Economic Impact Of Lyme Disease

According to an actuarial study on Lyme costs, “37% of the financial costs of this disease is incurred before the correct diagnosis is made.” According to a 1998 CDC study, early Lyme costs averaged $161 per patient and neurologic Lyme disease averaged $61,243 per year. (Cardiac involvement $6,845.00. Arthritic involvement $34,354.00)

Source- Emerg Infect Dis. 1999 May-Jun;5(3):321-8. The cost effectiveness of vaccinating against Lyme disease. Meltzer MI, Dennis DT, Orloski KA. Source- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.


July 2019- Survey By Igenex- The Staggering Cost of Lyme Disease and Other Tick-Borne Illnesses

Cost of Lyme Disease

Studies 1992 - 2018

Cost-effectiveness of longer-term versus shorter-term provision of antibiotics in patients with persistent symptoms attributed to Lyme disease. Berende A, Nieuwenhuis L, Ter Hofstede HJM, Vos FJ, Vogelaar ML, Tromp M, van Middendorp H, Donders ART, Evers AWM, Kullberg BJ, Adang EMM. PLoS One. 2018 Apr 2;13(4):e0195260. doi: 10.1371/journal.pone.0195260. eCollection 2018. PMID: 29608590

The Financial Implications of a Well-Hidden and Ignored Chronic Lyme Disease Pandemic. Davidsson M. Healthcare (Basel). 2018 Feb 13;6(1). pii: E16. doi: 10.3390/healthcare6010016. PMID: 29438352

A systematic review and meta-analysis for the adverse effects, immunogenicity and efficacy of Lyme disease vaccines: Guiding novel vaccine development. Badawi A, Shering M, Rahman S, Lindsay LR. Can J Public Health. 2017 Apr 20;108(1):e62-e70. doi: 10.17269/cjph.108.5728. Review. PMID: 28425901

The cost of Lyme borreliosis. van den Wijngaard CC, Hofhuis A, Wong A, Harms MG, de Wit GA, Lugnér AK, Suijkerbuijk AWM, Mangen MJ, van Pelt W. Eur J Public Health. 2017 Jun 1;27(3):538-547. doi: 10.1093/eurpub/ckw269. PMID: 28444236

The HUMTICK study: protocol for a prospective cohort study on post-treatment Lymedisease syndrome and the disease and cost burden of Lyme borreliosis in Belgium. Geebelen L, Lernout T, Kabamba-Mukadi B, Saegeman V, Sprong H, Van Gucht S, Beutels P, Speybroeck N, Tersago K. Arch Public Health. 2017 Aug 7;75:42. doi: 10.1186/s13690-017-0202-z. eCollection 2017. PMID: 28794875

Hospitalized Children With Encephalitis in the United States: A Pediatric Health Information System Database Study. Bagdure D, Custer JW, Rao S, Messacar K, Dominguez S, Beam BW, Bhutta A. Pediatr Neurol. 2016 Aug;61:58-62. doi: 10.1016/j.pediatrneurol.2016.04.014. Epub 2016 May 6. PMID: 27353693

Testing practices and volume of non-Lyme tickborne diseases in the United States. Connally NP, Hinckley AF, Feldman KA, Kemperman M, Neitzel D, Wee SB, White JL, Mead PS, Meek JI. Ticks Tick Borne Dis. 2016 Feb;7(1):193-198. doi: 10.1016/j.ttbdis.2015.10.005. Epub 2015 Oct 30.

Health care costs, utilization and patterns of care following Lyme disease. Adrion ER, Aucott J, Lemke KW, Weiner JP. PLoS One. 2015 Feb 4;10(2):e0116767. doi: 10.1371/journal.pone.0116767. eCollection 2015. PMID: 25650808

The burden of Lyme borreliosis expressed in disability-adjusted life years. van den Wijngaard CC, Hofhuis A, Harms MG, Haagsma JA, Wong A, de Wit GA, Havelaar AH, Lugnér AK, Suijkerbuijk AW, van Pelt W. Eur J Public Health. 2015 Dec;25(6):1071-8. doi: 10.1093/eurpub/ckv091. Epub 2015 Jun 16 PMID: 26082446

Epidemiology and cost of hospital care for Lyme borreliosis in Germany: lessons from a health care utilization database analysis. Lohr B, Müller I, Mai M, Norris DE, Schöffski O, Hunfeld KP. Ticks Tick Borne Dis. 2015 Feb;6(1):56-62. doi: 10.1016/j.ttbdis.2014.09.004. Epub 2014 Oct 19. PMID: 25448420

Lyme borreliosis: reviewing potential vaccines, clinical aspects and health economics. Šmit R, Postma MJ. Expert Rev Vaccines. 2015;14(12):1549-61. doi: 10.1586/14760584.2015.1091313. Epub 2015 Sep 28. Review. PMID:26414102

Vaccines for tick-borne diseases and cost-effectiveness of vaccination: a public health challenge to reduce the diseases' burden. Šmit R, Postma MJ. Expert Rev Vaccines. 2016;15(1):5-7. doi: 10.1586/14760584.2016.1111142. Epub 2015 Nov 11. PMID: 26559456

Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)--design of a randomized controlled trial of prolonged antibiotic treatment in patients with persistent symptoms attributed to Lyme borreliosis. Berende A, ter Hofstede HJ, Donders AR, van Middendorp H, Kessels RP, Adang EM, Vos FJ, Evers AW, Kullberg BJ. BMC Infect Dis. 2014 Oct 16;14:543. doi: 10.1186/s12879-014-0543-y.

Lyme disease testing by large commercial laboratories in the United States. Hinckley AF, Connally NP, Meek JI, Johnson BJ, Kemperman MM, Feldman KA, White JL, Mead PS. Clin Infect Dis. 2014 Sep 1;59(5):676-81. doi: 10.1093/cid/ciu397. Epub 2014 May 30. PMID: 24879782

Empiric antibiotic treatment of erythema migrans-like skin lesions as a function of geography: a clinical and cost effectiveness modeling study. Lantos PM, Brinkerhoff RJ, Wormser GP, Clemen R. Vector Borne Zoonotic Dis. 2013 Dec;13(12):877-83. doi: 10.1089/vbz.2013.1365. Epub 2013 Oct 9. PMID: 24107201

Comparative cost-effectiveness of two-tiered testing strategies for serodiagnosis of lyme disease with noncutaneous manifestations. Wormser GP, Levin A, Soman S, Adenikinju O, Longo MV, Branda JA. J Clin Microbiol. 2013 Dec;51(12):4045-9. doi: 10.1128/JCM.01853-13. Epub 2013 Sep 25. PMID: 24068010

Evaluating frequency, diagnostic quality, and cost of Lyme borreliosis testing in Germany: a retrospective model analysis.Müller I, Freitag MH, Poggensee G, Scharnetzky E, Straube E, Schoerner Ch, Hlobil H, Hagedorn HJ, Stanek G, Schubert-Unkmeir A, Norris DE, Gensichen J, Hunfeld KP. Clin Dev Immunol. 2012;2012:595427. doi: 10.1155/2012/595427. Epub 2011 Dec 27. PMID: 22242037

Healthcare access and burden of care for patients with Lyme disease: a large United States survey. Johnson L, Aylward A, Stricker RB. Health Policy. 2011 Sep;102(1):64-71. doi: 10.1016/j.healthpol.2011.05.007. Epub 2011 Jun 14. PMID: 21676482

A safe and cost-effective approach to treating Lyme cardiac disease in an era of health care reform. Kim J, Beldner SJ, Jadonath R, Altman EJ. Pacing Clin Electrophysiol. 2011 Jun;34(6):666-9. doi: 10.1111/j.1540-8159.2011.03095.x. Epub 2011 Mar 31. No abstract available. PMID: 21453343

Neuroborreliosis--an epidemiological, clinical and healthcare cost study from an endemic area in the south-east of Sweden.Henningsson AJ, Malmvall BE, Ernerudh J, Matussek A, Forsberg P. Clin Microbiol Infect. 2010 Aug;16(8):1245-51. doi: 10.1111/j.1469-0691.2009.03059.x. Epub 2009 Sep 29. PMID: 19793326

Cost-effectiveness of peptide-antigen immunoassays for Lyme disease. Porwancher RB. J Infect Dis. 2004 May 15;189(10):1962; author reply 1962-4. No abstract available. PMID: 15122535

Lyme disease--what is the cost for Scotland? Joss AW, Davidson MM, Ho-Yen DO, Ludbrook A. Public Health. 2003 Jul;117(4):264-73. PMID: 12966749

Cost-effectiveness analysis of the Lyme disease vaccine. Hsia EC, Chung JB, Schwartz JS, Albert DA. Arthritis Rheum. 2002 Jun;46(6):1651-60. PMID: 12115198

Vaccination for Lyme disease: cost-effectiveness versus cost and value. Sigal LH. Arthritis Rheum. 2002 Jun;46(6):1439-42. Review. No abstract available. PMID: 12115172

The cost-effectiveness of vaccination against Lyme disease. Shadick NA, Liang MH, Phillips CB, Fossel K, Kuntz KM. Arch Intern Med. 2001 Feb 26;161(4):554-61. PMID: 11252114

The cost-effectiveness of vaccinating against Lyme disease. Prybylski D. Emerg Infect Dis. 1999 Sep-Oct;5(5):727-8. No abstract available. PMID: 10511535

Recommendations for the use of Lyme disease vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP) [No authors listed] MMWR Recomm Rep. 1999 Jun 4;48(RR-7):1-17, 21-5. Erratum in: MMWR Morb Mortal Wkly Rep 1999 Sep 24;48(37):833. PMID: 10371254

The cost effectiveness of vaccinating against Lyme disease. Meltzer MI, Dennis DT, Orloski KA. Emerg Infect Dis. 1999 May-Jun;5(3):321-8. PMID: 10341168

Tick bites and Lyme disease in an endemic setting: problematic use of serologic testing and prophylactic antibiotic therapy.Fix AD, Strickland GT, Grant J. JAMA. 1998 Jan 21;279(3):206-10. PMID: 9438740

Test-treatment strategies for patients suspected of having Lyme disease: a cost-effectiveness analysis. Nichol G, Dennis DT, Steere AC, Lightfoot R, Wells G, Shea B, Tugwell P. Ann Intern Med. 1998 Jan 1;128(1):37-48. PMID: 9424980

A cost-of-illness study of Lyme disease in the United States. Maes E, Lecomte P, Ray N. Clin Ther. 1998 Sep-Oct;20(5):993-1008; discussion 992. Erratum in: Clin Ther 1999 Feb;21(2):430. PMID: 9829450

Antibiotic therapy for Lyme disease in Maryland. Strickland GT, Caisley I, Woubeshet M, Israel E. Public Health Rep. 1994 Nov-Dec;109(6):745-9. PMID: 7800782

Empiric parenteral antibiotic treatment of patients with fibromyalgia and fatigue and a positive serologic result for Lyme disease. A cost-effectiveness analysis. Lightfoot RW Jr, Luft BJ, Rahn DW, Steere AC, Sigal LH, Zoschke DC, Gardner P, Britton MC, Kaufman RL. Ann Intern Med. 1993 Sep 15;119(6):503-9. PMID:8357117

[Cefuroximaxetil: Effective and Cost Effective, From Respiratory Tract Infections to Lyme Disease. Proceedings from the 18th International Congress of Chemotherapy. Stockholm, 27 June-2 July 1993]. [No authors listed] Fortschr Med Suppl. 1993;151:1-15. German. No abstract available. PMID: 7905849

Prevention of Lyme disease after tick bites. A cost-effectiveness analysis. Magid D, Schwartz B, Craft J, Schwartz JS. N Engl J Med. 1992 Aug 20;327(8):534-41. PMID: 1298217

J Infect Dis. 1997 Sep;176(3):819-21.

Utilization and cost of serologic tests for Lyme disease in Maryland.

Strickland GT, Karp AC, Mathews A, Peña CA.

Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.


To ascertain use of serologic tests for Lyme disease (LD) in Maryland, all laboratories registered with the State Health Department were surveyed. Results show that from 1992 to 1995, 17 laboratories performed 100,000 serologic tests costing $7.1 million on Maryland residents; 90% of these tests were EIAs. The proportion of positive EIAs increased from 3.4% in 1992 to approximately 7.0% in 1994 and 1995, and the percentage of positive second tests (Western blot, WB) fell from 7.9% to 5.0%-5.5%. The large number of EIAs performed in comparison with the low incidence of LD in the state results in a low predictive value of a positive EIA test. Therefore, the WB is indicated to confirm equivocal and positive EIA tests when characteristic clinical findings of LD are not present. The 30,000 tests for LD performed annually on Maryland residents at a cost of over $2 million in direct medical costs must be added to the public health burden of LD in this state.

Last Updated- July 2019

Lucy Barnes