Breaking News
May 3, 2019 - Vaping and Smoking May Signal Greater Motivation to Quit
May 3, 2019 - Dementia looks different in brains of Hispanics
May 3, 2019 - Short-Staffed Nursing Homes See Drop In Medicare Ratings
May 3, 2019 - Study of teens with eating disorders explores how substance users differ from non-substance users
May 3, 2019 - Scientists develop new video game that may help in the study of Alzheimer’s
May 3, 2019 - Arc Bio introduces Galileo Pathogen Solution product line at ASM Clinical Virology Symposium
May 3, 2019 - Cornell University study uncovers relationship between starch digestion gene and gut bacteria
May 3, 2019 - How to Safely Use Glucose Meters and Test Strips for Diabetes
May 3, 2019 - Anti-inflammatory drugs ineffective for prevention of Alzheimer’s disease
May 3, 2019 - Study tracks Pennsylvania’s oil and gas waste-disposal practices
May 3, 2019 - Creating a better radiation diagnostic test for astronauts
May 3, 2019 - Vegans are often deficient in these four nutrients
May 3, 2019 - PPDC announces seed grants to develop medical devices for children
May 3, 2019 - Study maps out the frequency and impact of water polo head injuries
May 3, 2019 - Research on Reddit identifies risks associated with unproven treatments for opioid addiction
May 3, 2019 - Good smells may help ease tobacco cravings
May 3, 2019 - Medical financial hardship found to be very common among people in the United States
May 3, 2019 - Researchers develop multimodal system for personalized post-stroke rehabilitation
May 3, 2019 - Study shows significant mortality benefit with CABG over percutaneous coronary intervention
May 3, 2019 - Will gene-editing of human embryos ever be justifiable?
May 3, 2019 - FDA Approves Dengvaxia (dengue vaccine) for the Prevention of Dengue Disease in Endemic Regions
May 3, 2019 - Why Tonsillitis Keeps Coming Back
May 3, 2019 - Fighting the opioid epidemic with data
May 3, 2019 - Maggot sausages may soon be a reality
May 3, 2019 - Deletion of ATDC gene prevents development of pancreatic cancer in mice
May 2, 2019 - Targeted Therapy Promising for Rare Hematologic Cancer
May 2, 2019 - Alzheimer’s disease is a ‘double-prion disorder,’ study shows
May 2, 2019 - Reservoir bugs: How one bacterial menace makes its home in the human stomach
May 2, 2019 - Clinical, Admin Staff From Cardiology Get Sneak Peek at Epic
May 2, 2019 - Depression increases hospital use and mortality in children
May 2, 2019 - Vicon and NOC support CURE International to create first gait lab in Ethiopia
May 2, 2019 - Researchers use 3D printer to make paper organs
May 2, 2019 - Viral infection in utero associated with behavioral abnormalities in offspring
May 2, 2019 - U.S. Teen Opioid Deaths Soaring
May 2, 2019 - Opioid distribution data should be public
May 2, 2019 - In the Spotlight: “I’m learning every single day”
May 2, 2019 - 2019 Schaefer Scholars Announced
May 2, 2019 - Podcast: KHN’s ‘What The Health?’ Bye-Bye, ACA, And Hello ‘Medicare-For-All’?
May 2, 2019 - Study describes new viral molecular evasion mechanism used by cytomegalovirus
May 2, 2019 - SLU study suggests a more equitable way for Medicare reimbursement
May 2, 2019 - Scientists discover first gene involved in lower urinary tract obstruction
May 2, 2019 - Researchers identify 34 genes associated with increased risk of ovarian cancer
May 2, 2019 - Many low-income infants receive formula in the first few days of life, finds study
May 2, 2019 - Global study finds high success rate for hip and knee replacements
May 2, 2019 - Taking depression seriously: What is it?
May 2, 2019 - With Head Injuries Mounting, Will Cities Put Their Feet Down On E-Scooters?
May 2, 2019 - Scientists develop small fluorophores for tracking metabolites in living cells
May 2, 2019 - Study casts new light into how mothers’ and babies’ genes influence birth weight
May 2, 2019 - Researchers uncover new brain mechanisms regulating body weight
May 2, 2019 - Organ-on-chip systems offered to Asia-Pacific regions by Sydney’s AXT
May 2, 2019 - Adoption of new rules drops readmission penalties against safety net hospitals
May 2, 2019 - Kids and teens who consume zero-calorie sweetened beverages do not save calories
May 2, 2019 - Improved procedure for cancer-related erectile dysfunction
May 2, 2019 - Hormone may improve social behavior in autism
May 2, 2019 - Alzheimer’s disease may be caused by infectious proteins called prions
May 2, 2019 - Even Doctors Can’t Navigate Our ‘Broken Health Care System’
May 2, 2019 - Study looks at the impact on criminal persistence of head injuries
May 2, 2019 - Honey ‘as high in sugars as table sugar’
May 2, 2019 - Innovations to U.S. food system could help consumers in choosing healthy foods
May 2, 2019 - FDA Approves Mavyret (glecaprevir and pibrentasvir) as First Treatment for All Genotypes of Hepatitis C in Pediatric Patients
May 2, 2019 - Women underreport prevalence and intensity of their own snoring
May 2, 2019 - Concussion summit focuses on science behind brain injury
May 2, 2019 - Booker’s Argument For Environmental Justice Stays Within The Lines
May 2, 2019 - Cornell research explains increased metastatic cancer risk in diabetics
May 2, 2019 - Mount Sinai study provides fresh insights into cellular pathways that cause cancer
May 2, 2019 - Researchers to study link between prenatal pesticide exposures and childhood ADHD
May 2, 2019 - CoGEN Congress 2019: Speakers’ overviews
May 2, 2019 - A new strategy for managing diabetic macular edema in people with good vision
May 2, 2019 - Sagent Pharmaceuticals Issues Voluntary Nationwide Recall of Ketorolac Tromethamine Injection, USP, 60mg/2mL (30mg per mL) Due to Lack of Sterility Assurance
May 2, 2019 - Screen time associated with behavioral problems in preschoolers
May 2, 2019 - Hormone reduces social impairment in kids with autism | News Center
May 2, 2019 - Researchers synthesize peroxidase-mimicking nanozyme with low cost and superior catalytic activity
May 2, 2019 - Study results of a potential drug to treat Type 2 diabetes in children announced
May 2, 2019 - Multigene test helps doctors to make effective treatment decisions for breast cancer patients
May 2, 2019 - UNC School of Medicine initiative providing unique care to dementia patients
May 2, 2019 - Nestlé Health Science and VHP join forces to launch innovative COPES program for cancer patients
May 2, 2019 - Study examines how our brain generates consciousness and loses it during anesthesia
May 2, 2019 - Transition Support Program May Aid Young Adults With Type 1 Diabetes
May 2, 2019 - Study shows how neutrophils exacerbate atherosclerosis by inducing smooth muscle-cell death
May 2, 2019 - Research reveals complexity of how we make decisions
Summer Bummer: A Young Camper’s $142,938 Snakebite

Summer Bummer: A Young Camper’s $142,938 Snakebite

[ad_1]

It was dusk as Oakley Yoder and the other summer camp kids hiked back to their tents at Illinois’ Jackson Falls last July. As the group approached a mound of boulders blocking the path, Oakley, then 9, didn’t see the lurking snake — until it bit a toe on her right foot.
“I was really scared,” Oakley said. “I thought that I could either get paralyzed or could actually die.”
Her camp counselors suspected it was a copperhead and knew they needed to get her medical attention as soon as they could. They had to keep her as calm and motionless as possible — the venom could circulate more quickly if her heart raced from activity or fear.
One counselor gave her a piggyback ride to a van. Others distracted her with Taylor Swift songs and candy as the van sped from their location in a beautiful but remote part of the Shawnee National Forest toward help.
First responders met them and recommended Oakley be taken by air ambulance to a hospital.
The helicopter flight transported Oakley 80 miles from a school parking lot just outside the forest to St. Vincent Evansville hospital in Indiana, where she received four vials of antivenin and was then transferred to Riley Hospital for Children in Indianapolis for observation.
Her parents, Josh Perry and Shelli Yoder, were already in bed that night when they got the call about what had happened to Oakley. They jumped in the car and arrived at Riley about two hours before their daughter. Once she made it, doctors closely observed her condition, her toe still oozing and bruised. By lunchtime, Perry said, physicians reassured the parents that Oakley would be OK.
“It was a major comfort for me to realize, OK, we’re getting the best care possible,” said Perry, who is a health care ethics professor at the business school at Indiana University Bloomington. Less than 24 hours after the bite, Oakley left the hospital with her grateful parents.
Then the bills came.
Patient: Oakley Yoder, now 10, of Bloomington, Ind. Insured through Indiana University Bloomington, where her father and mother work as faculty.
Total Bill: $142,938, including $67,957 for four vials of antivenin. ($55,577.64 was charged for air ambulance transport.) The balance included a ground ambulance charge and additional hospital and physician charges, according to the family’s insurer, IU Health Plans.
Service Providers: St. Vincent Evansville hospital, part of Ascension, a nonprofit Catholic health system. Riley Hospital for Children, part of Indiana University Health, a nonprofit health system. Air Evac Lifeteam, an air ambulance provider.
Medical Service: The essential part of Oakley’s treatment involved giving her four vials of snake antivenin called CroFab.
What Gives: When bitten by a venomous snake, there is no time to waste. If left untreated, a venomous bite can cause tissue damage, hemorrhaging and respiratory arrest. Children tend to experience more severe effects because of their relatively small size.
CroFab has dominated the U.S. market for snake antivenin since its approval in 2000. When Oakley was bitten, it was the only drug available to treat venomous bites from pit vipers. (Oakley probably was bitten by a copperhead snake, a type of pit viper, the camp directors told her parents.)
In short, the drugmaker, London-based BTG Plc, essentially had a monopoly.
The average list price for CroFab is $3,198 per vial, according to the health care information tech company Connecture. Manufacturing costs, product improvements and research all factor into the drug’s price, said Chris Sampson, spokesman for BTG.

A Mexican version of snake antivenin can cost roughly $200. But it couldn’t be sold in the U.S. (More about that in a moment.)
Dr. Leslie Boyer, founding director of the VIPER Institute, a venom research center at the University of Arizona, acknowledges that some of the price in the U.S. can be attributed to strict Food and Drug Administration requirements for testing and monitoring.
But more than that, she added: “It’s a profitable drug, and everyone wants a piece of it.”
She should know: Funded by government grants and at times working with colleagues over the border in Mexico, her group was instrumental in developing CroFab.
Antivenins were first developed more than a century ago. Although CroFab is safer and purer than antivenins of the past, the process — while labor-intensive — remains fundamentally the same. Snakes, spiders and other creatures are milked for their venom, then a small amount of the toxin is injected into animals like horses or sheep. They then make antibodies without falling ill, and the protective molecules are extracted from their blood and processed to make antivenin.
Despite the longtime use of antivenins, CroFab and other such products remain a lucrative prospect for manufacturers. Who wouldn’t pay top dollar for an antivenin when their child has been bitten by a venomous snake?
What patients pay for CroFab can widely vary. Treatment may require a few vials or dozens of them — it depends on factors like the size of the patient, the potency of venom in the bite and how quickly the patient is treated. The more antivenin needed, the higher the cost.
(Story continues below.)

But hospitals also jack up the price, even though some of these facilities purchase the drug at a discount, said Dr. Merrit Quarum, chief executive officer of WellRithms, a health care cost containment company.
In Oakley’s case, St. Vincent Evansville hospital charged $16,989.25 for each unit of CroFab, according to the facility’s bill. That’s more than five times as high as the average list price.
WellRithms analyzed Oakley’s bill from St. Vincent Evansville at Kaiser Health News’ request and found providers generally accept $16,159.70 for all four vials of the drug.
In a statement, St. Vincent Evansville noted that the family was not responsible for that full tab and instead was expected to pay less than $3,500. But the facility appears to have since lowered its price for CroFab. According to its price list — posted online to satisfy a recent federal requirement — the drug now costs $5,096.76 per vial.
And the snake antivenin market now has another drug competing for patients: Anavip. The Mexican product — launched in October — has a list price of $1,220 a vial in the U.S, a fraction of what Latin Americans pay for it, according to Rare Disease Therapeutics, which distributes the drug in the U.S.
Anavip’s arrival was stalled by a lawsuit filed by BTG in 2013 that claimed the drug infringed on its patent.
The drug’s true effect on the market remains unclear. CroFab and Anavip are not entirely interchangeable. (The FDA hasn’t approved Anavip for copperhead bites, for instance.) And, as part of the legal settlement, Anavip makers must pay royalties to BTG until the CroFab patent expires in 2028.
Resolution: The insurer, IU Health Plans, negotiated down the antivenin and air ambulance charges and ended up paying $44,092.87 and $55,543.20, respectively. After adjustments to additional bills, IU Health Plans paid a total of $107,863.33. Oakley’s family did not pay a dime out of pocket for her emergency care, but such high outlays contribute to rising premiums.
Secondary insurance offered through the summer camp covered $7,286.34 in additional costs that otherwise would have come out of Perry and Yoder’s pockets for their deductible and coinsurance. The policy covers up to $25,000 in damages.
Oakley’s foot is healed, but her toe bends slightly downward and is sensitive to pressure. She intends to return to the same camp this summer.
Perry teaches a course on the ethics of the health care industry, and yet he said the cost of Oakley’s care shocked him. But he is aware of how rarely a patient ends up paying nothing for health care. “I know that in this country, in this system,” he said, “that is a miracle.”
Takeaway: Hospitals and insurers can negotiate; snakes don’t. If you’ve been bitten by a snake, “take care of your injury,” said Boyer. Don’t wait while you worry about the cost.
When you get a bill, compare what the facility charged against other health care providers’ prices using their public charge lists online. Cost estimation tools like Fair Health Consumer or Healthcare Bluebook allow you to see how your bill compares with the average.
Momentum is growing for government action on drug prices. In states and in Congress, various proposals have been floated, which include: allowing Medicare to negotiate drug prices, tying the U.S. price of expensive drugs to the average price in other developed countries and allowing the government to inject competition into the market when there is none — such as by speeding generic drug approvals or allowing imports.
Consumers should keep an eye on these proposals as they move through the political process.
NPR produced and edited the interview with Kaiser Health News’ Elisabeth Rosenthal for broadcast. Jake Harper of WFYI in Indianapolis provided audio reporting.
Bill of the Month is a crowdsourced investigation by Kaiser Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!
Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

[ad_2]

About author

Related Articles