Class of 2008 Abstract / Objectives: To determine the ecomomic impact of recurrent coagulopathy with crotaline envenomation, using the current standard of care (crotalinae polyvalent immune Fab antivenom), and establish a model of pharmacoeconmic assessment for future studies. Methods: Design of recurrent coagulopathy cost assessment tool including payor costs and patient costs. Using medical and medical billing references, government websites, business websites, and published studies, determine average costs for major variables affecting the cost of recurrent coagulopathy to the payor and the patient. Results: A prospective study has been designed to take place during the historic height of Arizona snake bite season in 2008. Conclusions: Based on previous studies of recurrent coagulopathy an estimated 45-53% of crotaline envenomation patients can expect to experience recurrent coagulopathy after treatment with crotalinae polyvalent immune Fab antivenom. The economic impact to the payor is expected to be high with laboratory costs of $49.45 each, doctor visits costing $66.02, emergency room visits costing $351, and $3563.75 per vial of crotalinae polyvalent immune Fab antivenom. Historically the cost of recurrent coagulopathy to the patient has not been evaluated. Considering lost wages, transportation to and from medical care, and the cost of additional household help and child care, this cost is expected to be great enough to adversely impact individuals and families.

Class of 2007 Abstract / Objectives: The purpose of this study is to determine the direct costs of scorpion envenomation events in the acute care setting for patients treated in a southern Arizona hospital. Methods: A chart review analysis of documented treatment of scorpion envenomations at a university hospital was conducted to compile demographic, drug use, and resource utilization information. Patients were selected based on an ICD-9 code diagnosis of scorpion envenomation within the years 1993 to 2001. Results: 103 patient charts were reviewed. The average length of stay was 1.21 days (range 0.5-6.5 days), the average age was 4.7 years (range 0.2-53 years old). Males comprised 54% of the patients, 51.9% Caucasian, 41.6% Hispanic, and 60.2% were from an urban setting. The average drug cost was $51.82 (SD=53.22). The total average cost in the entire population was $6,764.54, (SD= $3,866.55). The average cost of rural versus urban was $7,535.74 and $6,254.55, respectively (p=0.100). The average cost for male versus female was $6,949.64 and $6,520.90 (p= 0.581), and the average cost for the 0-3 years group was $6,721.10, the >3 years to 14 years group’s average cost was $6,643.33, and the >14 years of age group’s average cost was $8,578.42. None of the comparisons between age groups were statistically significant, with p values ranging from 0.274 to 0.922. Conclusions: Although scorpion envenomations were costly, there were no statistically significant differences noted between any of the comparison groups. Transportation, including air transport in the rural setting, did not account for a significant change in cost. Many of the patients that were envenomated in the rural setting were seen at a regional hospital and then transported as necessary.