The Economic Impact of Recurrent Coagulopathy in Crotaline Envenomation

Abstract

OBJECTIVES: The study’s purpose was determining the economic impact of recurrent coagulopathy with crotaline envenomation using the current standard of care, crotalinae polyvalent immune Fab antivenom (CroFab), and to establish a model of pharmacoeconomic assessment for future studies. METHODS: A recurrent coagulopathy cost assessment tool was designed that included payer and patient costs. This system used medical and billing references, government and business websites, published studies, and average costs for major variables affecting costs of recurrent coagulopathy to the payer and patient. RESULTS: Of the 42 subjects screened during the study period, 13 were eligible, and 5 chose to participate. On average, lab results were the most significant cost to payers ($247.25). No subject required additional vials of CroFab as a result of recurrent coagulopathy and therefore this was the least costly parameter. There were no correlation between lab costs, doctor visits, or ER visits. Lost wages were the highest cost to patients, with an average of $880.85. Household help and child care were the least costly parameters in this study group. The loss to follow-up was a substantial barrier to obtaining the projected number of study subjects. CONCLUSIONS: A major limitation of this study is the small sample size. Therefore, only generalizations can be made by analyzing the data in regards to the true costs of recurrent coagulopathy to patients and payers. Future pharmacoeconomic studies regarding average costs related to crotaline envenomation should consider experimental mortality a significant barrier to obtaining significant results.