UKIAH DAILY JOURNAL (California) 25 September 03 UVMC's antivenin supply depleted (Laura Clark)
Like an echo bouncing off of last year, Ukiah Valley Medical Center announced this week it has reached a "critical stage in snake antivenin stock."
The hospital actually never recovered from its shortage of antivenin last season.
"There was no relief at all with the amount we requested (last season) compared to what was delivered," said Jarrod McNaughton, UVMC director of marketing. "So throughout this whole year that product has been on back order and never come up to the level it needs to be."
He said current antivenin inventory at the hospital is down to one vial of CROFAB (Crotalidae Polyvalent Immune Fab Ovine) and eight vials of Equine (Crotalidae Antivenin Polyvalent).
Ideally, the hospital's "on hand level" is 20 vials of CROFAB.
CROFAB, made from a sheep serum, is the least allergenic of the two antivenins, which is why more hospitals prefer to have it on hand.
Equine is made from a horse serum, and more people tend to be allergic to it, McNaughton said, which may explain why Equine, though costly, is still much less expensive than CROFAB.
The wholesale cost -- or the hospital's cost of Equine -- is $860 per dose, McNaughton said.
The cost of CROFAB is $1,500 a dose, McNaughton said.
Or at least it was.
"We go through pharmaceutical brokers and we were just called yesterday and it has now doubled to $3,000 per dose," McNaughton said Tuesday.
It takes 10 to 15 doses of CROFAB antivenin to treat a person for a rattlesnake bite, he noted.
Asked if the hefty price increase of the product had anything to do with supply and demand, McNaughton said he couldn't say. "Nobody seems to have an answer for me right now," he said. "It is frustrating that depending on the availability of the product, the price changes for our community," he said.
Mendocino County is not alone in its shortage of antivenin. According to hospital officials, it is scarce throughout the state and the result of a production problem.
"There is no product available out there," said Carolyn Kozik, a registered nurse and vice president of patient care at UVMC.
With that said, hospital officials want to assure people that if they are bitten they will be treated, one way or another.
"Our policy at UVMC is if we can't get the antivenin to the patient, we will get the patient to the antivenin -- we will transport them out," emergency room physician Charles Evans said.
UVMC has treated four bites with the antivenin so far this season.
CROFAB is made by Protherics Manufacturers, and Savage Laboratories is the sole distributor and marketer of the antivenin, McNaughton said.
A call to Protherics had not been returned by press time Wednesday.
UVMC's antivenin supply depleted