Thursday, February 08, 2018

The High Cost of a Wild Animal Bite

If you occasionally handle wild animals, as I do, it's a game of Russian Roulette. If you do very much of this, you will eventually get bit even if you are careful. And if you get bit, you have to decide what to do. Do you wash it out and treat it like a knife wound, or do you go "Oh my God, it could be RABIES" and rush to the the nearest hospital or doctor for a full rabies work up?

I have faced that predicament and written about it, but now Vox lays out the financial consequences of rushing to a doctor.

[T]he drug that prevents rabies from spreading to the brain can cost more than $10,000 in the United States. In some cases I reviewed, hospitals charged more than six times what the identical drug would cost in the UK.

Insurance plans will often negotiate down those charges, but even those lower prices are still multiples higher than what patients pay in our peer countries, such as Canada or England.

“Rabies treatment is more expensive in the United States, as are many medical treatments, because we don’t have price controls,” says Charles Rupprecht, a biomedical consultant who previously ran the rabies control program at the Centers for Disease Control and Prevention.

Emergency rooms, meanwhile, can exacerbate the pricing problem.

ERs typically are the only locations where patients can find the lifesaving treatment. And they charge significant “facility fees” to anyone who walks through their doors to seek treatment — including patients seeking a rabies vaccine.

Because rabies treatments includes a series of four shots delivered over two weeks — all at separate appointments — those costs can add up quickly.

“I have to go to the ER to get the drug, and each time I walk in the door, that is a $250 copayment just to start,” says Lisa Peterson, who went through rabies treatment in Utah in 2016 after being bitten by a raccoon. The public health department told her the only place she could get the injection was at the local emergency department.

She is still paying off her bills for the treatment — about $4,500 in total — with $100 a month. She still has about $600 to go, from emergency room visits that happened in the fall of 2016.


Jennifer said...

Can't you avoid the risk by getting vaccinated? Can't be that expensive, you could probably do it yourself with vaccines available online. Sub-cutaneous vaccination is a breeze

Tracy said...

Better than dying

Peter Apps said...

Patrick, have you had the rabies vaccine ? When I was doing hands on wild animal work I had it routinely.

PBurns said...

Rabies vaccines for dogs don't work for humans.

I had the pre-exposure vaccine when I was a kid in Africa.

The post exposure treatment is a series of four shots.

The pre-exposure prophylaxis is only the first shot of that four-shot regime.

If you get bit, they will still give you all four shots as if you never had the pre-exposure.

The pre-exposure shot is only useful if you are far in-country far from the hospital.

Jennifer said...

WHO confirmation of what you said
My question is WHY? Seems to me, mammals are mammals. What makes humans so much more difficult to protect from this awful virus?

CJames said...

For that money, it seems like at least some folks would be better off buying a last minute plane ticket and taking a spontaneous trip abroad. (This is obviously not a real solution for most people, but) medical tourism, right? Spend a couple weeks somewhere with a sane healthcare system- get your rabies shots and go skiing in quebec. Get the shots and see some glaciers in Iceland. I bet it comes out cheaper.

tuffy said...

because i had to handle wildlife and dogs off the street, i had the human Rabies vaccinations, (not the one used for dogs)…i have titres done periodically and they are always good. it is a good vaccine.
i wonder if the human post-exposure protocol is absolutely necessary, or only 'to be sure'...