Genital wart patients in Korea rose 3.5-fold. The bill rose 9.8-fold, and men and women were not treated the same way

Two analyses of Korean national health insurance claims, published a year apart in the same journal, describe the same decade of anogenital wart treatment from different angles. Read together they raise a question neither set out to answer: why the bill grew so much faster than the caseload.

The two curves#

The first study extracted every claim coded A63.0 in men, as either a primary or secondary diagnosis, from the Health Insurance Review and Assessment Service between 2007 and 2018.

Age concentrated the burden narrowly. Prevalence peaked between 25 and 29 at 1,492.15 per 100,000 in 2018 — about one man in 67 in that age band treated in a single year — against 7.28 per 100,000 at ages 10 to 14 in 2014, the lowest figure in the series.

What the treatment data adds#

A second analysis of the same national data, covering 2010 to 2019, separated claims by how the warts were treated: cauterisation, excision, cryotherapy and laser as surgical treatment, podophyllin as non-surgical, and surgery for anorectal lesions counted separately.

• Patient numbers rose every year across all treatment methods.
• Surgical treatment predominated among men; drug treatment predominated among women.
• Non-surgical treatment fell in men over the decade while rising in women.
• Surgery for anorectal warts rose by more than 250 percent, and men underwent it four times as often as women.
• The mean number of sessions was higher in men, for both surgical and non-surgical treatment.
• Most treatment took place in primary care clinics, with Seoul and Gyeonggi-do accounting for the largest patient numbers regardless of method.

A decade in which a growing caseload shifts toward the more expensive treatment category, is delivered in more sessions per patient, and includes a category rising by 250 percent is a decade in which cost should be expected to outrun headcount. The treatment data does not prove that is what happened, because the two analyses do not link cost to method — but it is the mechanism the numbers point at.

The scale in a single year#

A separate ecological study using 2019 National Health Insurance Service data counted 52,009 cases of condyloma acuminata across Korea's 250 municipalities, 70.03 percent of them in men. That is one year of a condition whose treatment volume had been rising for a decade without interruption.

What these figures do not establish#

1. Claims data counts treatment, not disease. A rise in people treated is consistent with rising incidence, rising presentation, rising diagnosis, or changes in coding, and these analyses cannot separate them.
2. The cost figures are reported in US dollars across a period in which the won-dollar exchange rate moved substantially, and are not adjusted for medical price inflation. Some of the 9.76-fold rise is currency and prices rather than care delivered.
3. The two studies cover overlapping but different periods — 2007 to 2018 and 2010 to 2019 — and the first covers men only, so the comparison between them is indicative rather than exact.
4. Neither study links individual cost to individual treatment method, so the shift toward surgery is a plausible driver of the cost gap and not a measured one.
5. The 2019 ecological count uses a different data source and case definition again, and is offered as scale rather than as a continuation of the same series.

What can be said plainly is that Korea treated three and a half times as many men for this condition at the end of the period as at the start, paid nearly ten times as much to do it, and treated men and women by different means throughout — and that no published analysis has yet explained why.