It’s a parents worst nightmare (part 1): Josh Perry and Shelli Yoder received a call in the middle of the night that their daughter, away at summer camp, had been bitten by a copperhead snake. She was being transported via air ambulance to a hospital from the remote wooded location. Josh and Shelli launched out of bed to race her to the hospital.

It’s a parents worst nightmare (part 2): Josh and Perry received medical bills some weeks later for their daughter’s treatment: $142,938.

The bill was not for a lengthy hospital stay, not for dozens of medication administrations, not for interventional procedures. The air ambulance was $55,577.64; the Emergency Room was $3,851. Amazingly, the antivenin, four vials worth, cost $67,957. That’s $16,989.25 per vial.

How did it get to cost so much? And who bears this cost?

Kaiser Health News reports that the manufacturer of this antivenin has a virtual monopoly in the US. The manufacturer, CroFab, charges $3,198 per vial. Some of you have already figured out that is a $13,791.25 difference. A portion of the cost was then negotiated down by the family’s health insurance, which paid $107,863.33. Although the family did not pay anything out of pocket, these often extravagant costs for medication frequently end being absorbed by rising premiums or by Medicare/Medicaid. In effect, we all pay.

Efforts are under way to manage health care costs. [Recent federal law](https://www.aarp.org/health/health-insurance/info-2019/hospitals-post-prices-online.html) requires hospitals to post prices online. Perhaps coincidentally, the hospital in this story now charges $5,096.76 for this antivenin. Competition may be helping too: other antivenin products are arriving on the market for approximately 1/3 of the price.

As multiple efforts grow and evolve to manage drug prices, stories like these will (hopefully) become less commonplace.

Read the Kaiser Health News article [here](https://khn.org/news/april-medical-bill-of-month-143k-snakebite-antivenin/).