Cost of illness in patients with post-treatment Lyme disease syndrome in Belgium.
Journal
European journal of public health
ISSN: 1464-360X
Titre abrégé: Eur J Public Health
Pays: England
ID NLM: 9204966
Informations de publication
Date de publication:
01 08 2023
01 08 2023
Historique:
medline:
3
8
2023
pubmed:
28
3
2023
entrez:
27
3
2023
Statut:
ppublish
Résumé
A proportion of patients with Lyme borreliosis (LB) report long-term persisting signs and symptoms, even after recommended antibiotic treatment, which is termed post-treatment Lyme disease syndrome (PTLDS). Consensus on guidance regarding diagnosis and treatment is currently lacking. Consequently, patients suffer and are left searching for answers, negatively impacting their quality of life and healthcare expenditure. Yet, health economic data on PTLDS remain scarce. The aim of this article is therefore to assess the cost-of-illness related to PTLDS, including the patient perspective. PTLDS patients (N = 187) with confirmed diagnosis of LB were recruited by a patient organization. Patients completed a self-reported questionnaire on LB-related healthcare utilization, absence from work and unemployment. Unit costs (reference year 2018) were obtained from national databases and published literature. Mean costs and uncertainty intervals were calculated via bootstrapping. Data were extrapolated to the Belgian population. Generalized linear models were used to determine associated covariates with total direct costs and out-of-pocket expenditures. Mean annual direct costs amounted to €4618 (95% CI €4070-5152), of which 49.5% were out-of-pocket expenditures. Mean annual indirect costs amounted to €36 081 (€31 312-40 923). Direct and indirect costs at the population level were estimated at €19.4 and 151.5 million, respectively. A sickness or disability benefit as source of income was associated with higher direct and out-of-pocket costs. The economic burden associated with PTLDS on patients and society is substantial, with patients consuming large amounts of non-reimbursed healthcare resources. Guidance on adequate diagnosis and treatment of PTLDS is needed.
Sections du résumé
BACKGROUND
A proportion of patients with Lyme borreliosis (LB) report long-term persisting signs and symptoms, even after recommended antibiotic treatment, which is termed post-treatment Lyme disease syndrome (PTLDS). Consensus on guidance regarding diagnosis and treatment is currently lacking. Consequently, patients suffer and are left searching for answers, negatively impacting their quality of life and healthcare expenditure. Yet, health economic data on PTLDS remain scarce. The aim of this article is therefore to assess the cost-of-illness related to PTLDS, including the patient perspective.
METHODS
PTLDS patients (N = 187) with confirmed diagnosis of LB were recruited by a patient organization. Patients completed a self-reported questionnaire on LB-related healthcare utilization, absence from work and unemployment. Unit costs (reference year 2018) were obtained from national databases and published literature. Mean costs and uncertainty intervals were calculated via bootstrapping. Data were extrapolated to the Belgian population. Generalized linear models were used to determine associated covariates with total direct costs and out-of-pocket expenditures.
RESULTS
Mean annual direct costs amounted to €4618 (95% CI €4070-5152), of which 49.5% were out-of-pocket expenditures. Mean annual indirect costs amounted to €36 081 (€31 312-40 923). Direct and indirect costs at the population level were estimated at €19.4 and 151.5 million, respectively. A sickness or disability benefit as source of income was associated with higher direct and out-of-pocket costs.
CONCLUSIONS
The economic burden associated with PTLDS on patients and society is substantial, with patients consuming large amounts of non-reimbursed healthcare resources. Guidance on adequate diagnosis and treatment of PTLDS is needed.
Identifiants
pubmed: 36972275
pii: 7087174
doi: 10.1093/eurpub/ckad045
pmc: PMC10393486
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
668-674Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association.
Références
J Public Health (Oxf). 2017 Mar 1;39(1):74-81
pubmed: 26966194
Ticks Tick Borne Dis. 2014 Feb;5(1):58-62
pubmed: 24215678
Ticks Tick Borne Dis. 2015 Feb;6(1):56-62
pubmed: 25448420
Appl Health Econ Health Policy. 2006;5(2):75-85
pubmed: 16872249
J Womens Health (Larchmt). 2009 Jun;18(6):831-4
pubmed: 19514824
PLoS One. 2019 Jan 4;14(1):e0210280
pubmed: 30608986
Drug Alcohol Rev. 2009 Mar;28(2):117-21
pubmed: 19320695
Eur J Clin Microbiol Infect Dis. 2012 Sep;31(9):2385-90
pubmed: 22391757
Int J Gen Med. 2013 Apr 23;6:291-306
pubmed: 23637552
Front Med (Lausanne). 2017 Dec 14;4:224
pubmed: 29312942
Ticks Tick Borne Dis. 2019 Apr;10(3):598-605
pubmed: 30772196
BMC Fam Pract. 2014 May 01;15:79
pubmed: 24885888
Euro Surveill. 2011 Jul 07;16(27):
pubmed: 21794218
Clin Infect Dis. 2015 Jun 15;60(12):1776-82
pubmed: 25852124
Nat Rev Dis Primers. 2016 Dec 15;2:16090
pubmed: 27976670
Trends Microbiol. 2013 Aug;21(8):372-9
pubmed: 23876218
Healthcare (Basel). 2018 Nov 05;6(4):
pubmed: 30400667
Arch Med Sci. 2012 Dec 20;8(6):978-82
pubmed: 23319969
Front Med (Lausanne). 2020 Feb 25;7:57
pubmed: 32161761
Front Cell Infect Microbiol. 2013 Aug 14;3:40
pubmed: 23967405
Milbank Q. 1986;64(4):489-547
pubmed: 3102916
BMC Public Health. 2022 Nov 28;22(1):2194
pubmed: 36443755
Clin Microbiol Infect. 2010 Aug;16(8):1245-51
pubmed: 19793326
Cureus. 2021 Oct 12;13(10):e18703
pubmed: 34659931
Front Cell Infect Microbiol. 2014 Jun 03;4:74
pubmed: 24918091
Eur J Public Health. 2017 Jun 1;27(3):538-547
pubmed: 28444236
J Neuroimmunol. 2013 Feb 15;255(1-2):85-91
pubmed: 23141748
BMJ. 2020 May 26;369:m1041
pubmed: 32457042
Int J Technol Assess Health Care. 2002 Summer;18(3):705-10
pubmed: 12391960
Lancet. 2018 Aug 11;392(10146):452
pubmed: 30129444
BMC Infect Dis. 2022 Sep 28;22(1):756
pubmed: 36171561