July 6, 2013 in Health, Idaho

Rare rabies cure drives cost

Three bats in North Idaho have tested positive for disease this year
By The Spokesman-Review
 

When Nicholle Joyce learned she’d been exposed to a rabid bat at a Spirit Lake home and she was nine days into the 10-day window for a lifesaving vaccine for the fatal disease, she did what her doctor’s office suggested – she went to the emergency room.

The result: A $5,000 bill for her, and a matching one for her friend who was in the same bind. Joyce had insurance, but it had a $3,000 deductible and is only paying about $830. Her friend had none; Medicaid covered the shots for the friend’s 15-month-old son but not for the single mom who works as an aesthetician.

“It’s absolutely impossible for everyone to get a due-on-receipt of $5,000 and just go with it,” said Joyce, a veterinary technician from Athol.

Health officials said they, too, were shocked by the high price of the rabies vaccine, which consists of five shots on four specific days during several weeks; so far this year, three bats have been found in North Idaho that tested positive for rabies. But it’s something that’s so rarely needed that few doctor’s offices would stock it.

“It’s very unfortunate, but it’s a rare occurrence,” said Tom Shanahan, Idaho Department of Health and Welfare spokesman.

Now, however, the Dirne Community Clinic in Coeur d’Alene, which hasn’t offered the rabies vaccine in the past, is looking into adding it because of Joyce’s case. “It certainly would be a lot less,” said Dirne CEO Mike Baker; his community health center charges patients on a sliding scale based on their income and works with both insured and uninsured patients.

Dirne patients with no insurance and very low incomes typically pay $25 or $50 for a visit. Plus, he said, “We actually have the ability to purchase these vaccines at a significantly discounted rate.”

Though rabiesvaccinecost.com reports that nationwide, the series of rabies shots typically costs a patient between $2,000 and $7,000, Baker said his suppliers tell him his clinic should be able to get the vaccine in two days for a much lower cost, likely about $1,000. Plus, he said, some low-income patients may qualify for assistance programs from the drug manufacturers that could reduce their costs for the vaccine to zero.

“Last year we got close to $2 million in donated medications from the pharmaceutical companies for our patients,” Baker said.

Even that might not have helped Joyce and her friend, Lanmana Parys, of Spirit Lake, because they didn’t seek treatment until the ninth day of the 10-day window. “I’d stress early visits, wherever you go,” Baker said. “If you think you’re at all ever exposed, don’t wait – just go in.”

Idaho, Washington and Montana do not have any state program to assist patients with the cost of rabies vaccine. Joyce had gone over to Parys’ house for a visit in May and stayed overnight after enjoying dinner and a bonfire. The friends and Parys’ young son woke up in the morning to find a dying bat on their staircase inside the house. They contacted the Panhandle Health District, which tested the bat and found it positive for rabies.

When a bat has been inside a place where people are sleeping, they are assumed to be exposed, because it could have bitten or scratched them without leaving a mark.

Joyce only went to the emergency room after calling her doctor’s office, waiting four hours for a response, and then being told by the nurse there that the Kootenai Medical Center emergency room stocks the vaccine.

She said, “Unfortunately we were clueless – I mean, who deals with this? Nobody.”

Joyce said once the trio arrived at the emergency room, there were only two doses of the vaccine available, so she waited several hours for hers to arrive from Spokane. She and her friend had to take time off from work on each of the three subsequent vaccination days and drive to Coeur d’Alene. She was told only that the vaccines would be expensive and didn’t know what the cost would be until the bill arrived in mid-June.

Parys also had to have a veterinarian visit her home and update vaccines for her horses, dogs and cats, all of which were quarantined for 45 days. That cost her several hundred dollars more.


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