Abstract
BackgroundLyme disease is the most frequently reported vector borne infection in the United States. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome – a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States.Objectives1) to examine the impact of Lyme disease on health care costs and utilization, 2) to understand the relationship between Lyme disease and the probability of developing PTLDS, 3) to understand how PTLDS may impact health care costs and utilization.MethodsThis study utilizes retrospective data on medical claims and member enrollment for persons aged 0-64 years who were enrolled in commercial health insurance plans in the United States between 2006-2010. 52,795 individuals treated for Lyme disease were compared to 263,975 matched controls with no evidence of Lyme disease exposure.ResultsLyme disease is associated with $2,968 higher total health care costs (95% CI: 2,807-3,128, p<.001) and 87% more outpatient visits (95% CI: 86%-89%, p<.001) over a 12-month period, and is associated with 4.77 times greater odds of having any PTLDS-related diagnosis, as compared to controls (95% CI: 4.67-4.87, p<.001). Among those with Lyme disease, having one or more PTLDS-related diagnosis is associated with $3,798 higher total health care costs (95% CI: 3,542-4,055, p<.001) and 66% more outpatient visits (95% CI: 64%-69%, p<.001) over a 12-month period, relative to those with no PTLDS-related diagnoses.ConclusionsLyme disease is associated with increased costs above what would be expected for an easy to treat infection. The presence of PTLDS-related diagnoses after treatment is associated with significant health care costs and utilization.
Highlights
Lyme disease is a growing health care problem in Northern Hemisphere countries worldwide, with cases in the United States increasing by approximately 200% in the last two decades. [1] [2] [3] Recent estimates indicate that the incidence of Lyme disease ranges from 240,000– 440,000 new cases a year, making Lyme disease the seventh most common reportable infectious disease in the United States. [4] [5] The tick-borne bacteria associated with Lyme disease in North America, Borrelia burgdorferi, causes an early stage acute skin infection that often is associated with a skin lesion called erythema migrans
The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome – a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease
Lyme disease is associated with $2,968 higher total health care costs and 87% more outpatient visits over a 12month period, and is associated with 4.77 times greater odds of having any post-treatment Lyme disease symptoms (PTLDS)-related diagnosis, as compared to controls
Summary
Lyme disease is a growing health care problem in Northern Hemisphere countries worldwide, with cases in the United States increasing by approximately 200% in the last two decades. [1] [2] [3] Recent estimates indicate that the incidence of Lyme disease ranges from 240,000– 440,000 new cases a year, making Lyme disease the seventh most common reportable infectious disease in the United States. [4] [5] The tick-borne bacteria associated with Lyme disease in North America, Borrelia burgdorferi, causes an early stage acute skin infection that often is associated with a skin lesion called erythema migrans. 10–20% of patients treated for Lyme disease with a recommended 2–4 week course of antibiotics will have patient-reported symptoms that may last for weeks, months or years. [14] As a result, little is known about the impact of Lyme disease infection on health care utilization and costs. [19] A Maryland study found that the annual direct medical cost of treating early- and late-stage Lyme disease decreased from means of $1,609 to $464 and. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome – a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States
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