The Mexican drug manufacturer, the Instituto Bioclon in Huehuetoca, Mexico, has a coral snake antivenom, believe by some to be more effective than Wyeth’s whole IgG antivenom. Its brand name is Coralmyn®, and is not currently licensed for sale by the FDA. The tests required for licensing are estimated to cost $3-5 million, and because coral snake envenomation is so rare it could be decades for Bioclon to recover its investment. Coralmyn® is an FAB antivenom, manufactured by taking the whole IgG molecule produced in a horse or sheep and digesting them with an enzyme (pepsin or papain), and then recovering the fragments that bind to the toxins in the snake venom. This type of antivenom is relatively new and is thought to reduce the probability of side effects (anaphylactoid reactions) seen with the whole IgG antivenom used for the past 110 years.
CroFab is the antivenom now used for North American pit viper bites and has been shown to be effective in serious envenomations. However, the economics of the FAB antivenoms versus the whole IgG antivenoms is highly questionable. A vial of FAB antivenom can cost US$1200, while a vial of whole IgG antivenom can be produced for as little as US$40. Whole IgG antivenoms are a century old technology that is highly effective and relatively inexpensive. There is not a lot of money to be made from the production of whole IgG antivenom in the USA because there are relatively few envenomations in any given year. However, if you are the unfortunate person to be bitten, it is your life that is at stake. This is an excellent example of the failure of the market to produce needed medicine, and why medicine for profit is a wrong-headed approach to healthcare. And, yes countries in South America, Africa, and Asia do produce whole IgG antivenoms for reasonable costs and control the side effects with epinephrine that costs about US$2.
Brown, N. and J. Landon, 2010. Antivenom: the most cost-effective treatment in the world? Toxicon 55(7):1405-1407.
Murphy, J. C. 2010. Secrets of the Snake Charmer. Bloomington, 400 pp. (Chapter 6)
Simpson, I. D. and R. L. Norris, 2009. The global snakebite crisis a public-health issue misunderstood, not neglected. Wilderness and Environmental Medicine 20:43-56.