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Dawn DeCourcey of Stafford was bitten by a copperhead in mid-July. |
BY AARON RICHARDSON
Getting bitten by a copperhead means pain, swelling, blistering and tissue damage. But if you're a healthy adult, chances are that with proper treatment, you'll survive.
Surviving, however, may be the least of your concerns when the medical bill arrives.
According to Dr. Nathan Charlton at the Blue Ridge Poison Control Center at the University of Virginia Medical Center, one vial of the antivenin Crofab costs about $1,200. And that's not even one dose.
"A total dosing for a severe envenomation could cost up to $10,000," Charlton said.
Depending on the health insurance plan, that could mean a big out-of-pocket expense.
Scott Golden, a public relations representative at Anthem Blue Cross, said that Crofab is usually covered.
"If you have Anthem prescription drug coverage, it would be covered as a Tier 2 drug," he said.
Some plans, however, can carry as much as a 10 percent co-pay.
"How much you pay all depends on the coverage you have," Golden said.
The only way of truly knowing whether the antivenin is covered is to look at the specifics of each health insurance plan.
TREATMENT IS COSTLY
Stafford County resident Dawn DeCourcey says she is pleased with the coverage she had when she was bitten by a copperhead in July.
"My hospital bills will be up over 20 grand, and I'll be out 100 bucks," said DeCourcey, 40, a mother of two.
DeCourcey, who describes her coverage as "very good," said United Health Care paid $12,000 on drugs to treat the bite on her ankle.
The drugs helped her snakebite symptoms, but DeCourcey said there were side effects.
"I broke out in a rash from it," she said.
Aside from the side effects from the drug itself, DeCourcey said she needs physical therapy for a torn Achilles tendon.
"I had to walk with a pointed toe, and my Achilles shrank," she said. "The first time I went to put my heel down, my Achilles tore."
The recommended dosage of Crofab begins with four to six vials of the drug.
If symptoms return, the doctor may decide that an additional four to six vials are necessary.
If symptoms persist further, the hospital can administer another two vials every six hours for up to 18 hours.
The treatment, however, is almost inevitable, particularly with severe bites.
"It comes down to cost-benefit, and it's a really good antivenin," Charlton said.
ANTIVENIN IS EXPENSIVE
The drug is so expensive in part because it is extremely complicated and time-consuming to produce.
To make Crofab, venom from four snakes, including the cottonmouth and three types of rattlesnakes, is introduced into the bloodstreams of healthy sheep.
The sheep produce antibodies to fight the venom. Once the antibodies are ready, they are isolated, freeze-dried and finally added to sterile water for intravenous injection.
Not only is production of the drug a complicated process, it is the only antivenin on the market for poisonous snakes in the United States.
Because the antivenin is produced from four snakes carrying similar venom, there is no need for people to risk further injury killing the snake.
"We didn't even look for it," said DeCourcey, who was bitten at 4:30 in the afternoon. "The next day we found a copperhead in our pool that my husband took care of."
BITES RARELY DEADLY
Dosages of the serum come down to an assessment of the bite by the attending physician.
"Dosing is somewhat subjective," Charlton said. "It depends on the amount of swelling and the extent of travel."
Dr. Tania White, an emergency medicine specialist at Mary Washington Hospital, said that use of the antivenin is largely determined by how old the bite is.
"If there is little swelling or bruising after eight to 12 hours, the patient may not need it," said White, who sees between 25 and 35 snakebites a year.
If the bite is two to four hours old, and symptoms are mild, the patient usually receives three to four vials of antivenin as a precaution, White said.
The starting dose for a moderate to serious envenomation would be four to six vials.
Ed Clark, president of the Wildlife Center of Virginia, said that most of the time, venomous snakes do not inject venom.
"If you are bitten, chances are 75 per cent that the snake is not injecting any venom," he said.
According to Clark, snakes such as copperheads will administer a "dry bite" as a warning.
"You have a bigger chance of dying running a stoplight on the way to the hospital than you do from a snakebite," Clark said.
Aaron Richardson: 540/374-5000, ext 5617
Email: arichardson@freelancestar.com
About 8,000 people are bitten by venomous snakes each year in the United States, and five to 10 of those bites are deadly. Virginia has only three native venomous snakes: the timber rattlesnake, found in mountainous areas and in southeastern Virginia, where it is sometimes called the canebrake rattlesnake; the cottonmouth, found in southeastern Virginia; and the copperhead, which is common statewide. Virginia's poisonous snakes have elliptical pupils (like cat's eyes) instead of round ones, and triangular, spade-shaped heads instead of narrow, oval heads. If you or someone you know is bitten, assume the snake is poisonous and seek medical care. If possible, wash the bite with soap and water and remove constrictive items such as jewelry or tight clothing near the bite. Other tips: Mark the place and time of the bite on the person with a pen. Also note any swelling. Keep the affected area below heart level to reduce the flow of venom. Keep the person calm, and restrict movement of the affected area. DO NOT give the victim drugs or alcohol, cut the wound, apply a tourniquet or ice, or use any form of suction. --Information provided by the Virginia Herpetological Society and the Blue Ridge Poison Center |
