unscheduled commercial carriers, which could force providers to increase inventory to avoid drug shortages or delays in patient care, hospital officials say. Guharoy has instructed that Genentech sales representatives should be barred from Ascension facilities—one of the USA’s largest nonprofit hospital systems. Arnold says Genentech will not reconsider its decision.
Published Online November 7, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)71040-X This online publication has been corrected. The corrected version first appeared at thelancet.com/oncology on November 24, 2014 For Time magazine’s coverage of hospital officials’ responses to Genentech’s decision see http://time.com/3541484/ cancer-drug-price-hikes/ For the letter to Genentech see http://www.aha.org/advocacyissues/letter/2014/141028-lethealthorgs-clark.pdf
Bryant Furlow e591
