Every once in awhile somebody will go and get themselves bitten by a venomous snake, and come home with an outrageous hospital bill that makes headlines.
Nobody expects antivenom to be cheap. Making the most common rattlesnake antivenom, for instance, involves injecting sheep with snake venom and then harvesting the antibodies produced by the animals’ immune systems. But does that process, complicated as it may be, add up to the estimated $2,300 per vial hospitals pay for the stuff?
Leslie Boyer wanted to find out. She’s the founding director of the VIPER Institute at the University of Arizona, a research group studying ways to improve the medical treatment of venom injuries. VIPER was instrumental in the development of CroFab, the leading rattlesnake antivenom, as well as its upcoming competitor Anavip.
Boyer knows more than just about anyone about how antivenoms work, and how to study them in the lab. But she couldn’t figure out why the price was so high. So, as she writes in an upcoming issue of the American Journal of Medicine, she requested “cost data from factory supervisors, sales representatives, animal managers, hospital administrators, health care finance officers, hospital pharmacists, grants managers and insurance specialists representing over 20 organizations involved in antivenom work affecting Latin America and the USA.” She and her colleagues at VIPER used the numbers to build a pricing model for a typical arachnid antivenom sold in the United States. Here’s how that model breaks down:
Shockingly, the cost of actually making the antivenom — of R&D, animal care, plasma harvesting, bottling, and the like — added up to roughly one tenth of one percent of the total cost. Clinical trials to evaluate the efficacy of the antivenom accounted for another 2 percent. Other miscellaneous costs, including licensing fees, wholesaler fees, regulatory, legal and office costs, and profit to medical providers, added up to 28 percent.