Why a simple, lifesaving rabies shot can cost $10,000 in America
Vox
By Sarah Kliff
February 7, 2018
On November 17, 2016, a bat flew into Ally McNamee’s mouth.
At the time, McNamee was a student at Keene State College in New Hampshire. A bat flew into her house, and she attempted to shoo it away with a broom, assuming the bat would retreat. It did not.
“It flew at my face, and I screamed,” McNamee says. “My mouth was open. I definitely caught a wing.”
When she woke up the next day, she started to worry about rabies. She went to the local urgent care center, which sent her to the emergency room. It was the only facility that stocked the drugs necessary to treat rabies, a situation that is typical across the United States.
A few weeks later, the bill arrived: $6,017. The vast majority of the charge was for a drug to treat rabies exposure called immunoglobulin. The emergency room billed this drug at $3,706.
And it turns out McNamee’s bill was actually at the low end of what hospitals charge for the drug in the United States, which can sometimes be closer to $10,000.
Vox learned of McNamee’s bat incident during a running, months-long investigation into emergency room costs. Readers from across the country have contributed more than 1,000 bills to Vox’s emergency room bill database. In reviewing those bills, I kept coming across something I didn’t expect to see: readers with significant medical debt from rabies treatment.
Michael Cinkosky also sent me a bill from a visit to a hospital near Denver. A bat collided with his 8-year-old son’s chest last summer and left behind two scratch marks, a sign of a possible bite. That hospital billed the same rabies drug at $10,494.
The Cinkosky family was responsible for $3,563 of the hospital bill, which they’re still paying off.
“Rabies is 100 percent fatal. What are you going to do? Not get it?” Cinkosky says. “We’ve been living off our reserves because of the bills, and that’s not a good long-term strategy.”
In England, the drug to treat rabies exposure costs $1,600. Here, hospitals charge $10,000.
The price of rabies treatment in American reveals unique failures of our country’s health care system. It shows that in the United States, pharmaceutical companies can set sky-high prices for lifesaving medication.
Specifically, the drug that prevents rabies from spreading to the brain can cost more than $10,000 in the United States. In some cases I reviewed, hospitals charged more than six times what the identical drug would cost in the UK.
Insurance plans will often negotiate down those charges, but even those lower prices are still multiples higher than what patients pay in our peer countries, such as Canada or England.
On November 17, 2016, a bat flew into Ally McNamee’s mouth.
At the time, McNamee was a student at Keene State College in New Hampshire. A bat flew into her house, and she attempted to shoo it away with a broom, assuming the bat would retreat. It did not.
“It flew at my face, and I screamed,” McNamee says. “My mouth was open. I definitely caught a wing.”
When she woke up the next day, she started to worry about rabies. She went to the local urgent care center, which sent her to the emergency room. It was the only facility that stocked the drugs necessary to treat rabies, a situation that is typical across the United States.
A few weeks later, the bill arrived: $6,017. The vast majority of the charge was for a drug to treat rabies exposure called immunoglobulin. The emergency room billed this drug at $3,706.
And it turns out McNamee’s bill was actually at the low end of what hospitals charge for the drug in the United States, which can sometimes be closer to $10,000.
Vox learned of McNamee’s bat incident during a running, months-long investigation into emergency room costs. Readers from across the country have contributed more than 1,000 bills to Vox’s emergency room bill database. In reviewing those bills, I kept coming across something I didn’t expect to see: readers with significant medical debt from rabies treatment.
Michael Cinkosky also sent me a bill from a visit to a hospital near Denver. A bat collided with his 8-year-old son’s chest last summer and left behind two scratch marks, a sign of a possible bite. That hospital billed the same rabies drug at $10,494.
The Cinkosky family was responsible for $3,563 of the hospital bill, which they’re still paying off.
“Rabies is 100 percent fatal. What are you going to do? Not get it?” Cinkosky says. “We’ve been living off our reserves because of the bills, and that’s not a good long-term strategy.”
In England, the drug to treat rabies exposure costs $1,600. Here, hospitals charge $10,000.
The price of rabies treatment in American reveals unique failures of our country’s health care system. It shows that in the United States, pharmaceutical companies can set sky-high prices for lifesaving medication.
Specifically, the drug that prevents rabies from spreading to the brain can cost more than $10,000 in the United States. In some cases I reviewed, hospitals charged more than six times what the identical drug would cost in the UK.
Insurance plans will often negotiate down those charges, but even those lower prices are still multiples higher than what patients pay in our peer countries, such as Canada or England.
Depending on where you go, a key rabies drug could cost $280 — or $9,912
Between 20,000 and 40,000 Americans are treated each year for rabies exposure, typically after encounters with wildlife including bats, raccoons, and skunks.
The first step in treatment involves two drugs: a rabies vaccine and something called rabies immunoglobulin. The immunoglobulin essentially kicks the immune system into overdrive, staving off the rabies virus until the vaccine begins to take effect.
“The immunoglobulin is what intervenes before the illness can go from the periphery of the body into the central nervous system, and eventually into the brain,” Rupprecht explains. “That buys you time.”
Rabies immunoglobulin costs more than something like a flu shot because it’s derived from human blood, which has to be carefully screened for disease. The cost means the drug is often unavailable in developing countries.