A decision on which of the two vaccines for cervical cancer will be used in the nationwide immunisation campaign is just weeks away.

The government is conducting a competitive tendering exercise to determine whether Sanofi Pasteur MSD's Gardasil or GlaxoSmithKline's Cervarix will be used, and a Department of Health spokesman said a decision would be made by the end of June.

The vaccines' respective efficacy will be a factor, but the government has also been clear from that outset about its desire to push down prices during the procurement process.

The routine vaccination of girls aged 12-13 years against the human papilloma virus (HPV) will begin in September and a two-year catch up campaign is planned to start in Autumn 2009, for girls up to 18 years.

The routine programme could cost the government up to £100 million a year and the catch up programme could require a further £200 million in 2009/10 and 2010/11.

Sanofi was first to market with its vaccine in October 2006, after clinical delays held up approval for GSK's Cervarix until the following October. In the UK the vaccines have the same price.

Although there are around 100 types of HPV, types 16 and 18 are responsible for more than 72% of all cervical cancers in Europe.

The two vaccines are both indicated for types 16 and 18 HPV, which are responsible for more than 72% of all cervical cancers in Europe, but Sanofi's Gardasil also provides some additional treatment coverage.

Despite screening for early detection, cervical cancer is the second most common cause of death from cancer (after breast cancer) among women aged 15-44 in Europe.

pharmafocus@wiley.com