The human papillomavirus (HPV) is one of the most common urogenital tract infections [1]. Some infections are associated with benign conditions, such as genital warts and laryngeal papillomatosis, while others are associated with malignancies, such as cervical, penile, oropharyngeal, anal, and vulvar cancers. A disease called genital warts occurs mainly in the low-risk group of HPV, represented by genotypes 6 and 11. Genotypes 16, 18, 31, 33, 35, 45, 51, 52, 56, 58, 59, and 68, which are high-risk groups for HPV, account for most of the causes of cervical cancer, anal cancer, vaginal cancer, vulvar cancer, and penile cancer [2].

Recently, the incidence of genital warts has been increasing. Kim et al. [3] reported the status of genital warts from 2010 to 2019. In 2010, 15,032 men and 10,176 women were treated, but an increase of 229% and 56% to 49,283 men and 15,920 women, respectively, occurred in 2019. The increase in total medical expenses is also increasing rapidly. The total treatment costs increased 366% from US$1,400,332 in 2010 to US$6,519,017 in 2019.

Currently, Cervarix and Gardasil are the commercially available vaccines for women aged 12 years and older, but Gardasil 9 is excluded. In 2019, The Korea Centers for Disease Control and Prevention conducted a cost-effectiveness study on introducing a national immunization program for a male HPV vaccine. A study of 220,000 12-year-old girls showed that US$12,640,000 in disease costs could be saved by administering a vaccine cost of US$33,200,000. On the other hand, a study of 220,000 12-year-old boys concluded that the vaccine cost of US$35,550,000 exceeded the disease cost of US$15,800,000.

Recently, the Korean Association of Urogenital Tract Infection and Inflammation announced that HPV disease is expanding to nasopharyngeal cancer in addition to cervical cancer. The main reason given was HPV infection in men and emphasized that HPV vaccine should be introduced in men. In addition, the Korean Society of Head and Neck Surgery emphasized the need for a male HPV vaccine as the number of oropharyngeal cancer patients has recently tripled.

In May 2023, the Korea Centers for Disease Control and Prevention announced it would conduct a cost-effectiveness study again. The cost of the disease is expected to increase input costs within four to five years due to the continuous increase in HPV infection, but one confounding variable has recently emerged. The price of Gardasil 9 has increased. MSD Korea plans to raise the prices of Gardasil and Gardasil 9 by 15 % and 17 %, respectively [4]. Compared to 2020, the price of Gardasil 9 increased by 25% in 2022. The Korean Society of Obstetrics and Gynecology is currently reviewing violations of the law for abuse of the monopolistic position of MSD. The Korean Urological Association and the Korean Society of Otorhinolaryngology-Head and Neck Surgery must also align with this trend.

In conclusion, the increasing prevalence of HPV will soon lead to the introduction of a vaccine for national immunization programs in men, but the price of Gardasil 9 appears to vary. Therefore, various related academic societies and institutions must exert pressure to limit the price of Gardasil 9.

No potential conflict of interest relevant to this article was reported.

No funding to declare.

K.H.Y. participated in conception, writing, and editing. J.C. participated in design.