Arizona hospital cuts scorpion antivenom price
Nobody disputes that Anascorp is effective and fast. The scorpion antivenom drug can help children and adults recover quickly from severe reactions to scorpion stings. But, as many who need the antivenom to recover from scorpion encounters discover, the hospital bills that come weeks after they leave the emergency room typically run tens of thousands of dollars. Chandler Regional Medical Center billed a female patient $83,046 for a June visit that included administering two doses of scorpion antivenom. The Chandler hospital's charge for the scorpion antivenom? $39,652 per dose. After The Arizona Republic reported the charges, the hospital said it would review its pricing for the drug. Arizona Department of Health Services records show the hospital has lowered its price to $8,000 per dose of Anascorp, a discount of $31,652, or 80 percent, per dose from its previous charge. Other hospitals' charges range from $7,950 per dose at Banner Health to $21,875 per dose at Phoenix Children's Hospital, according to Department of Health Services records.
Hospital representatives and the Tennessee-based company that owns the U.S. rights to Anascorp acknowledge the Mexican-made drug is expensive. But they say that is a function of the patchwork system of health care pricing, particularly for rare drugs sold in the U.S. "We are not pleased the therapy is as expensive as it is when we sell it to the hospital," said Jude McNally, medical science liaison with Tennessee-based Rare Disease Therapeutics. "The drug needed to be priced in a manner that we could keep it on the market and make it available."
Mexico-based Instituto Bioclon produces more than 250,000 vials of the scorpion antivenom each year for Mexican residents. The Mexican version of the drug is sold for about $100 per vial at pharmacies or for less at government-funded clinics and hospitals in Mexico.
Instituto Bioclon also makes the drug for the U.S. To pass muster with the Food and Drug Administration, McNally said, the Mexican factory had to make expensive improvements to its manufacturing process for the American version. Batches of the drug also are subject to continual testing by FDA inspectors, he added. "It is manufactured under a different process," McNally said. "The Mexican manufacturers coined the phrase "the long process'" when comparing the American with the Mexican version of the drug. Other economic factors contribute to the drug's prices, too. McNally said about 4,000 scorpion stings require antivenom each year in the U.S. And Rare Disease Therapeutics must price the drug high enough that it can pay FDA fees.
Although the privately owned Rare Disease Therapeutics does not disclose its finances, the company said it sells the serum to a distributor for the average wholesale price of $3,500 per vial. The distributor typically sells the drug directly to hospitals and other medical providers for about $3,780 per vial. From there, hospitals must establish the price at which they sell the drug, taking into account factors such as discounted prices for insurers and providing care for the poor and uninsured who may not be able to pay their bills. The drug is sold at discounted rates for government-funded health programs such as Medicare, Medicaid and the Veterans Administration. are Disease Therapeutics this week decided it would adopt a new policy to alleviate some financial pressure for hospitals. It will replace hospitals' expired vials of Anascorp for free. The drug now has a two-year shelf life.
Marcie Edmonds said she was shocked when she received a bill for more than $83,000 from Chandler Regional Medical Center. Her insurer, Humana, paid the hospital $57,509 for the bill. She was charged for the balance of $25,537. After The Republic reported on Edmonds' case, the hospital settled her bill for an undisclosed sum. But other Arizona residents have expressed shock when they discovered their charges. Anthem resident Matt Garner said his son Chase, 3, received superb care from John C. Lincoln Health Network following a scorpion sting in April. After receiving four intravenous doses, Chase was released from the hospital. Garner was billed more than $51,000. Nearly $50,000 was for the antivenom, for which John C. Lincoln charges more than $12,400 per dose, according to the Department of Health Services.
Garner's insurer, Blue Cross Blue Shield of Arizona, paid about $38,000, and the hospital wrote off the rest of the bill because Garner was between jobs and could not pay it at the time, he said. "People with open-heart surgery have told me they paid less," Garner said. |
