<p>Economic Evaluations of Interventions for Snakebites: A Systematic Review</p>

Abstract

Background Snakebite is an often-neglected event with a high rate of mortality and is concentrated in poor areas. We aimed to assess the economic impact and health effects of the implementation of interventions for snakebites through a systematic review of the scientific literature. Methods Thirty search strategies were conducted in seven databases, applying PRISMA’s identification, screening, selection, and inclusion phases. The reproducibility of the selection of studies and the extraction of information were guaranteed. The methodological quality was evaluated using the Consolidated Health Economic Evaluation Reporting Standards. Qualitative synthesis and meta-analysis were performed for determining the average cost-effectiveness (ACE) for each death and disability-adjusted life years (DALY) avoided. Results Six cost-effectiveness studies were included for the supply of antivenom (AV), taken as outcomes on days of hospitalization or in ICU, death and DALYs avoided. All studies only included institutional costs, and majority of them did not specify the analytical model or economic evaluation parameters and did not perform uncertainty analyses. The management protocol standardization with interdisciplinary attention improves ACE of AV. Cost-effectiveness ratio (CER) of treatment with AV was USD 1253 (constant value for the year 2017, adjusted by purchasing power parity) for each death avoided and USD 51 per DALY avoided. Conclusion High cost-effectiveness of the AV treatment for snakebites was evidenced, which shows that the allocation of resources for this event should be a healthcare priority in addition to implementation of strategies that improve the access to, opportunity, and quality of hospital and pre-hospital care and reduce the cost of AV.

Chronic health effects and cost of snakebite

“… Burden of snakebite No Author Location Cost Habib et al (2015) Nigeria The cost/death averted: $2330.16 The cost/DALY averted: $99.61 (discounted) and $56.88 (undiscounted) Hamza et al (2016) West Africa The cost/death averted for Guinea Bissau: US$1997 The cost/death averted for Liberia and Sierra Leone: US$6205 The cost/DALY averted for Benin Republic: US$$83 (95% Confidence Interval: US$36-$240) The cost/DALY averted for Sierra-Leone: US$281 ($159–457). Kasturiratne et al (2017) Sri Lanka Total number of DALYs for envenoming and death: 11, 101–15,076 per year For males 5624–7927 DALYs For females 5477–7150 DALYs The total DALYs (snakebites without envenoming) - 20–500 per year Total annual economic burden of snakebite: US$14,097,789 Quintana-Castillo et al (2020) Cost-effectiveness ratio (CER) of treatment with AV for each death avoided: US$1253 Cost-effectiveness ratio (CER) of treatment with AV per DALY avoided US$51 Magalhães et al (2020) Brazilian Amazon The estimated cost due to premature death: US$3031 300.38. The cost attributed to the loss of productivity: US$1539 518.62.…”

Epidemiology of Snake Bites Linked with the Antivenoms Production in Colombia 2008–2020: Produced Vials Do Not Meet the Needs

“…Understanding the health system affiliation status of people affected by snakebites allows the comprehension of the impact on the public health system and the affected population, especially when they have access to antivenoms with a high cost-effectiveness impact. 44 …”

“…Understanding the health system affiliation status of people affected by snakebites allows the comprehension of the impact on the public health system and the affected population, especially when they have access to antivenoms with a high cost-effectiveness impact. 44 The high accident rate in rural areas is related to the majority of their inhabitants living in scattered rural areas of agricultural activity in plantations of products such as banana or plantain, and cattle activities such as livestock. 45 Likewise, many disperse groups of indigenous and afro communities, inhabit these territories.…”

Association of a Network of Immunologic Response and Clinical Features With the Functional Recovery From Crotalinae Snakebite Envenoming

“…Despite positive cost-effectiveness assessments of snake antivenoms, the cost to individual SBE victims can be beyond the financial means of many of those affected (21)(22)(23). This creates another barrier to use if the need for treatment is unclear due to the uncertainty of the severity and anticipated clinical course of the SBE patient (24,25).…”