The XX Factor

HPV Costs Americans Nearly $2 Billion To Treat. Why Is It So Expensive?

A 13-year-old girl is vaccinated against HPV

Photo by Joe Raedle/Getty Images

According to a new study just released by the CDC, Americans contracted 20 million new sexually transmitted infections in 2008, and treating them will cost U.S. patients and insurance companies $15.6 billion over the course of the infections. After HIV—which will cost a projected $12.6 billion to treat—HPV is the most expensive STI to manage, running us a collective bill of $1.7 billion.

Most strains of HPV clear from the body safely within a couple of years. A handful of more dangerous strains, which cause cervical cancer and genital warts, are preventable by vaccine. Routine check-ups catch aggressive forms of the virus early. So why does it cost so much to treat HPV? Part of it is the sheer will of the virus—HPV is the most common of those 20 million STIs. But it’s also because, as costly as treatment is, prevention isn’t cheap, either.

In 2010, only 30 percent of American girls had received all three CDC-recommended doses of the HPV vaccine, according to a recent report from the National Cancer Institute. That sets us behind Canada, where between 50-85 percent of girls are vaccinated, and the United Kingdom and Australia, where over 70 percent of girls have completed the vaccine schedule. It’s tempting to chalk this up to all-American prudishness over the idea of inoculating 12-year-old girls against STIs. But according to the report, the U.S. health care system is to blame. The main barriers to vaccination are inadequate provider recommendations, a broken reminder system for urging patients to complete their doses, and concerns over cost and insurance coverage. Vaccination rates are lowest among girls living below the poverty line. And when those girls become women, they make up a disproportionate number of cervical cancer cases.

Thanks to a combination of biology and policy, women bear a “disproportionate burden” of STI treatment costs, CDC epidemiologist Catherine Satterwhite told Bloomberg. “Young women in particular are at greater risk” of contracting STIs, she said, and are less likely to have access to superior health insurance and medical care for preventing and treating them. In 2011, the CDC voted to extend its recommendations for the HPV vaccine to boys, in order to prevent genital warts, cancers of the anus, head, and neck—and, though it went unsaid, cervical cancer in their sex partners. But the CDC’s educational materials still list the vaccination of boys and men as an afterthought to vaccinating girls.

Though huge percentages of men and women both carry the virus, preventing HPV is still seen as a women’s issue. A 2009 BMJ study assessed the medical costs of vaccinating 12-year-old boys and girls against common strains of HPV. Researchers concluded that while vaccinating girls is a sound societal investment, “including boys in an HPV vaccination programme generally exceeds conventional thresholds of good value for money.” Because dangerous strains of HPV end up disproportionally harming—and costing—women, it makes more financial sense for girls to invest in the vaccination, as opposed to the boys who might be spreading the HPV to them. And since that level of investment is often cost-prohibitive for American girls, we need to make sure our health care system is there to foot the bill.