| Joined: Oct 2010 Posts: 12 Member | OP Member Joined: Oct 2010 Posts: 12 | I would like to know why insurance companies won't cover the HPV vaccine for boys?Since my brother had BOT cancer, I wanted my boys ( 15 & 13) to receive the vaccine. I was told I could pay for it at $185 a shot and it would be a series of 3 shots!!! Of course if they were girls, my insurance would cover it. Seems like a little gender discrimination.
Sister to Randy (47, nonsmoker) Base of tongue, scc, stage IV, lymph node involvement Dx Nov 2009, started rad/ chemotherapy 12/09,PEG tube Finished 02/10
| | | | Joined: May 2011 Posts: 287 Gold Member (200+ posts) | Gold Member (200+ posts) Joined: May 2011 Posts: 287 | Randy's Sister, Human papillomavirus ( HPV) infection has been established as a necessary factor in the development of cervical cancer and that is why insurance companies do not mind covering it as in long-term it saves them from treatment expenses. In case of Oral cancer, HPV is one of the factor that accounts for over 30% of incidences. Economics is preventing them for accepting it as a norm but in few years from now with growing scientific evidence, they may start covering it atleast for the youth who seem to be most affected. Father; 67 yrs; RIP: 2012/05/26
TX:SCC pT2N1M0G2;Glossectomy+SND+CCRT(59.3Gy+6xCis.)[2009] TX:Nodal Mets; 3xDCF[2011/05/05] TX: RND + PMMC Flap[2011/07/11] DX:SCC PNI+ECE TX:Re-RT 60Gy[2011/09/21] TX:Gefitinib 250mg[2011/12/18]
| | | | Joined: Mar 2002 Posts: 4,918 Likes: 67 OCF Founder Patient Advocate (old timer, 2000 posts) | OCF Founder Patient Advocate (old timer, 2000 posts) Joined: Mar 2002 Posts: 4,918 Likes: 67 | OCF fought with the CDC several times and David Hastings went to their meeting on vaccines as our representative. The broadest recommendation was given at that time for pediatricians to even vaccinate boys. Before that they were using the vaccine "off-label"" which puts their license at risk if something goes wrong. That approval got rid of the off label use of it issue. But there has been no clinical trial which show definitively that it will prevent oral cancers, regardless of what the scientific community believes (that it will). So with few parents realizing that it is beneficial (since all they hear about is genital benign warts) they don't pursue it. Even if insurance did pay for it they wouldn't see the value.
In October there is another CDC meeting where we hope to fight for and get a statement that includes oral / head and neck cancers in the discussion. Once that happens, insurance companies will have a vaccine that is not just for cervical cancers (men don't get them) so there will be a legal argument to get them to cover giving boys the shot as well.
By the by, with about 50% of girls in the US vaccinated after many years of the vaccine being n the market, most have only had one of the three shots in the series. It is interesting to see that the earliest girls (single shot) still have 100% coverage almost a decade out, meaning that the booster shots may not in the long run be necessary. How long the vaccine will be protective is still to be determined - a decade is good, but it will take many more years to find out how long (perhaps a life time) the coverage lasts.
Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant. | | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | Senior Patient Advocate Patient Advocate (old timer, 2000 posts) Joined: Sep 2006 Posts: 8,311 | Actually the CDC voted to give the male Gardasil vaccination it's Permissive Recommendation which is just short of what they call their Routine Recommendation which is their highest recommendation. Difference is that if a parent with a boy goes to a doctor the doctor is not required to inform the parent of the availability of the vaccine unless the parent asks. Also bear in mind that the FDA has only approved the male HPV vaccine for the treatment of Genital Warts, NOT oral cancer since the only approved studies so far were for genital warts. That was the sticking point with the CDC and that's what I and others were there to try and persuade the inner circle of the ACIP (Advisory Committee on Immunization Practices)to look beyond and approve this vaccine for EVERYTHING that HPV can cause in males not just the one thing the study included. Gardasil wanted to bring the male HPV vaccine to market as fast as possible and if they had to do a study on HPV and oral cancer that would have taken decades so they opted to study just genital warts which I believe only took 5 years. Also keep in mind that one of the criteria that the ACIP MUST consider is the cost of Quality Adjusted Life Years (QALY) that adding this vaccine to a previously approved female vaccination program would cost. Also realize that if 100% of females were vaccinated then the cost to add the male vaccine would be the highest as the only beneficiaries could be what they called MSM (Men having Sex with Men). The Committee was presented with 5 different QALY studies which all started off with assuming a minimum of a 30% female vaccination rate (even though historically statistics show that only 17% of females get all 3 shots) and then going up from that. They also only considered the benefits of reducing the medical costs associated with eliminating male genital warts. So you can imagine, relatively speaking, the cost of QALY's was very high. Some studies did attempt to add the costs associated with oral, anal and penal cancers but the Committee was told that "UNTIL we are presented with proven data and the drug is approved for those diseases, we can not consider them in our recommendation." The male vaccine is included in the federally funded VFC (Vaccine for Children) program which I believe means it's free to covered individuals but I assume only for what the FDA has approved the vaccine for which again is not for the Tx of oral cancer. I assume other insurance carriers would have the same limitations.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | Joined: Oct 2006 Posts: 209 Gold Member (200+ posts) | Gold Member (200+ posts) Joined: Oct 2006 Posts: 209 | It's open enrollment time for employee benefits for 2012. I just got my package in the mail from my employer. New for 2012 is HPV vaccine schedule fully covered under the wellness program for both BOYS AND GIRLS.
Ginny, spouse of MikeG. SSC BOT T2N1M0 Stage III, Dx 06/27/06 at age 52, Tx 07/31/06 through 09/28/06 Chemo Cisplatin & 5FU x2, Radiation x42. Cancer free and doing well.
| | | | Joined: Jul 2010 Posts: 531 "Above & Beyond" Member (500+ posts) | "Above & Beyond" Member (500+ posts) Joined: Jul 2010 Posts: 531 | My daughter has had 2 of the 3 shots and at 18 I think it was her first pap and it came out abnormal...after freezing and a 2 colposcopys I think it is Nov 17th she is going for Laser Surgery. Here is mom telling her Oh a pap smear is nothing (she has never been with a man...she is gay) and what happens she has an abnormal pap test...she is freaking out bout being put to sleep for this surgery. I am not worrying about this, I've read where in young women it can change in a couple years to normal. She has mild dysplasia it is called. I pray I don't have to worry...
CG to Ron Out of Pain 4/3/13 4/12-lung and under chin growth no treatment 1/13/12 lung biopsy 6/11 recur 6/30 resection #2 Clear margins Clear 12/10 Surg 5/13/10 neck dis/nodes part gloss/flap R thigh all teeth out RAD 30 8/10 DX 4/2/10 "Oral Cavity" T3NOMO 12/28/07 Non Hodg Lymph remission 7/08 passed away 4.3.15, RIP Ron, you are greatly missed
| | | | Joined: Mar 2002 Posts: 4,918 Likes: 67 OCF Founder Patient Advocate (old timer, 2000 posts) | OCF Founder Patient Advocate (old timer, 2000 posts) Joined: Mar 2002 Posts: 4,918 Likes: 67 | Low grade dysplasia is not a big threat, it seldom progresses to anything significant, but the safe play is to remove it. And yes the HPV16 virus can be transferred between people of the same sex, so the virus is an equal opportunity offender.
Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant. | | | | Joined: Oct 2006 Posts: 209 Gold Member (200+ posts) | Gold Member (200+ posts) Joined: Oct 2006 Posts: 209 | Nice segment just aired on Good Morning America discussing HPV vaccine for boys. Just the facts. Nice.
Ginny, spouse of MikeG. SSC BOT T2N1M0 Stage III, Dx 06/27/06 at age 52, Tx 07/31/06 through 09/28/06 Chemo Cisplatin & 5FU x2, Radiation x42. Cancer free and doing well.
| | | | Joined: Jun 2008 Posts: 475 Platinum Member (300+ posts) | Platinum Member (300+ posts) Joined: Jun 2008 Posts: 475 | Just saw that segment too on GMA, nice to hear . . . .
Susan Lauria - OCF Director of Events - Always looking for volunteers to help spread the word about early detection! Contact me if you can help!
*Brother passed away from tongue cancer in 2006 at age 47, was co-caregiver, he was non-smoker/casual drinker
LETS MAKE ORAL CANCER HISTORY!
| | | | Joined: Oct 2006 Posts: 209 Gold Member (200+ posts) | Gold Member (200+ posts) Joined: Oct 2006 Posts: 209 | A 2nd shorter segment just aired on GMA a couple minutes ago. The first one was with George Stephenopolis and a doctor interview, this second one a news recap. Expecting the CDC to approve the vaccine for boys to prevent head and neck cancers.
Ginny, spouse of MikeG. SSC BOT T2N1M0 Stage III, Dx 06/27/06 at age 52, Tx 07/31/06 through 09/28/06 Chemo Cisplatin & 5FU x2, Radiation x42. Cancer free and doing well.
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