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Antitrust Scrutiny of Lyme Guidelines

By Marcia Coyle
April 27, 2007

A state attorney general's novel investigation into the development of treatment guidelines for Lyme disease should put health care and professional medical societies on alert to a possible new front in antitrust litigation, say antitrust lawyers and others. Connecticut Attorney General Richard Blumenthal late last year issued a subpoena to the Infectious Diseases Society of America (IDSA) for information on how it established its latest guidelines on the diagnosis and treatment of Lyme disease ' guidelines that were subsequently adopted by the Centers for Disease Control and Prevention (CDC). While IDSA has responded to the subpoena, Blumenthal said his investigation is ongoing. 'We've reached no conclusion,' he said.

And although some have characterized it as novel or unprecedented, Blumenthal said the inquiry involves 'basic antitrust principles applied to medical care.' The antitrust implications here, he explained, are the restraint on doctor and patient choices for treatment of the disease because of the guidelines, and particularly their effect on insurance companies' willingness to pay for treatment.

Nineteen members of Congress recently sent a letter to the CDC requesting that agency to review the IDSA guidelines, which they said have 'the potential to effectively shut down' all treatment of chronic Lyme disease. The IDSA reacted on Jan. 17 with a letter to Congress explaining its guideline process.

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