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WHO Approves HPV Vaccine Cervarix For Use In Developing Countries
The World Health Organization has approved GlaxoSmithKline"s human papillomavirus vaccine Cervarix, thus enabling United Nations agencies and partners to officially purchase millions of doses for use in low-income nations, the AP/San Diego Union-Tribune reports (AP/San Diego Union-Tribune, 7/9). Cervarix is highly effective at preventing HPV types 16 and 18, which cause about 70% of cervical cancer cases (GSK release, 7/9). According to the AP/Union-Tribune, more than 80% of the estimated 280,000 cervical cancer deaths annually occur in developing countries.Cervarix has not been approved for use in the U.S. and Japan, but it is available in 97 other countries. FDA is expected to decide in the next few months whether to approve Cervarix for use in the U.S. (AP/San Diego Union-Tribune, 7/9). The agency in 2006 approved Merck"s HPV vaccine Gardasil for girls and women ages nine to 26. Centers for Disease Control and Prevention guidelines recommend routine three-dose vaccination for girls ages 11 and 12 and for girls and women ages 13 to 26 who have not yet been vaccinated (CDC fact sheet, June 2008).The three-shot regimen typically costs about $360. It is unclear if GSK will provide Cervarix at a lower cost to U.N. agencies purchasing it for developing countries (AP/San Diego Union-Tribune, 7/9). GSK said that it is "eager to work with our long-term partner GAVI as well as other private [non-governmental organizations] or governments of developing countries to identify financing mechanisms for the vaccine" (Stovall, Dow Jones, 7/9). The global health association GAVI is a major buyer of vaccines for the developing world. In 2008, GAVI prioritized the purchase of HPV vaccines for the world"s 73 poorest nations. The organization includes U.N. agencies, the World Bank and the Bill and Melinda Gates Foundation (AP/San Diego Union-Tribune, 7/9).
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Hormone Therapy Use Associated With Increased Risk Of Ovarian Cancer
Compared with women who have never taken hormone therapy, those who currently take it or who have taken it in the past are at increased risk of ovarian cancer, regardless of the duration of use, the formulation, estrogen dose, regimen or route of administration, according to a study in the July 15 issue of JAMA.
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When Managing Low-Risk Patients With Chest Pain In The Emergency Department, Cardiac CT Is More Cost Effective

The use of cardiac CT for low-risk chest pain patients in the emergency department, instead of the traditional standard of care (SOC) workup, may reduce a patient"s length of stay and hospital charges, according to a study performed at the University of Washington School of Medicine, Seattle, WA. The SOC workup, which is timely and expensive, consists of a series of cardiac enzyme tests, ECGs and nuclear stress testing. Fifty patients were included in the study. "We found that cardiac CT based workups in low risk chest pain patients decreased the length of hospital stay up to 20 hours and was significantly cheaper (44% less) than using the standard of care workup," said Janet May, MS, lead author of the study. "The SOC mean length of stay was 25.4 hours and the mean length of stay for cardiac CT with observation was 14.3 hours. The mean charges for SOC were $7,597; the mean charges for cardiac CT with observation were $6,153; and the mean charges for cardiac CT without observation were $4,251," said May. "Delivering care through emergency departments is expensive, so cost containment in that setting is critical. Over six million patients present to US emergency rooms each year with chest pain and up to 79% of those patients fall into the low-risk category," she said. "Our study shows that cardiac CT has the potential to significantly reduce cost and length of stay in the emergency department by rapidly identifying those patients who can safely be discharged quickly," said May. This study appears in the July issue of the American Journal of Roentgenology. Heather Curry American Roentgen Ray Society


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