"It's not just about living long, but about living healthily for a long time. In a super-aged society, a health care strategy that prevents diseases rather than treating them is crucial not only for individuals but also for national finances."
On the 27th, Professor Lee Hang-gil of Ewha Womans University College of Pharmacy said, "The national finances cannot handle an approach that is solely focused on treatment," adding, "Preventive interventions such as adult vaccines must be well utilized."
Professor Lee serves as the Commissioner of the Korean Society for Health Technology Assessment and is active as an expert evaluating the economic viability of vaccines and pharmaceuticals introduced in the country. Recently, he oversaw the report titled "Value of Adult Vaccination in Response to a Super-Aged Society," co-published by the British Chamber of Commerce in Korea and Korean GSK.
Korea has already entered a super-aged society where the population aged 65 and older exceeds 20%. If the current trend continues, it is projected that by 2072, nearly half of the population will be elderly over 65. Consequently, the burden of medical expenses is also increasing.
Professor Lee noted that adult vaccines can not only prevent viral infections in the elderly but also reduce the burden of medical expenses. A classic example includes respiratory syncytial virus (RSV) and shingles. Healthy individuals recover quickly, but the elderly are more likely to be hospitalized or die.
RSV tends to circulate every winter. Most people are unaware of the infection as the symptoms are similar to those of a cold. However, infants, the elderly, and those with chronic heart and lung diseases, who have weakened immune systems, can develop pneumonia and other serious infections and require early diagnosis and appropriate treatment in healthcare facilities.
Shingles is a nerve disease that develops from infection by the varicella zoster virus. In childhood, it manifests as chickenpox, resulting in blisters all over the body, but when the virus reactivates in adulthood, it appears as a shingles rash characterized by streaks on the skin. The rash gradually transforms into blisters, causing pain.
Professor Lee pointed out, "While RSV and shingles can be prevented with vaccines, the vaccination rates are low due to cost burdens." In fact, the vaccination rate for the influenza vaccine, included in the National Immunization Program (NIP) and provided for free, is about 80%, while the domestic vaccination rate for shingles, which is not included, stands at only 38.2%. This figure also includes support for shingles vaccination from some local governments.
Available shingles vaccines in Korea include Shingrix from Korean GSK, Sky Zoster from SK bioscience, and Zostavax from Korean MSD. The RSV vaccines include Arexvy from Korean GSK and the preventive antibody injection Beyfortus from SK bioscience and Sanofi, but they are also not included in the National Immunization Program and are administered individually or supported by some local governments.
Adult vaccines are more expensive compared to vaccines for infants and toddlers. However, if included in the National Immunization Program, economies of scale could potentially lower prices. Professor Lee stated, "Considering the significant differences in vaccination rates based on whether financial support is provided, there is a need to explore measures to enhance accessibility to vaccines for adults."
Professor Lee mentioned that a co-payment model, where individuals bear part of the cost, could be considered. Furthermore, given that it is challenging to introduce all new vaccines under a single financial structure, a gradual introduction or a financial model that combines health insurance with local government budgets, similar to Japan, should also be considered.
There is already a basis for persuading the central government and local authorities. Professor Lee cited the economic evaluations of shingles and RSV vaccines as an example. Vaccinating about 23.33 million people aged 50 and older with the shingles vaccine would incur an expense of 3.7 trillion won. However, the socio-economic benefit (ROI) is shown to be 1.52, indicating that the economic benefits of vaccination exceed 5.6 trillion won.
The RSV vaccine, too, if administered to 14.67 million people aged 60 and older, has an ROI estimated at 1.65 for an expense of 2.6 trillion won. If the vaccination age is raised by increments of 10 years, the ROI for shingles vaccine drops to 1.46 and for the RSV vaccine to 1.33, but they are still considered economically viable.
Professor Lee remarked, "If an investment of 100 million won can reduce social losses by more than 160 million won through preventive effects, then this clearly represents a socially valuable investment." He also noted that the analysis of Quality-Adjusted Life Year (QALY) shows that vaccination is effective in extending healthy life span and reducing productivity losses.
Professor Lee stated that the paradigm of vaccination policy needs to change with the demographic shifts. Until now, the government's vaccination programs have focused on reducing infant mortality rates. He said, "In a super-aged society, it is essential to strengthen vaccination to enable the elderly not just to live long but to age healthily, termed 'Healthy Ageing.'"
However, baseless vaccine hesitancy and conspiracy theories are spreading both domestically and internationally, becoming obstacles to healthy aging. Professor Lee stated, "The effectiveness and safety of vaccines are based on scientific evidence from clinical trials," adding, "There needs to be greater awareness that vaccination contributes to the overall health protection of society, beyond just protecting oneself."