(RxWiki News) In the past, patients with Lyme disease — a disease spread through the bites of ticks — had a single doctor visit and were prescribed antibiotics. That course of treatment, however, may not be enough for all patients. And more treatment could increase health care costs.
A new study found that many Lyme disease patients may wind up with a prolonged illness and have symptoms long after they finish antibiotics.
As a result, the cost to treat Lyme disease may be much higher than once thought, according to a research team co-led by Emily R. Adrion, MSc, a PhD candidate in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.
“Our study looks at the actual costs of treating patients in the year following their Lyme diagnosis,” Adrion said in a press release. “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.”
It’s an expensive proposition, and there’s controversy over whether the lingering symptoms are truly related to the Lyme infection, these researchers said.
Lyme disease is caused by a bacterium called Borrelia burgdorferi. Many cases of Lyme disease are responsive to a two- to four-week course of antibiotics, particularly if treatment is started early.
However, some people with Lyme disease continue to have symptoms for months or even years after the infection has been treated. These patients make multiple doctor visits and need repeated lab testing.
Adrion and team estimated that 240,000 to 440,000 new cases of Lyme disease occur each year.
Adrion’s team collected medical claims data from around 47 million US patients enrolled in commercial health insurance plans between 2006 and 2010. They found nearly 53,000 cases of Lyme disease.
These patients had been treated with antibiotics within 30 days of diagnosis or testing. Adrion and colleagues compared these patients with a much larger group who had never had Lyme disease.
A patient with Lyme disease cost the health care system $2,968 more than a similar person without Lyme disease, Adrion and team found. Patients with Lyme disease had 87 percent more doctors’ visits and 71 percent more emergency room visits within the first year of being diagnosed.
A condition called Post-Treatment Lyme Disease Syndrome (PTLDS) may occur in up to 20 percent of patients with Lyme disease, according to the Centers for Disease Control and Prevention (CDC). Adrion and colleagues found, however, that more than 63 percent of patients with Lyme disease developed at least one PTLDS symptom.
Adrion and colleagues noted that considerable debate exists in the medical community about whether chronic Lyme disease or PTLDS even exists.
Lyme disease patients who developed one or more PTLDS symptoms, such as fatigue, nerve pain, joint pain or cognitive problems, cost the health care system $3,798 more than people who did not have such symptoms. This study did not, however, identify costs like lost productivity or out-of-pocket expenses from insurance co-pays.
Altogether, Lyme disease cost between $712 million and $3.1 billion to treat each year, Adrion and team found.
Study lead author John Aucott, MD, an assistant professor of rheumatology at the Johns Hopkins University School of Medicine, said in a press release, "These patients are lost. No one really knows what to do with them. It’s a challenge, but the first thing we need to do is recognize this is a problem. There’s not a magic pill. These patients already got the magic pill and it didn’t work.”
This study was published online Feb. 4 in the journal PLOS ONE.
A grant from the Lyme Disease Research Foundation funded this research. Dr. Aucott was a board member for the Lyme Disease Research Foundation.