Pharmacoeconomics

VIPER faculty study the economic impact of venom injury and antivenom treatment.

Manufacturing and distributing a drug for a rare problem costs a lot of money.

From the moment of a good idea to the reality of a marketable drug, products in the United States typically take well over 10 years of hard work. Drug companies in general will spend tens or even hundreds of millions of dollars to prove the safety and effectiveness of their products. For a condition with only a few hundred patients per year, the testing challenge is greater but the potential for profit is smaller. It is obvious why most US drug manufacturers prefer not to take on the burden of antivenom production: the numbers do not add up to a good business decision.

In the United States, an "orphan drug," too rare for most traditional drug companies to manufacture, is one that is used to help fewer than 200,000 people annually; and all types of antivenom qualify as orphan drugs.

But letting bitten people go without antivenom also has a big economic impact. 

Around the world patients who do not receive antivenom suffer from the consequences of ongoing venom in the body, for days to months following the injury. Depending on the animal involved, depending on the patient's underlying health, and depending on the ability of local healthcare to provide support, these patients may spend weeks on a ventilator in Intensive Care; they may have a leg amputated; they may miss weeks or months of work; they may have a disabling stroke; or they may die. Awful as it sounds, all of these conditions can be studied not only in terms of medical disease but also in terms of their economic impact. And that impact is pretty high. High enough to make antivenom development very definitely worthwhile to society as a whole — IF the costs and benefits of making, selling, and using it are considered as a package.

VIPER economists do the math.

Using our unique statewide scorpion antivenom network as a starting point for analysis, VIPER faculty and students affiliated with the UA College of Pharmacy's HOPE Center (Health Outcomes and PharmacoEconomics) took a serious look at the costs involved. By factoring in ambulance and helicopter transport, emergency and intensive care, the number of serious and mild cases, hospital locations, and a variety of ways that the state might deliver antivenom, the analytical team made a number of important discoveries. Using scorpion antivenom could make good economic sense for Arizona, but the specifics of where the savings come from have turned what looked like a simple question into a fascinating economic model with implications for antivenom distribution around the world. Results of the first HOPE/VIPER pharmacoeconomic study are in peer review, with publication expected some time in 2013.