MOH recommends HPV vaccine for men who have sex with men, but PHARMAC doesn’t fund it


Vaccine vial
Not the HPV vaccine

Update 30 May 2016: PHARMAC is currently consulting on a proposal to widen funding for the HPV vaccine to everyone under the age of 26.

PHARMAC currently funds the human papillomavirus (HPV) vaccine for all girls under 20. The intention is that through ‘herd immunity’, males will be protected too. However, herd immunity does not help males who exclusively have sex with other males (and herd immunity doesn’t kick in for males at all until female vaccination rates are above a certain percentage).

The Ministry of Health’s Immunisation Handbook even recommends the HPV vaccine (and the Hepatitis A vaccine) for men who have sex with men (MSM). MSM are at higher risk for HPV infection, anal cancer and high-grade anal intraepithelial neoplasia. They are more likely to acquire HPV compared to other males. But they’d need to pay around $500 to buy the vaccine’s three doses themselves.

In August 2013, the Pharmacology and Therapeutics Advisory Committee recommended that the HPV vaccine for males aged between 9 and 26 years who self-identify as having sex with other males be listed in the Pharmaceutical Schedule (aka funded) with a high priority.

The application’s status is now ‘ranked’, which PHARMAC describes as “prioritised; PHARMAC has assessed the application and has ranked it against other funding options”. It has had this status since November 2013, well over two years.

It is preferable to vaccinate people at a younger age to reduce the chances of exposure to HPV strains prior to vaccination–the younger people are vaccinated, the stronger the immunogenicity. PHARMAC sitting on this means that for some people the vaccine will be less effective when it is eventually funded than if they received it today.

The Human Rights Act 1993 is meant to protect New Zealanders against this sort of discrimination, but it would be much easier if PHARMAC just did the right thing.

Below: PHARMAC’s response to an Official Information Act request on this topic. The funding of medicines is a numbers game so naturally all mentions of relevant dollar figures have been redacted by the agency.

In the interests of full disclosure, I filed a Human Rights Commission complaint about this issue last year.

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