Lyme Disease and Health Care Costs

Area of Science:

• Infectious Diseases
• Public Health
• Health Economics

Background:

• Lyme disease (LD) is the most prevalent vector-borne illness in the United States, with increasing incidence and geographic spread.
• Understanding the economic impact of LD, including patient out-of-pocket (OOP) expenses, is crucial due to its growing prevalence.

Purpose of the Study:

• To evaluate the healthcare costs associated with LD diagnoses in a large US population.
• To stratify costs based on localized versus disseminated disease presentations.

Main Methods:

• A retrospective cohort study utilizing deidentified claims and electronic health records from Optum Market Clarity (December 2014 - January 2023).
• Patients with LD diagnoses were identified and categorized into localized, disseminated, or indeterminate disease.
• Healthcare costs were assessed using multiple methods, including episode-specific costs, baseline vs. follow-up comparisons, and case-control analyses, considering both direct and OOP costs.

Main Results:

• The study included 70,531 LD case patients. Estimated direct costs for LD were substantial, with episode costs averaging $2227.
• All-cause 6-month follow-up costs were significantly higher for LD patients compared to baseline and control groups, ranging from $3304 to $5571.
• Mean OOP costs attributed to LD ranged from $188 to $399. Annual US costs for LD were estimated between $591 million and $1.05 billion, with $411-$771 million linked to disseminated disease.

Conclusions:

• Lyme disease imposes a significant financial burden on both the healthcare system and patients, particularly in cases of disseminated disease.
• The findings emphasize the critical need for implementing effective preventive measures to mitigate the economic impact of LD.