The brake was put on the brakes as a research result found that the expansion of health insurance coverage for ‘Human Papilloma Virus Vaccination (HPV)’, which was promoted as a presidential election pledge by President Yoon Seok-yeol and a national task, was “not cost-effective”.
Current HPV vaccine national mandatory vaccination (NIP) targets are female youth aged 12 to 17 and low-income females aged 18 to 26, but the Yoon Seok-yeol government planned to expand the target to males of the same age.
However, experts are emphasizing the effect of vaccination, saying that it is necessary to pay attention to the increase in HPV-related diseases regardless of gender, so the health authorities are in a position to “continue to promote the expansion of support targets.”
◇ It was planned to expand by early 2024, but it acts as an ‘unexpected reef’
The final report of ‘Cost-Effectiveness Analysis for National Vaccination Expansion of HPV Vaccine’ obtained by News1 on the 18th concluded that “As a result of economic evaluation, all analysis scenarios in the basic analysis are not cost-effective.”
This is a study conducted by the Korea Health and Medical Research Institute from January 2021 to February 2023, commissioned by the Agency for Disease Control and Prevention.
With this study, the Agency for Disease Control and Prevention prepared for the current HPV vaccination of 12-year-old girls △ transition to 9-valent vaccine for girls △ introduction of 9-valent vaccine for male and female 12-year-olds △ cost-effectiveness for each scenario such as introduction of 12-year-old boys (2/4 vaccine) sex was analyzed.
The vaccines applied to the NIP project are Cervarix, a bivalent vaccine, and Gardasil, a quadrivalent vaccine. The 9-valent vaccine ‘Gardasil 9’ has not been applied.
As a result of the analysis, the research team said, “In the case of 9-valent vaccination for girls aged 12, if the price of 9-valent vaccine is lowered, it becomes cost-effective, but in other cases, it was not cost-effective in various analyses.” It is considered that the expansion of the vaccination target or the conversion of the 9-valent vaccine is not positive.”
From the perspective of the Agency for Disease Control and Prevention, which has decided to expand male vaccination and is building grounds to promote it as a presidential pledge and a national task, it is like meeting an unexpected rock. Health authorities were planning to expand the HPV vaccine’s NIP by early 2024.
HPV, well known as the virus that causes cervical cancer in women, is sexually transmitted and can infect both men and women if they have sex.
HPV causes about 37,000 cancers, and high-risk HPV is known to cause 5% of all types of cancer worldwide.
In particular, it was a problem because it was not known whether or not he was infected because he did not have conspicuous symptoms. Vaccination is the best way, but if it is not free, the cost of vaccination ranging from 320,000 to 480,000 won has to be paid.
Nevertheless, about 150 countries are doing HPV prevention programs as national vaccination programs, and 17 of the top 20 gross national product (GDP) countries in member countries of the Organization for Economic Co-operation and Development (OECD) include men in their national HPV vaccination programs.
It seems that there was a problem with the design of the research model when the research result was found to be ineffective compared to the cost this time.
A research team from the Institute of Health and Medical Services also said, “The burden of cervical cancer and its precancerous stage among related diseases is significantly higher than that of other diseases (oropharyngeal cancer, tonsil cancer, anal cancer, genital cancer, genital warts, etc.).” “There is a limitation that the effect of HPV vaccination on male benefits was very small,” he explained.
After hearing the opinions of experts from related societies, the Agency for Disease Control and Prevention decided to conduct an additional analysis to reflect the increasing trend of oropharyngeal cancer and anal cancer in domestic men.
Regardless of the medical department, experts on cancer caused by HPV infection are emphasizing with one voice, “It is necessary to pay attention to the recent increase in HPV-related diseases regardless of gender.”
Lee Seung-joo, president of the Korean Society of Urogenital Infectious Diseases and professor of urology at St. Vincent’s Hospital, Catholic University of Korea, said, “HPV causes head and neck cancer and anal cancer in men, and among them, awareness of head and neck cancer caused by HPV is increasing. HPV in the United States Head and neck cancer caused by cervical cancer has outpaced cervical cancer.”
Lee Se-young, insurance director of the Otorhinolaryngology Association and professor of otolaryngology at Chung-Ang University Hospital, said, “The HPV type that causes oropharyngeal cancer can be prevented by vaccination. The incidence of oropharyngeal cancer is increasing, especially in men, and it is questionable whether it is right to implement a policy for cost effectiveness.” “Inoculation is economical and effective,” he emphasized.
An official from the Agency for Disease Control and Prevention said, “As of now, the results have shown that the economic feasibility is low, but after reviewing scenarios and variables through consultation in related fields, it was determined that additional analysis was necessary.”
The official added, “We will continue to promote the expansion of support targets through follow-up research,” but added, “It is still difficult to predict whether and when NIP will be introduced.”
