Analysis of Antivenin Usage in Taiwan from National Health Insurance Research Database, 2008-2012

Analysis of Antivenin Usage in Taiwan from National Health Insurance Research Database, 2008-2012

Taiwan is located in subtropical region, currently identified 23 species of snakes, among them 6 venomous ones are medically important. These are Protobothrops mucrosquamatus, Viridovipera stejnegeri, Deinagkistrodon acutus, Naja atra, Bungarus multicinctus, and Daboia russellii. Presently, the only therapeutic treatment for venomous snakebites is to administer specific type of antivenin. In Taiwan, the antivenins are only produced by the Center for Research, Diagnostics and Vaccine Development at Taiwan Centers for Disease Control. This study aims to analyze the database from national health insurance in order to understand the usage of antivenin in Taiwan from 2008-2012. The results showed that, on average, 1,202 patients applied for antivenin each year. Annually, the average number of person uses of lyophilized antivenin of Tr. mucrosquamatus and Tr. gramineus (FH) was 998 patients, followed by antivenin of B. multicinctus and N. atra (FN), 286 patients; antivenin of D. acutus (FA), 16 patients; and antivenin of D. russellii (FR), less than 3 patients. In terms of usage, annual amount of FH was 2,736 vials; FN, 1,006 vials; FA, 36 vials; and FR, 7 vials. The amount of antivenin used by outpatients or hospitalized patients in Taiwan was, in descending sequence, FH, FN, FA and FR respectively. Analysis of the clinical usage of antivenin provides us references for the production of the antivenins.