Cost-effectiveness of Antivenoms for Snakebite Envenoming in Nigeria

Economic analysis was conducted from a public healthcare system perspective. estimates of model inputs were obtained from the literature. incremental cost effectiveness ratios (icers) were quantified as deaths and disability-adjusted-life-years (daly) averted from antivenom therapy. a decision analytic model was developed and analyzed with the following model base-case parameter estimates: type of snakes causing bites,antivenom effectiveness to prevent death,untreated mortality,risk of early adverse reactions (ear),mortality risk from ear,mean age at bite and remaining life expectancy,and disability risk (amputation). end-user costs applied included: costs of diagnosing and monitoring envenoming,antivenom drug cost,supportive care,shipping/freezing antivenom,transportation to-and-from hospital and feeding costs while on admission,management of antivenom ear and free alternative snakebite care for ineffective antivenom.we calculated a cost/death averted of ($2330.16) and cost/daly averted of $99.61 discounted and $56.88 undiscounted. varying antivenom effectiveness through the 95% confidence interval from 55% to 86% yield a cost/daly averted of $137.02 to $86.61 respectively. similarly,varying the prevalence of envenoming caused by carpet viper from 0% to 96% yield a cost/daly averted of $254.18 to $78.25 respectively. more effective antivenoms and carpet viper envenoming rather than non-carpet viper envenoming were associated with lower cost/daly averted.treatment of snakebite envenoming in nigeria is cost-effective with a cost/death averted of $2330.16 and cost/daly averted of $99.61 discounted,lower than the country's gross domestic product per capita of $1555 (2013). expanding access to effective antivenoms to larger segments of the nigerian population should be a considered a priority.snakebite envenoming is a major public health problem throughout the rural tropics. antivenom is effective in reducing mortality and remains the mainstay of therapy. this study aimed to determine the cost-effectiveness of using effective antivenoms for snakebite envenoming in nigeria. © 2015 habib et al.