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Abstract <p>Envenomation is a global health issue, with over 9,000 encounters managed in the United States yearly. The introduction of immunoglobulin fragment antivenom has reduced the risk of hypersensitivity. This study compares treatment costs of crotaline envenomation using the Fab and F(ab’)<sub>2</sub> antivenoms as reported to the North American Snakebite Registry (NASBR), a nationwide surveillance tool.</p> Methods <p>This was a retrospective analysis of NASBR data between 2018 and 2020. The following data points were assessed: patient demographics (age, gender, race), snake species, type of antivenom used, and treatment costs. Unit costs were estimated based on United States Centers for Medicare and Medicaid Services data. Average (mean) per patient costs from the payer perspective were calculated by multiplying resources by the unit costs. Sensitivity analyses were performed regarding cost variance and snake species. All costs reported in this study are in U.S. dollars.</p> Results <p>The average total cost of treatment was $31,343 per person, with medications contributing 72% of the total. Average total cost among patients who received Fab treatments was $33,347 per person compared to $19,747 among patients who received F(ab’)<sub>2</sub>. Antivenom costs accounted for 75% of the total cost in the Fab group and 42% in the F(ab’)<sub>2</sub> group. F(ab’)<sub>2</sub> required more vials than Fab (median 18 versus 10). Non-antivenom costs such as hospitalizations were higher in the F(ab’)<sub>2</sub> group. Using average sale prices increased average total cost to $52,572; Fab remained more expensive.</p> Conclusion <p>Antivenom is the primary cost driver in snakebite treatment in North America. Treatment with F(ab’)<sub>2</sub> resulted in lower overall costs, driven by lower cost of antivenom. F(ab’)<sub>2</sub> did not significantly lower overall resource use except for blood product administration.</p>

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The Cost of Antivenom: A Cost Minimization Study using the North American Snakebite Registry

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月14日

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  • Benjamin Herzel,
  • Neev Batavia,
  • Paul Gavaza,
  • Tammy Phan,
  • Emmelyn Samones,
  • Anne-Michelle Ruha,
  • Jakub Furmaga,
  • Christopher Hoyte,
  • Brian J. Wolk,
  • Peter Akpunonu,
  • Adam Algren,
  • Alexandra Amaducci,
  • Sukhshant Atti,
  • Connie Aubin,
  • Kevin Baumgartner,
  • Gillian Beauchamp,
  • Jeffrey Brent,
  • Dazhe Cao,
  • Emma Cassidy,
  • Samy Chettat,
  • Michael Christian,
  • Joseph Clemons,
  • Ryan Cole,
  • Matthew Cook,
  • Matthew Correia,
  • Robert Cox,
  • Lee Crawley,
  • Sara Delatte,
  • John Delbianco,
  • Jason Devgun,
  • Frank Dicker,
  • Christopher Dion,
  • Natalie Ebeling-Koning,
  • Bernard Eisenga,
  • Claire Epperson,
  • Sing-Yi Feng,
  • Andrew Ferdock,
  • Derek Fikse,
  • Will Goodrich,
  • Spencer Greene,
  • Stacey Hail,
  • Robert Hendrickson,
  • Rey Hernandez,
  • Ariana Hines,
  • Ruby Hoang,
  • Luisa Holguin,
  • Christopher Holstege,
  • Adrienne Hughes,
  • Chase Jones,
  • Bryan Judge,
  • Sabrina Kaplan,
  • Kenneth Katz,
  • Abigail Kerns,
  • Andrew Koons,
  • Jessica Kreuger,
  • Alexander Lazar,
  • Michael Levine,
  • Brian Lewis,
  • Erica Liebelt,
  • David Liss,
  • Chin-Yu Lo,
  • Anette Lopez,
  • Michael Marlin,
  • Kelsey Martin,
  • Serah Mbuga,
  • Katelyn McClain,
  • Andrew Micciche,
  • Michael Mullins,
  • Karen Muschler,
  • Angela Padilla-Jones,
  • Lesley Pepin,
  • Jennifer Perry,
  • Tony Rianprakaisang,
  • Brad Riley,
  • Daniel Rivera,
  • Brett Roth,
  • William Rushton,
  • David Schaffer,
  • Evan Schwarz,
  • Michael Semple,
  • Kerollos Shaker,
  • Kapil Sharma,
  • Sophia Sheikh,
  • Miya Smith,
  • Dawn Sollee,
  • Hannah Spungen,
  • Meghan Spyres,
  • Molly Stott,
  • Ryan Sumaitis,
  • Courtney Temple,
  • Steve Thornton,
  • David Vearrier,
  • Alya Wezza,
  • Hannah Wilkins,
  • Amy Young

摘要

Abstract

Envenomation is a global health issue, with over 9,000 encounters managed in the United States yearly. The introduction of immunoglobulin fragment antivenom has reduced the risk of hypersensitivity. This study compares treatment costs of crotaline envenomation using the Fab and F(ab’)2 antivenoms as reported to the North American Snakebite Registry (NASBR), a nationwide surveillance tool.

Methods

This was a retrospective analysis of NASBR data between 2018 and 2020. The following data points were assessed: patient demographics (age, gender, race), snake species, type of antivenom used, and treatment costs. Unit costs were estimated based on United States Centers for Medicare and Medicaid Services data. Average (mean) per patient costs from the payer perspective were calculated by multiplying resources by the unit costs. Sensitivity analyses were performed regarding cost variance and snake species. All costs reported in this study are in U.S. dollars.

Results

The average total cost of treatment was $31,343 per person, with medications contributing 72% of the total. Average total cost among patients who received Fab treatments was $33,347 per person compared to $19,747 among patients who received F(ab’)2. Antivenom costs accounted for 75% of the total cost in the Fab group and 42% in the F(ab’)2 group. F(ab’)2 required more vials than Fab (median 18 versus 10). Non-antivenom costs such as hospitalizations were higher in the F(ab’)2 group. Using average sale prices increased average total cost to $52,572; Fab remained more expensive.

Conclusion

Antivenom is the primary cost driver in snakebite treatment in North America. Treatment with F(ab’)2 resulted in lower overall costs, driven by lower cost of antivenom. F(ab’)2 did not significantly lower overall resource use except for blood product administration.