Economic burden of human papillomavirus-related cancers in New Zealand

Introduction Prevalence of human papillomavirus (HPV)-related cancers in New Zealand (NZ) exceeds that of other high-income countries. These cancers are preventable by vaccination; however, NZ has a low and declining HPV vaccination rate. Literature on the economic burden of HPV-related cancers in NZ is limited. This study quantifies the economic burden of HPV-related cancers in NZ. Methods A retrospective analysis of NZ patients with the six known HPV-associated cancers—oropharyngeal, cervical, vaginal, vulvar, anus/anal canal and penile cancers—between 1 July 2017 and 30 June 2022 was performed. Total number of patients with these cancers, including non-HPV cases, was identified from the NZ Cancer Registry (NZCR). As HPV status is not recorded on the NZCR, the number of HPV-positive cases was estimated using data published by the Centre for Disease Control and Prevention (CDC). A prevalence cost-of-illness, non-discounted, approach was used to estimate the treatment cost of HPV-related cancers in the public health sector, with costs calculated using national data collections capturing outpatient, inpatient and pharmaceutical events. Results There were an estimated 2342 cases of HPV-attributable cancers, with a cumulative treatment cost of NZ$82.4 million over a 4 year financial period, mostly incurred within the first 2 years of diagnosis. An additional $49 million was incurred for cervical pre-cancer detection by coloscopy and colposcopy-directed treatments. Conclusion The cost of HPV-attributable cancers in NZ during 2019–2022 was conservatively estimated at NZ$131.4 million. This underestimates the true economic burden of the disease as it only includes treatment costs in the public health sector and the proportion of the HPV-associated cancers is based on CDC data. Despite the significant economic burden associated with HPV-related cancers, the vaccination rates in NZ are declining, highlighting the urgent need to increase the HPV vaccination rate to at least 90%, in line with the targets set by other developed countries. Further research evaluating the ethnic disparities and socioeconomic implications of HPV-related cancers is needed.