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What's your poison: a Mexican lab hopes its anti-venoms take a bite out of hospital costs across the globe.

Alfredo Chavez Haro, an emergency room doctor in southern central Mexico, remembers well the six-year-old child who came into his Bed Cross emergency room. Bitten by a scorpion--just one of 230,000 victims he's seen in three decades treating every manner of calamity in his home state of Guanajuato--the child was losing control of his lungs and his throat had begun to shut. "He knew he was in the jaws of death before he should have had even a notion of what death is," Chavez says.

Scorpion stings can be fatal especially for children (this patient survived), who account for most of the country's scorpion-related fatalities. Even if the victim survives, the ordeal is traumatic. Yet deaths from such stings could become a thing of the past. A Mexican pharmaceutical company, Bioclon, has invented a drug that has cut yearly scorpion-related deaths to 100 from 800. Of the 250,000 people stung every year in Mexico, those who receive the drug--known as Alacramyn--are in and out of a hospital in an hour.

Bioclon now wants to take the anti-venom to the United States, where it is undergoing clinical studies to be approved by the Food and Drug Administration (FDA) for regular distribution. In Arizona, the drug is already authorized for use in emergencies. But public-health officials say they need it now.

The new drug, developed at Mexico's National Autonomous University (UNAM), cost just US$37, down from more than $350. "We haven't had a death or serious side effects" using Alacramyn, Chavez says. U.S. healthcare facilities rarely have to deal with life-threatening scorpion bites since many hospitals have pediatric intensive-care units, says Leslie Boyer, medical director at the Arizona Poison and Drug Information Center at the University of Arizona. However, a stay in such a facility to treat a sting normally lasts 24 hours and costs run as high as $8,000 to care for a victim. Alacramyn can cut that cost to a fraction, says Boyer.

"We are actually relying on the charity of a private Mexican organization to save the lives of rural Arizona children who would not have access to this care;' says Boyer, who stumbled across Bioclon by accident a few years ago when accompanying National Geographic magazine reporters working on a story on venomous creatures in Mexico.

While on the road, Boyer came across a lab where UNAM researchers were testing Alacramyn. Interested, Boyer withdrew a scorpion from her bag and a lab scientist used it on a test animal. The animal went from near death to recovery in about 10 minutes once it received Alacramyn, says Boyer.

For years, Arizona hospitals have relied on homegrown anti-venom that is inferior to Alacramyn. Then the manufacturer of that drug announced in 2000 it would cease production. A five-year supply is running out, and Boyer and other healthcare officials there want Alacramyn distributed as soon as possible. "I couldn't stand the thought of saying 'Sorry, we know of something good 200 miles south of the border but you can't have any'," Boyer says.

Bioclon researchers are eager to repeat their results in the United States and hope the U.S. government greenlights distribution soon. "We calculate we will finish [clinical studies] this year and present the results to the FDA and get the final biological license application, which is the last stage;' says Jorge Paniagua, head of research at Biodon, which also has begun testing antibodies to be administered to people bitten by snakes and spiders. Tests on those drugs should begin soon. "I think we are going to begin clinical studies this year," says Paniagua.

Mexico always will be Bioclon's largest market due to the sheer number of victims, but the company expects to export to Central and South America as well as Africa and Asia, wherever venomous insects and reptiles are a big problem. In the United States, only about 10,000 people suffer scorpion stings, and fatalities are very few and far between. No anti-venoms exist on the market in part because pharmaceutical companies must spend billions to bring new drugs to market. For a large drug company, the return on an investment for manufacturing and marketing anti-venoms just isn't there for a scorpion anti-venom.

Side effects. Part of what makes the drug so attractive is its ability to treat a patient with a very low risk of side effects, says Lourival Possani, head of UNAM's biotechnology institute. The drug is made by injecting venom into a horse and later extracting the antibodies from the horse's blood. UNAM scientists say they have successfully isolated only those molecules needed to fight off the poisons. Doing so lowers the risks of side effects, like toxic shock Today, UNAM is researching ways to derive anti-venoms from human blood that would eliminate problems associated from using horse blood. "People don't believe that, in a third-world country, you can do things good enough to compete in a first-world country," Possani says.

In the United States, one pharmaceutical company is ready to make emerging-country drug discoveries more available. Rare Disease Therapeutics produces pharmaceuticals and medical supplies targeted to smaller groups of consumers. Such products, known as "orphan drugs" in the industry, are designed to help the needs of people that larger drug companies would otherwise overlook due to financial considerations.

In 2001, Rare and Bioclon teamed up to bring Alacramyn into the United States, where a dull-yellow scorpion that grows up to 20 centimeters, known as the bark scorpion, poses a threat to children in the southwestern United States. The drug will be marketed under the name Anascorp in the United States. "We're basically developing that anti-venom for the state of Arizona;' says Rare Disease Therapeutics President Milton Ellis. The bark scorpion is the first creepy-crawly on its hit list. The company wants to take new Bioclon products to market in the United States, including ones designed to treat all types of rattlesnake bites as well as black widow spider bites. Rare and Bioclon are also considering making an anti-venom to treat bites from coral snakes in Florida.

Pharmaceuticals giant Merck already manufactures a drug to treat black widow bites, although that company no longer wants to produce it and is coordinating its market exit with Rare Disease Therapeutics to fill the gap, Ellis says. Once approved, Rare will distribute the Mexican anti-venoms across the United States and in Canada. One short-term obstacle, however, is having enough venom in the first place: Snakes, scorpions and spiders must be "milked" regularly to create a supply of anti-venom. "The critters have to cooperate," Ellis says.


While scorpions sting thousands a year, high treatment costs can fall
with new drugs.

 Number of people Average cost per
 stung a year: treatment without Alacramyn:

Mexico 250,000 US $350

United States 10,000 US $6,000-US $8,000(E)

E = Estimate

SOURCE: UNAM, University of Arizona
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Title Annotation:PHARMACEUTICALS; Bioclon has invented a drug called Alacramyn for scorpion bite
Author:Jones, Forrest
Publication:Latin Trade
Geographic Code:1MEX
Date:Sep 1, 2005
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