Alex Hern

Dispatches from the front line of the internet

Syndicate contentRSS

US runs out of coral snake anti-venom

Either big government bureaucracy, or big pharma greed, has gone mad. Or both.

A coral snake. Photograph: Getty Images
A coral snake in Peru. Photograph: Getty Images

Metafilter user maxwelton writes:

If you're thinking about being bitten by a coral snake in the United States, you may want to do so before the end of the month. October 31, 2012 is the extended-extended-extended-expiration date for batch 4030026 of the only FDA-approved antivenin for coral snake bites. (Antivenin shortages are not uncommon, surprisingly enough.) FDA-approved coral snake antivenin has not been available new since 2003, as Wyeth Pharmaceuticals ceased its manufacture, citing a lack of profit. Antivenin from non-FDA-approved sources exists, but the $3-5M estimated cost of FDA approval (borne by the manufacturer) and the few doses used per year mean it's a non-starter for the manufacturer of Coralmyn, for example.

There are two lessons to be learnt here, and likely people will already know which one they're planning on emphasizing. One is that the FDA sorely needs to come up with a better way to run its approval process when it comes to niche medicines. It's one thing demanding an expensive battery of tests if the manufacturing company thinks it will be selling billions of doses a year (and in fact, recent examples have hinted that perhaps those tests ought to be even more rigorous), but if it costs millions to bring a drug to market, many valuable treatments will be lost to the cost of bureaucracy.

The other side of the coin is that the profit motive is frequently toxic when it comes to the pharmaceutical industry. This particular antivenin could be made by any manufacturer, since it is already FDA approved. Yet no manufacturers are interested in creating it, because they can't make enough profit on doing so. The market outside the US is curtailed - because Coralmyn, made by a Mexican pharma company, is a better product - and the market in the US is too small for anyone to care about.

Anyone, that is, other than the 100-or-so Americans bitten by Coral snakes every year. Without an antivenin, the treatment is far harsher - and more expensive to boot. Popular Mechanics' Glenn Derene writes:

Many hospitals will have no other option but to intubate coral snake bite victims on ventilators for weeks until the effects of the toxin wear off--potentially costing hundreds of thousands of dollars per bite. "It's probably going to end up costing us far more not to deal with this than to deal with it," [Eric] Lavonas [of the Rocky Mountain Poison and Drug Center] says, "both in human suffering, and in dollars and cents."

11 comments

justin Pridgen's picture

find it funny how fast people jump to conclusions and how ignorant people can be if you dont kno what your talkin abt why talk? and why yes coral snakes "red on yellow" in the US can very in South america... and if you could read says a picture of a coral snake in peru, so quick to call out flaws but not quick enough to google search coral snakes from peru to double check someone mistakes just cause makes you feel smarter but whos looking stupid now lol,

asianguyensingle's picture

Red cross sells it online.

New satan's picture

Red on yellow kill a fellow;
Red on black poison lack.

The snake in the pic is a false coral snake not a coral snake.

Alex Hern's picture

See the reply below, but it is a coral snake, albeit one from Peru, not the US. 

David Attaturk's picture

Godamm these useless NS. journo freaks! These corals and kraits are even deadlier than most cobras. There has never been a proven field case of one of these snakes killing someone in recent times. to get them to bite thier jaws are narrow you would have to spread your toes by hand and direct their mouth on the soft tissue in between. we will probably end up eating these when the recession really bite.
Think before you are bitten by your own analogy.

Alex Hern's picture

I have no idea what your point is.

jmoney's picture

Dude, that snake in the photo is not a coral snake. "Red and yellow kill a fellow."

Alex Hern's picture

As Wikipedia helpfully clarifies:

[This rhyme] reliably applies only to coral snakes native to North America: Micrurus fulvius (Eastern or common coral snake), Micrurus tener (Texas coral snake), and Micruroides euryxanthus (Arizona coral snake), found in the southern and western United States. Coral snakes found in other parts of the world can have distinctly different patterns, have red bands touching black bands, have only pink and blue banding, or have no banding at all.

The snake in the picture is one from Peru, according to the caption provided by Getty, and is indeed a coral snake.

anonymous coward's picture

The way the FDA works is a big problem. I do not know pharmecuticals but for medical devices thje approval process (PMA) is impossibly expensive for all but a handful of devices a year. The result is that a loophole based on equivalence to a substantially equivalent prexisiting or predicate device (510k) is used for almost all new medical devices in the the US. This has led to an absurd strecthing of what constituted a equivalent pre-exisiting device and the inability to economically develop genuinely new devices. The net result is that almost all new medical deivces are first introduced in europe which has a sane risk based regulatory system. The US is falling further and further behind in medical technology with many devices in widespread use unable to be used in the US at all.

Lox's picture

Is it, Martin? I guess Alex Hern refers to the fact that the lesson you learn depends on your prejudices. Is the state to decide what medicines will be developed? Personally, I'd perhaps go along with AH's implied suggestion for a streamlined approval process for rarely used medicines.

Martin Wisse's picture

The real lesson to be learned is that in a properly functioning health care system, this would be paid for by the state...

Latest tweets