US $ 143,000 ticket for snake bite treatment reveals a waste of antivenom prices

Snake bites can be painful and scary. But they may seem like minor pinches after the hospital's billing service stains.

According to a Kaiser Health News report, the emergency treatment of a Copperhead bite at a 9-year-old Indiana girl last summer cost $ 142,938. The bill includes $ 67,957 for four bottles of antivenom. This equates to $ 16,989.25 for each vial, more than five times the average market price of $ 3,198. The bill also included $ 55,577.64 for air ambulance transportation.

The girl, now 10 years old, was absent from the summer camp last July for hiking in Illinois. When she went over a pile of rocks on the trail, she got her right foot bitten. Her camp counselors suspected that it was a Copperhead snake that had bitten her and rushed for treatment. She arrived at St. Vincent Evansville Hospital, in Indiana, in an air ambulance, where doctors gave her four bottles of an antivenom called CroFab. She was then transferred to the Riley Children's Hospital in Indianapolis for her to recover. In total, she was released within 24 hours of the bite.

Crofab, like other antivenoms, is manufactured according to a standard process: the antivenom manufacturers of the milk rabbit and other venomous creatures for their venom, which they then inject in small harmless amounts to animals (here sheep, other horses). These animals make protective antibodies against the toxic components of venom, called venom. The manufacturers extract these antibodies from the animals' blood to target them against the venom, treat them, test them for quality and safety, then lyophilize and distribute them as an antivenom.

Although this is a simple process, relatively few people end up needing any kind of antivenom – less than 50,000 a year in the country. And that leads to high prices.

"[W]When prices are set after the commercial approval of these lifesaving antidotes, the impact of development costs is magnified, as is the cost of bureaucracy and profit, "writes Dr. Leslie Boyer in a 2015 editorial on the subject. She is the founding director of the VIPER Institute (Institute of Immunochemistry, Pharmacology and Venom Emergency Response) at the University of Arizona Health Sciences Center in Tucson, which has contributed to the development of Crofab, among other antivenoms.

In his 2015 editorial, Boyer lamented the awards of an antivenom scorpion that his group also helped develop, ranging from $ 7,900 to $ 39,652 per bottle in the United States. A sister drug, meanwhile, costs only $ 100 in Mexico.

The staggering price difference is due to "the application of a for-profit drug development philosophy to the treatments that other countries place in the field of public health", she concluded.

When KHN interviewed St. Vincent-Evansville Hospital on the charges against Crofab, the hospital found that the family of the girl bitten by a snake did not have to pay for the note. The insurance covered the price of the antivenom. And finally, the family insurer negotiated the $ 67,957 antivenom bill at $ 44,092.87.

But, as KHN notes, such insurers' expenses help raise the price of premiums and health costs in general. The outlet also noted that the hospital has since dropped its load of Crofab. It is now $ 5,096.76 per bottle, compared with $ 16,989.25 previously. The price change comes as a result of the release in the United States of a Mexican antivirus product, called Anavip, in October, which has a list price of $ 1,220 per vial.