Abstract
We evaluated MarketScan, a large commercial insurance claims database, for its potential use as a stable and consistent source of information on Lyme disease diagnoses in the United States. The age, sex, and geographic composition of the enrolled population during 2010–2018 remained proportionally stable, despite fluctuations in the number of enrollees. Annual incidence of Lyme disease diagnoses per 100,000 enrollees ranged from 49 to 88, ≈6–8 times higher than that observed for cases reported through notifiable disease surveillance. Age and sex distributions among Lyme disease diagnoses in MarketScan were similar to those of cases reported through surveillance, but proportionally more diagnoses occurred outside of peak summer months, among female enrollees, and outside high-incidence states. Misdiagnoses, particularly in low-incidence states, may account for some of the observed epidemiologic differences. Commercial claims provide a stable data source to monitor trends in Lyme disease diagnoses, but certain important characteristics warrant further investigation.
Highlights
We evaluated MarketScan, a large commercial insurance claims database, for its potential use as a stable and consistent source of information on Lyme disease diagnoses in the United States
Consistent with the methods described in Nelson et al, we restricted the MarketScan population to persons who had insurance coverage for an entire calendar year and who had the potential for associated pharmaceutical claims data to more accurately convey annual rates of coded Lyme disease diagnoses [11]
MarketScan, containing data on >25 million persons annually, is one of the largest sources of health insurance claims data currently available for US residents. We evaluated this database for its potential to serve as a stable source of data on Lyme disease diagnoses
Summary
We evaluated MarketScan, a large commercial insurance claims database, for its potential use as a stable and consistent source of information on Lyme disease diagnoses in the United States. Age and sex distributions among Lyme disease diagnoses in MarketScan were similar to those of cases reported through surveillance, but proportionally more diagnoses occurred outside of peak summer months, among female enrollees, and outside high-incidence states. Lyme disease is caused by infection with certain Borrelia spirochetes and transmitted to humans by Ixodes ticks [1] It is the most commonly reported vectorborne disease in the United States, despite a highly focal geographic distribution [1,2]. Intended for billing purposes, insurance claims data have been used to describe the epidemiology of many types of conditions [8,9,10], including the frequency and characteristics of clinician-diagnosed Lyme disease, its geographic distribution, and risk factors for disseminated illness [11,12]. We evaluated the stability and representativeness of a single commercial claims database during 2010–2018, variability in characteristics of identified Lyme disease diagnoses, and comparability to data obtained through routine passive surveillance
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