Blue Cross Blue Shield decides to cover HPV vaccine in males

By Deborah Kotz, Globe Staff

Blue Cross Blue Shield of Massachusetts announced today that it will start covering the human papillomavirus (HPV) vaccine for males. As I reported last month, the insurer had refused to cover the nearly $400 cost of the three shots required for full protection against the virus -- which causes cervical cancer in girls and anal and throat cancers in both genders.

The US Food and Drug Administration has approved the HPV vaccine for teenage boys and men up to age 26, but the federal Centers for Disease Control and Prevention says males “may get HPV vaccine” but doesn’t recommend it. The CDC does, however, recommend the vaccine for girls, and Blue Cross covers the cost of the immunization in them.

“It is our understanding that the CDC is expected to recommend the use of this vaccine in males at its October meeting,” Blue Cross Blue Shield spokesman Jay McQuaide said in an e-mail. “In anticipation of the CDC taking this expected step in October, we are beginning the process to cover the vaccine in males.”

He added that the action was based on the company’s normal business practice and “unrelated to the Globe story.”

Gay rights advocates welcomed the news since gay men are at particular risk of contracting anal cancer through HPV infections. “We’re thrilled that they have joined the Commonwealth’s other major insurers in providing coverage for this important preventative measure,” said Bennett Klein, AIDS law project director at the Gay & Lesbian Advocates & Defenders, an organization that had recently urged Blue Cross Blue Shield to cover the vaccine in males and had their request turned down. “Now it is up to patients to make sure they request this vaccine from their doctors.”

Males with Blue Cross Blue Shield coverage must ask their doctors to submit a “request for individual consideration” to obtain coverage for the vaccine, and the insurer said the requests would be reviewed and routinely granted, with exceptions made for those with serious health conditions or who fall outside the recommended age range.

If the CDC decides to recommend HPV for boys and men in October, then Blue Cross Blue Shield said it will adopt a permanent change in its policy that would allow coverage without the need for formal requests to be filed.

“If the CDC does not recommend the use of the vaccine in males in October, then we will need to take a hard look at our decision to provide coverage and may reconsider,” McQuaide said.

Tufts Health Plan, Harvard Pilgrim, Neighborhood Health Plan, and MassHealth (which serves the state’s Medicaid patients) all provide coverage for boys and young men.