
Why Snakebites Are About to Get a Lot More Deadly - cwan
http://www.popularmechanics.com/science/health/snakebites-about-to-get-more-deadly?click=pp
======
fjabre
While it's done a lot of good for making things safe to eat and is a necessary
public service I'm going to have to say that currently:

...The FDA sucks...

You need millions in legal/preparation fees just to get your foot in the door
and the level of bureaucratic bullshit you have to deal with still blows my
mind.

My company has had a lot of experience in this sorry to say.

Again. Going to reiterate here: The FDA sucks and needs to be completely
overhauled. Lots of PhDs and government bureaucrats spending too much time
behind a desk with no real world experience and dictating arcane rules to the
rest of us - that's the FDA I know.

~~~
Retric
I don't think the FDA is the real problem on this one. There is a known
treatment whose patents have expired, however for now nobody is willing to
manufacture it.

~~~
atlbeer
It's just not profitable to manufacture the currently known solutions.

If someone discovers a new, better antivenin you would still have to spend
millions of dollars and wait years to pass the FDA guidelines. That alone
probably destroys the profitability margins of most discoverable solutions due
to the small demand.

------
NathanKP
It seems ridiculous to me that the FDA prevents scientists and doctors from
getting known, proven anti-venom products back in the market, whereas the rich
corporations can get drugs on the market that still aren't proven to be much
more effective than a placebo, but with worse side effects.

~~~
elidourado
My view is that people should be allowed to opt out of FDA regulation if they
wish to do so. It's my body; I should be allowed to put anything I want into
it.

It took 10 years for the first beta blockers to be approved in the US after
they were in use in Europe. In that amount of time, thousands of Americans
died for lack of the drugs. It's hard to distinguish this from mass murder, or
at least mass manslaughter.

~~~
proee
It's not that simple. If they allow the sale of non regulated drugs then
you'll have a 10x increase in commercials on TV trying to sell you an untested
and unregulated "purple pill".

The fine print will say "this drug has not been tested and is not approved by
the FDA. It may cause death or create an uncontrolled viral outbreak..."

The drug will sell like hotcakes though because the commercials will have lots
of happy-smiley people and the distributor will get a healthy 80% profit
margin on the sales.

There's some comfort in knowing that a non-profit agency is looking into the
safety of a drug before it goes out to the public for consumption.

~~~
tlrobinson
Why not simply prohibit advertising of non-FDA approved drugs?

~~~
psadauskas
If I write a blog post saying I like X non-approved drug, do I get arrested?
What if I was paid to do it?

Prohibiting advertising strays dangerously close to the 1st Amendment.

~~~
staunch
Drugs companies were prohibited from advertising on television until not so
long ago. There's even a special law:
[http://en.wikipedia.org/wiki/Prescription_Drug_Marketing_Act...](http://en.wikipedia.org/wiki/Prescription_Drug_Marketing_Act_%28PDMA%29)

~~~
roboneal
Arguably, that is the crux of the 1st Amendment issue -- government regulation
of speech - including that of "evil" or "unpopular" drug companies -- is a
slippery slope.

~~~
nitrogen
The past few years seem to indicate that we're slipping _up_ the slope, then,
as what was once prohibited is now allowed, both in the case of prescription
drug advertisements and corporate political speech.

------
old-gregg
_..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.._

Granted, the antivenom situation is ridiculous, but the quote above exposes
yet another, much larger ridiculous issue: why is it OK to charge "hundreds of
thousands of dollars" for a few weeks of hospital stay?

Is it because lung vent. machines are $1 billions apiece, or what? How do they
come up with those ridiculous bills? Are they really riding 1000% profit
margins there or what's going on?

~~~
ojbyrne
[http://blogs.law.harvard.edu/philg/2010/05/10/americas-
effic...](http://blogs.law.harvard.edu/philg/2010/05/10/americas-efficient-
health-care-system-my-15-bill-for-a-checkup/)

"So… in terms of the real economy, this was an $83 transaction, equivalent to
what you might spend on dinner for two. But instead of being paid with a
credit card swipe, there were apparently multiple clerks involved at the
doctor’s office and the insurer. Negotiations happened behind the scenes. A
paper invoice was printed and put into an envelope by hand. A check was mailed
through the U.S. mail"

~~~
RyanMcGreal
Know what would fix that? Universal, single payer health insurance.

~~~
walkon
Then move to the UK, where their debt is about to eclipse that of Greece.

~~~
froo
Thats not a very constructive comment, but taking the trollbait - there are
examples of other countries around the world (my own for example) that have
public option health cares who's economies aren't in the tank.

~~~
RyanMcGreal
Just to clarify: all of the industrialized world (except for the US) has
universal health care.

As for the troll, a couple of points:

1\. Britain has government-controlled health care, not just government-funded
health care. In Canada, where I live, the government is the single payer but
health care itself is provided by a wide variety of small and large
businesses, including doctors' offices, walk-in clinics, testing labs, and so
on.

2\. Among industrialized countries, Britain is at the very low end of the
spectrum for health care expenditures, either per capita or as a percent of
GDP. Government-funded and -controlled health care in Britain has done a
phenomenal job of containing costs.

------
Jun8
Whew, this article was a real eye-opener. I didn't know we had anti-venom
shortages, my assumption being that you can go to a hospital after a bite in
time you'll be easily cured.

~~~
chriskelley
Just last week a family friend was bitten by a huge copperhead and was in real
bad shape. My mother, a nurse for 40 years and the director of protocols for a
string of hospitals in southwest Missouri, took him to the hospital for care.
They were very hesitant to give him the anti-venom, but after about 20 hours
and a move to the ICU, they gave him the ONLY dose they had at the hospital.
He's a big burly bastard, and they decided he needed another dose. They had to
put him in an ambulance and take him an hour to the next hospital to get
another dose.

My mother, after seeing everything first hand, launched into a review of their
snake-bite procedures. She came to find out after speaking with the head
pharmacist, that the anti-venom our friend needed was $64,000 - and they have
a short shelf life! This was the reasoning for only having one dose at the
hospital they went to.

Our friend is fine, and has a good story to tell. My mother called a 'meeting
of the minds' for the hospitals she oversees to try to find a solution.

All that to say, yes, there are indeed problems with anti-venom!

~~~
mhb
How come they didn't put the anti-venom in the ambulance and drive it to him?

~~~
chriskelley
The second hospital was a larger hospital in Springfield. The doctors at the
first recommended they move him instead of the anti-venom because they said
the docs at the larger hospital were more experienced in snakebites, and he
was plenty stable. However, according to my mom, their procedures weren't any
better.

------
yalurker
My first thought reading the article: Could something like the Bill & Melinda
Gates Foundation step in to make life-saving but unprofitable drugs available?

This seems like a very legitimate problem that might be worthy of attention
from some non-profit, but maybe it just effects too few people?

~~~
megablast
Maybe it is just too expensive to keep producing these drugs, when they are
not needed. As horrible as it is to say, there is a price on a human life. If
those millions can be better spent elsewhere, surely we should be doing that.

------
boyter
Interesting. Being an Aussie it makes me wonder what the situation regarding
anti-venoms are here, because lets face it everything over here is either
poisonous or venomous which with the small population and the large distances
makes it potentially a worse problem.

~~~
thisrod
Going by rumours I've heard from snake fanciers, Australian doctors don't like
anti-venom as much as they used to. Besides being expensive, it's quite
dangerous. They've gotten so good at keeping people alive that it's often
safer to let the victim recover naturally.

The large distances don't matter as much as you'd think, because first aid
management of snakebite is very effective. If you're bitten by a snake, and
there are country people or bushwalkers around, you can spend many hours
getting to hospital, or even days.

~~~
boyter
I can belive that. What worries me is if you do need it that they cant get at
it quickly enough.

As for distances though im not sure if I would care to be waiting hours
following a Taipan bite considering how neurotoxic the venom is and how much
they can inject.

------
roboneal
Lost in all these borderline hysterical comments is that very few people get
bitten by coral snakes - so few - that the remaining stock is expiring on the
shelves.

No Demand = No Supply.

~~~
Goladus
Technically, it's small demand about to become no supply.

If bureaucracy is the only thing standing between a victim and treatment, a
certain passion is understandable. People have a tendency to recognize
injustice whether, rationally or statistically speaking, they shouldn't care
about it.

------
10ren
Adam Smith showed that some regulations lead to smuggling (he spoke of gold
and silver mainly).

Doesn't this antidote situation == instant black market, via internet-based
mail-order from countries where it isn't banned?

Though it probably wouldn't be delivered fast enough for when you need it; and
organizations that would sensibly keep a stock of it (hospitals, zoos) are not
in a position to buy from a black market; and if you're going to pay thousands
for something and inject it, you probably want more assurance than a dodgey
website can give. Unless you're dying.

------
ars
I think the US should fund the NiH to do drug studies for potentially good,
but uneconomic (usually because no patent is possible, but also if they isn't
a high demand) drugs.

Give it say 40 million a year, and they should do as many studies as they have
money for. I think that's enough for about 4-10 per year.

~~~
matwood
Just make it part of the science research grants they give out. I'm sure there
are some scientists out there who love to work with venom and anti-venom :)

------
giardini
It appears that anyone who could quickly provide the Mexican variant of the
coral snake antivenin would be in a position to profit. Isn't there some room
here for an entrepreneur/arbitrageur ("your money or your life!")?

~~~
rsheridan6
I guess you could life-flight the patient out of reach of the FDA, if they
could afford it.

------
gcv
Fascinating. I had no idea that anti-venoms make for such a great example of
regulatory failure: a completely strangled market and the resulting dangerous
shortages.

~~~
ubernostrum
Fascinating. I had no idea that _government regulation_ is the force which
drives companies to stop manufacturing products which are expensive to
manufacture and for which there's little demand in the market. You've truly
opened my eyes to this hitherto-unseen lurking evil.

~~~
gcv
The article clearly states that Coralmyn would have been on the market, except
for FDA approval. The demand is low, I agree, but regulatory overhead made the
difference between producing something and producing nothing.

------
natmaster
But without regulation there would be chaos! All corporations are evil and
want to kill you and the government is perfect and only has your best
interests at heart!

~~~
necubi
Actually, that's exactly true. Without regulation there _would_ be chaos. It's
not hard to look back a hundred years[1], before there was an FDA. Instead of
real, effective cures the market was dominated by patent medicine, most of
which was harmless (aside from not curing you) but much of which was actually
dangerous. The FDA was set up not as a silly, unnecessary regulatory layer but
to solve a very real problem that was actually killing and sickening people.

It's easy to decry regulation today, when we have never personally seen the
world before that regulation. But if you read your history, you would realize
today's world is much more pleasant to live in.

[1] OK, technically 104 years

~~~
InclinedPlane
I see your point and I think I mostly agree with you.

However, I don't think crediting the FDA with all of the benefits of the rise
of medicine as a scientific discipline through the late 19th and early 20th
century is entirely warranted. Were snake oil salesmen sidelined because of
the FDA or because doctor's started developing medicines that actually, and
obviously, worked (such as aspirin, sulfa drugs, etc)?

~~~
necubi
The point is, without the FDA there would be no way to tell the difference
between actually effective medicines and snake oil. Since snake oil is a lot
cheaper to research and make, economics would dictate that it would come to
dominate the market. And ordinary people, left to their own devices, are
spectacularly bad at differentiating between the two. This is clearly
demonstrated by the contemporary anti-vax movement (with its attendent
"alternative" cures) and the alternative medicine movement, which is almost
entirely snake oil.

~~~
natmaster
Clearly only the government is capable of scientific research. This is why we
cannot tell the difference between different computer hardware, because there
is no regulating government agency to do their magic for us.

------
jheriko
They say you can't put a price on human life... piffle.

------
Yaa101
all for the big buck...

------
ddustin
The FDA is here to protect you. If they didn't regulate testing of the anti-
venom, how would you know it wouldn't kill you?

