The estimated number of deaths from cervical cancer in the US in 2026 is 4,200. The death rate is 2.2 per 100,000 people down from 3.1 per 100,000 in 1992.
If we multiply 3.1e-5 by 50 years that's about a 0.15% chance of dying of this cancer. The HPV shots cost $500-1000 for the three shots, so the cost per life saved is about $650K. With the statistical value of a human life being about $12M this is quite cost effective.
I'm assuming the reduction in death continues to later in life after 30, but that's a reasonable assumption, IMO.
It's not reasonable to use the rates from 30+ years ago because survival rates for all cancers have been sharply increasing for decades. You also need to consider years of life lost if you're going to look at things economically, because you're formulating things as if somebody who died of cervical cancer never existed.
Cervical cancer disproportionately affects older women, even moreso than other cancers. The average age of diagnosis is 50 [1] and so the years of lost life due to cervical cancer is both going to be extremely low and going to disproportionately be very late life years lost. Rates in U30 are already near zero with an extremely high survival rate for those that do get it.
[1] - https://www.cancer.org/cancer/types/cervical-cancer/about/ke...
So use the current rate, which is 2.2 per 100,000. The argument is basically the same. The cost/benefit ratio is so good that your quibbles don't change the conclusion.
Do you understand the problem I'm describing? You are saying that women who got cervical cancer essentially died at birth. You need to look at years of life lost. Cervical cancer has a low frequency, high survivability, and disproportionately effects women in later age.
You also need to factor in the efficacy of the vaccines, which will not be 100%. The years of life lost/saved will end up most likely being in the days or weeks at most, and so the $12 million figure you pulled out of thin air, for a full lifetime, is highly inappropriate.
This also generalizes to many medical issues. For instance, contrary to what most people think, early cancer screening achieves very little in terms of life extension. Prostate cancer screening, for example, adds about 37 days to one's life expectancy. [1]
[1] - https://jamanetwork.com/journals/jamainternalmedicine/fullar...
Let me shoot right back and ask if you understand what I was saying.
Yes, I understood what you are saying. I was making a crude argument, but the crude argument showed benefit something like 18-36x the cost. The points you are making would reduce the benefit, but not by a factor anywhere close to 18.
I think it certainly will. We can test it fairly easily by getting some real numbers.
- Years of life lost per death = 17 [1]
- Mortality rate = 2.2/100k
- Life lost per person per year = ~3.3 hours (derived from 17 years * 2.2 cases / 100k people)
- Total change in life expectancy if completely eliminated = ~3.3 hours/year for ~50 years = 1 week
My argument is lowballing everything (or in other words working against me) since you used extreme ends for your argument, and I'm simply accepting them. I also used years of life lost data from 2000 when cancer survival rates have significantly improved since then, assumed 100% perfect efficacy and so on. It doesn't matter, because it's not even remotely close.
From these data we can see that your argument implies implies that a person would be willing to pay about $20,000 (midpoint of your 18-36 = 27 x $750 cost of vaccine) for an increase of 7 days of life expectancy. That's nonsensical, by orders of magnitude, unless you're only polling multi millionaires to determine a statistical value of life.
[1] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4167424/
That 2.2 per 100,000 is deaths PER YEAR, not PER LIFETIME. The vaccine is protecting against death each year over the person's life, not just in one year.
That is why I multiplied the change per year by 50, exactly as you did.
OK. If a life is worth $12M, that's $3300/week (assuming a 70 year lifespan). The shots cost $500-1000, a 3-6x ROI.
You're again playing very fast and loose with numbers there. The average female life expectancy is 81. And the shots only matter during the window of your life where cervical cancer is remotely relevant, which is during a typical sexual window where somebody may have multiple partners. 50 was already pushing the limits there, but I accepted it because even with that exaggeration, it's not close. But at some point you've got to start being remotely reasonable. And this is again before we even get into real efficacy, side effects, and other issues which matter quite a lot with diseases that have as low an impact as cervical cancer. E.g. a quick search shows a rate of severe side effects from the vaccines at 1.8 per 100k (which you need to multiply for a multi-shot regime). That matters quite a lot when the death rate from cervical cancer is 2.2 per 100k.
And more generally, I think converting this issue into weeks starts to emphasize how broken a metric statistical value of life is. Nobody, again outside of millionaires, is paying thousands or even hundreds of dollars for one more week of life expectancy. Even if they wanted to, the overwhelming majority of people just don't have that degree of disposable wealth. It's akin to you ask people how much they'd be willing to pay to e.g. deal with climate change, and they give some ridiculously large number. But then when it comes time to really pay, and not hypothetically pay, that number suddenly becomes quite close to $0.
Even if you just consider all of those 4000 + survivors would have got treatment for the cancer after getting it which costs far more than a vaccine.
Yep and significantly more than the death count would have needed expensive treatment and be out of the workforce for a time or permanently. Also the charged price isn't real cost to the economy. If they have a big margin on it after fixed research/approval expenses lots of it feeds back into the economy through taxes and dividends/reinvestment in other drug development.
Beyond death, it can also cause sterility and people may end up with extremely expensive IVF surrogacy pregnancies etc.
Good calc, here's some other benefits.
herd immunity: Vaccines benefit even those that don't take the vaccine now. eradication effects: vaccines benefit those that don't take the vaccine in the future.
fertility increase: non lethal cervical cancer can cause inability to get pregnant or carry a pregnancy to term. I don't know if it can cause birth defects.
Life Years: Early deaths save more Life Years than diseases that protect against later disease.
Quality Adjusted Life Years: Very nuanced, and I don't know how HPV cancers compare against the baseline of QALY. But being a vaccine that prevents, the Quality of life gained should be 100%, which would compare positively to treatments that do not cure completely
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