In 2006 Merck received FDA approval for Gardasil, the first vaccine for human papilloma virus (HPV) which had been identified as the cause of cervical cancer. Merck priced the vaccine at $360 for the three injections and was working on programs for the use of Gardasil in developing countries at much lower prices. Projected sales of Gardasil were $1 billion a year and billions more if states mandated vaccination. Prior to FDA approval, Merck began to develop a market for Gardasil and launched an intensive campaign to get states to make HPV vaccination of girls entering middle school mandatory. As the public and organized private groups became aware of Merck’s efforts, however, the campaign generated a backlash against mandatory vaccination. Merck subsequently suspended its campaign and reflected on the experience in deciding its next moves.
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