Brestrich Gordon, Diesing Joanna, Kossack Nils, Stark James H, Pilz Andreas, Yu Holly, Suess Jochen
Pfizer Pharma GmbH, Berlin, Germany.
Scientific Institute for Health Economics and Health System Research (WIG2 GmbH), Leipzig, Germany.
Zoonoses Public Health. 2025 Feb;72(1):23-31. doi: 10.1111/zph.13180. Epub 2024 Sep 5.
Lyme borreliosis (LB) is the most common tick-borne disease in Germany; however, data on the economic burden of LB are limited. In this study, we aim to report healthcare costs, healthcare resource utilisation (HCRU) and diagnostic consumption associated with LB by clinical manifestation.
Using specific case definitions, patients with localised disease (erythema migrans [EM]) or disseminated disease (Lyme arthritis [LA], Lyme neuroborreliosis [LNB] and other rarer manifestations [OTH]) were identified from a claims database in 2016 and followed up for 3 years (2016-2019). After propensity score matching, excess costs and HCRU were calculated as the differences between each LB cohort and the matched control cohort.
On a per-patient basis, the excess all-cause healthcare cost was €130 for EM during Quarter 1 of Year 1, and €1539 for LA, €3248 for LNB and €4137 for OTH during Year 1. Only for OTH, additional €1860 was observed in Year 2. No increase in costs was observed in Year 3. When extrapolated to all German patients with statutory health insurance, LB was associated with €64.5 million in excess costs. Although disseminated manifestations only accounted for 7.8% of all LB cases, they were responsible for 66% of overall costs. In addition, LB patients consumed healthcare resources of 1.4 million excess outpatient visits, 13,000 excess hospitalisations, 96,000 ELISAs and 65,000 Western blots.
This study shows the substantial economic burden of LB to the German healthcare system.
莱姆病（LB）是德国最常见的蜱传疾病；然而，关于莱姆病经济负担的数据有限。在本研究中，我们旨在按临床表现报告与莱姆病相关的医疗费用、医疗资源利用（HCRU）和诊断消耗。
采用特定的病例定义，从2016年的索赔数据库中识别出患有局限性疾病（游走性红斑[EM]）或播散性疾病（莱姆关节炎[LA]、莱姆神经疏螺旋体病[LNB]和其他罕见表现[OTH]）的患者，并随访3年（2016 - 2019年）。在倾向得分匹配后，计算每个莱姆病队列与匹配的对照队列之间的差异，得出额外费用和HCRU。
在第1年第1季度，每例EM患者的全因额外医疗费用为130欧元，第1年每例LA患者为1539欧元，每例LNB患者为3248欧元，每例OTH患者为4137欧元。仅OTH患者在第2年观察到额外费用1860欧元。第3年未观察到费用增加。外推至所有参加法定医疗保险的德国患者时，莱姆病相关的额外费用为6450万欧元。尽管播散性表现仅占所有莱姆病病例的7.8%，但它们占总费用的66%。此外，莱姆病患者消耗了140万次额外门诊就诊、13000次额外住院、96000次酶联免疫吸附测定（ELISA）和65000次免疫印迹法检测等医疗资源。
本研究显示了莱姆病给德国医疗系统带来的巨大经济负担。
