Why Merck's Gardasil Franchise Will Be Battered by Entry of GSK's Cervarix

Merck CEO Richard Clark thinks there's still plenty of steam left in the Gardasil franchise now it's lost its monopoly status as the only HPV vaccine on the market:
There is still a tremendous opportunity for HPV, for Gardasil, not only in the United States but on a global basis.
Here's what that "opportunity" looks like. This chart represents quarterly Gardasil sales since its launch:

Source: Merck's SEC statements. As you can see, this monopoly is already in decline even before competition arrives. It's losing $150 million in sales every quarter since its peak. Even if Gardasil retains its dominant market share, GlaxoSmithKline's Cervarix will still make inroads, driving its dollar sales down.

An FDA panel recommended approval of Gardasil for use in males aged 9-26, but even if it is eventually approved, it will likely do little to lift sales -- unless you believe that men are more enthusiastic about the vaccine than women: Only 18 percent of girls completed a three-course Gardasil vaccine, despite a federal recommendation that all get it. Takeup among men is likely to be lower than that. (Note that if you want to have unprotected sex with an American woman, Georgia, Mississippi, and South Carolina are the places to avoid, according to the CDC.)