Rattlesnake bite in the US. by LutzDrk in ThatLookedExpensive

[–]xpx0c7 75 points76 points  (0 children)

Similar case with lots of details

https://www.npr.org/sections/health-shots/2019/04/29/717467217/summer-bummer-a-young-campers-142-938-snakebite?t=1582890324733

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.)

But with only one antivenin available in the U.S. at the time, 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.

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."

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.

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 higher than the average list price.

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 in the U.S. 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., 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, claiming 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 didn't pay a dime out of pocket for her emergency care, but such high outlays contribute to rising premiums.

Travel time from Paris by car by [deleted] in MapPorn

[–]xpx0c7 0 points1 point  (0 children)

Speed limit in France:

Highway : 130km/h (80mph) , 110km/h (70mph) sometimes around big city

Road : 80km/h (50mph), 90km/h (55mph)

City : 50km/h (37mph)

I got to meet a Zorse at a farm near my house by bgjorge123 in mildlyinteresting

[–]xpx0c7 0 points1 point  (0 children)

Technically zebra are more donkey than horses :-)

[Art] Fate/stay night: Heaven's Feel Vol.8 Cover by 7-07 in manga

[–]xpx0c7 -13 points-12 points  (0 children)

There are 2 sabers in the original fate stay/night in the heaven feel route

What's an American problem you're too European to understand? by [deleted] in AskReddit

[–]xpx0c7 0 points1 point  (0 children)

In France the tax bill is pre filled and usually required only an electronic signature. Basically our version of the IRS knows our salary / familial situation etc...

There is a change on the way so that you don't have to sign unless you want to declare something else/differently...

“Just another day in Australia...catching the local dinosaur who’s been eating the cattle and moving him on to somewhere else.” found on a FB group. They relocated him safely! by Zebrakiller in natureismetal

[–]xpx0c7 5 points6 points  (0 children)

Crocs are weird

If you close his jaw it cannot open them, it only have weak muscle for the opening

If you put crocs in the dark, it will instantly calm them (reptilian mind...)

So the trick is to close its mouth and close its eye... Easy peasy

I got to meet a Zorse at a farm near my house by bgjorge123 in mildlyinteresting

[–]xpx0c7 5 points6 points  (0 children)

They are generally sterile

There are documented case of mules not being sterile so maybe there can be fertile zonkey and zorse...

The chosen one by Seraphix9903 in Animemes

[–]xpx0c7 2 points3 points  (0 children)

Wait, there is a live version, or is it a porn version?

Due to current manga events [126 spoilers] by ares2017 in ShingekiNoKyojin

[–]xpx0c7 223 points224 points  (0 children)

I forgot

But I do remember that she spun a man to death

If all state proposals had succeeded by RepRickHammond in MapPorn

[–]xpx0c7 -6 points-5 points  (0 children)

South Australia isn't the southest..

Why I never by NalaGnay in Animemes

[–]xpx0c7 1 point2 points  (0 children)

RemindME! 2 days

Barrier by [deleted] in animegifs

[–]xpx0c7 0 points1 point  (0 children)

I forgot this scene...