Making the public's need for HPV Vaccine: Influences of global pharmaceutical companies on cervical cancer prevention policies in Taiwan

Background: Soon after the US Food and Drug Administration (US FDA) licensed the first vaccine against human papillomavirus (HPV) in September 2006, Taiwan approved its use in October, and since then there have been aggressive marketing activities to promote its use.

Objectives: We examined the marketing strategies of global pharmaceutical companies and their influences on public opinions and disease prevention policy concerning HPV vaccine. In addition, we analyze how these strategies were embedded in a confluence of multiple social, economic and political forces.

Methods: Information was obtained through multiple methods, including literature review, in-dept interviews with major policy participants, and participatory observation in health care settings.

Results: The marketing activities for HPV vaccine have been aggressive and multidimensional. Recently, discussions have even moved to issues about how to assure equal access under the nation's compulsory National Health Insurance (NHI) system. For several reasons, marketing efforts might be more intensified in Taiwan as compared in other countries. From the perspective of pharmaceutical companies, Taiwan appeared to be an ideal target country – a newly developed country with middle income, a low Pap smear screening rate, and a high incidence of cervical cancer. Easy access to medical care, little social resistance to vaccine, and the existence of a compulsory NHI system also make it an appealing target.

Conclusion and implications: Global pharmaceutical companies have played a major role in shaping public's opinion and disease prevention policies in Taiwan. However, their influences and potential conflicting interests with public health have not been closely examined.