To prop up flagging sales, Merck & Co. is focusing Gardasi marketing efforts on women aged 19-26, even though many experts believe the vaccine is of little benefit to people in this age group.  Faced with declining sales of  Vytorin and Zetia, as well as questions about the safety of Singulair, its top-selling drug, Merck desperately needs to prop up Gardasil sales.

According to Bloomberg.com, US sales of Gardasil dropped by 33 percent this past summer.  To reach the older age group, Bloomberg.com reports that Merck is advertising on the networking Web site Facebook.com and in college bookstores and coffee shops. The company has also been selling $32 cervical-cancer awareness charm bracelets on the Internet. And, Merck is seeking Food & Drug Administration (FDA) approval to market Gardasil to women through age 45.But Merck’s latest Gardasil marketing efforts are being questioned on some fronts, as it is unclear how much older women would benefit from the vaccine.   In August, a study in the New England Journal of Medicine questioned the cost effectiveness of such an approach.  A treatment is typically considered cost effective if it costs health systems less than $50,000 or $100,000 for one additional year of life.  The  analysis, conducted by Harvard researchers,  predicted that it would cost $43,600 to extend life expectancy by one year when girls are vaccinated at 12. But when girls up to age 18 are included in the analysis, that ratio rises to $97,300 and to $153,000 through age 26.

The American Cancer Society is on record as recommending that Gardasil vaccination efforts focus on younger girls.  “The push needs to be with the 11- to 12-year-olds,”  Debbie Saslow, director of breast and cervical cancer for the American Cancer Society, told Bloomberg.com. “It is not going to be as effective in the older women.”