Lyme disease costs up to $1.3 billion per year to treat, study finds

Lyme disease, transmitted by a bite from a tick infected by the Borrelia burgdorferi bacteria, had long been considered easy to treat, usually requiring a single doctor's visit and a few weeks of antibiotics for most people.

But new research from the Johns Hopkins Bloomberg School of Public Health suggests that a prolonged illness associated with the disease in some patients is more widespread and serious than previously understood. With an estimated 240,000 to 440,000 new cases of the tick-borne illness diagnosed every year, the researchers found that Lyme disease costs the U.S. health care system between $712 million and $1.3 billion a year - or nearly $3,000 per patient on average - in return doctor visits and testing, likely to investigate the cause of some patients' lingering symptoms of fatigue, musculoskeletal pain and memory problems. These visits come after patients have finished their original course of antibiotics.

Some doctors call those persistent symptoms post-treatment Lyme disease syndrome (PTLDS); others call it chronic Lyme disease. Still others attribute the complaints of fatigue, headaches and memory problems to the hum of daily life, the aches and pains that come with aging. At the core of the controversy is whether PTLDS can be a severe and chronic condition that requires more than reassurance and symptomatic therapy. While a blood test can confirm Lyme disease, there is no definitive test for PTLDS and there are no approved or proven treatments. It's a controversial topic in medicine, the Hopkins researchers say.

A report on the findings is published online Feb. 4 in the journal PLOS ONE.

"Our study looks at the actual costs of treating patients in the year following their Lyme diagnosis," says study author Emily Adrion, MSc, a PhD candidate in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. "Regardless of what you call it, our data show that many people who have been diagnosed with Lyme disease are in fact going back to the doctor complaining of persistent symptoms, getting multiple tests and being retreated. They cost the health care system about $1 billion a year and it is clear that we need effective, cost-effective and compassionate management of these patients to improve their outcomes even if we don't know what to call the disease."

Adrion and her colleagues looked at medical claims data from approximately 47 million people enrolled in a wide range of commercial health insurance plans in the United States between 2006 and 2010. The researchers ended up analyzing 52,795 cases of Lyme disease patients under the age of 65 who had been treated with antibiotics within 30 days of a Lyme disease test order and/or Lyme disease diagnosis. The data were compared to nearly 264,000 other similar people with no evidence of Lyme disease exposure.

Lyme disease is an infection caused by a spirochete (say “SPY-ROH-KEET”) that humans can get from the bite of an infected deer tick. The spirochete's scientific name is Borrelia burgdorferi. Lyme disease is called “The Great Imitator” because its symptoms mimic many other diseases. It can affect any organ of the body, including the brain and nervous system, muscles and joints, and the heart.