Human rabies immune globulin (HRIG) and rabies vaccine are not inexpensive. They are special, uncommon medical interventions that are highly effective for life-critical animal exposure events that are uncommon. So, it would be expected that biomedical products that will never be used by a high-volume market would be pricey.
However, fortunately, the majority of the cost will be covered by insurers once medical necessity is established by us. As soon as that is determined, our insurance specialists immediately evaluate your personal insurance plan benefits and will give you an exact figure on your responsibility for your share of the cost.
One thing critically relevant to the overall cost of these products and services is the site (facility type) of their delivery/administration. An example is a young man who had a legitimate risk of rabies from an animal exposure who did what many do reflexively, he went to the local hospital Emergency Department. He was provided the HRIG and first of 4 doses of vaccine. The bill for these services was,
ER Visit $1,574
Rabies Vaccine $1,979 (one dose)
Injection Charge $2,614
After insurance benefits were calculated, the patient was assessed $5,000 as his personal responsibility and had to pay it with a credit card.
Had the same patient come directly to our facility, calculating our charges for the same services, note the significant difference in cost,
Office Consultation $482.82
HRIG $3,500 (varies by patient weight)
Rabies Vaccine $350 (per dose)
Patient Responsibility $30 Co-Pay
This patient provided a copy of his ER bill to us because he was outraged at the astronomically inflated charges that are usual whenever a hospital is involved, with no regulation over their pricing on the basis of value. Basically, it’s open-season on patients presenting for what they think is emergently needed care. After you have been seen and the service has been given, it’s usually too late to negotiate the bill. And, if the facility is “out-of-network” with your insurer, your total dollar responsibility beyond your insurance may be outrageous.
As we have stated elsewhere, rabies immunizations (once the wound has been cleaned thoroughly- see elsewhere in our website content) is a medical “urgency”, not emergency, if the animal contact has been within a few days (exceptions may be facial wounds). If there is a question of how quickly someone must receive HRIG/vaccine, we encourage you to call us 24/7 for advice. With proper care, you will survive the rabies exposure, but if you go to a hospital ER you may die from the bill.
Edward R. Rensimer, MD, FACP