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House bill 1326 is an act related to the use of long-term antibiotics for the treatment of Lyme disease.
The bill authorizes licensed physicians to prescribe long-term antibiotics for therapeutic purposes to patients diagnosed with Lyme.
HB 1326 protects physicians' rights to determine the most appropriate treatment protocol for their patients based on individualized clinical evaluation.
New Hampshire currently has the highest incidence of Lyme disease in the United States.
Source: Centers for Disease Control, 2009
Rockingham, Strafford and Hillsborough counties report the highest number of Lyme disease cases in the state.
In 2007, more than 50 percent of the ticks tested in these counties were infected with the bacteria that causes Lyme, putting residents in those counties at greater risk of contracting Lyme.
Source: NH Dept. of Health and Human Services
Many New Hampshire residents suffer on-going neurological and physical effects from Lyme disease that make it difficult or impossible for them to work, drive or continue life as they once knew it.
The long-term cost of Lyme disease to families, school systems, the health care system and the economy is astounding.
According to a study published in 1993 in Contingencies, an actuarial trade publication, the average treatment and diagnosis and lost wages related to Lyme disease was $61,688 per year per patient. Source: Lyme Disease Association
Children are in the highest risk category for contracting the disease, representing 25 percent of the total reported cases.
A CDC study indicates that children with chronic Lyme in one state have a median school absence of 140 days.
Columbia University reports that children suffering from chronic Lyme see significant drops in IQ as a result.
Scores of New Hampshire students diagnosed with Lyme are currently on Section 504-plans and IEPs to help them maintain their school work despite lengthy absences.
Many miss months and years of school. Source: Centers for Disease Control, Columbia University, NH Testimony
Background
There are currently two standards of treatment for Lyme disease, though New Hampshire's Health and Human Services' website links to only one.
The Infectious Disease Society of America (IDSA) characterizes Lyme disease as primarily acute and treated successfully in the vast majority of cases with, at most, a few weeks of antibiotics.
The International Lyme and Associated Diseases Society (ILADS) asserts that Lyme can be chronic and its doctors determine the duration of treatment based on individualized clinical evaluation.
Both ILADS and IDSA viewpoints are reflected in peer reviewed ``evidence-based'' guidelines.
When more than one standard of care exists, the critical question becomes who decides the appropriate course of treatment for the patient.
The New Hampshire Department of Health and Human Services only links to the IDSA guidelines, limiting public healthcare choice to one option. Under the medical ethical principle of autonomy, the treatment decision belongs to the patient.
The American Medical Association (AMA) requires that the physician disclose and discuss with the patient not only the risks and benefits of the proposed treatment, but also the risks and benefits of available alternative treatments.
A challenging political climate has translated into medical board actions against physicians nationwide for prescribing long-term Lyme disease treatment (ILADS vs IDSA guidelines).
This has had a chilling effect on the number of Lyme-literate physicians who are trained and/or are willing to treat this complicated disease. As a result, New Hampshire residents--and those around the country--get sicker.
If Lyme disease is left untreated or not treated aggressively, it can have far-reaching implications--not only for patients' health, but also for healthcare costs, disability compensation and worker productivity.
These costs far exceed the expense of paying for therapeutic antibiotics to treat the infection and its symptoms.
Many of New Hampshire's sickest residents travel across state borders to find physicians who are able and willing to treat Lyme disease based on individualized clinical evaluation.
New Hampshire families need to ensure that physicians, insurers, patients and governmental agencies understand that two treatment approaches exist, and that physicians should be free to provide long-term antibiotic treatment when deemed clinically necessary.
House Bill 1326 does not legislate treatment. This bill contains language that will protect New Hampshire licensed Lyme-treating physicians from prosecution by the New Hampshire Board of Medicine solely on the basis of a clinical diagnosis and/or treatment of long-term Lyme disease.
It allows a physician to prescribe, administer or dispense long-term antibiotic therapy to patients clinically diagnosed with Lyme or tick-borne diseases.
It specifies that the Board of Medicine shall not initiate disciplinary action against a licensed physician solely for prescribing, administering or dispensing long-term antibiotic therapy to a patient clinically diagnosed with Lyme.
The single most important aspect of this legislation is that a physician can treat with antibiotics for more than four weeks without the fear of disciplinary action; a treatment that has been approved by ILADS physicians and will provide necessary care for scores of New Hampshire residents afflicted with Lyme disease.
This law will be a relief to New Hampshire families who will finally be able to receive care in the Granite State; it offers hope that more physicians who are knowledgeable about Lyme disease will be encouraged to practice within the state of New Hampshire.
Please support New Hampshire House Bill 1326. We thank you in advance for your willingness to give thoughtful consideration to this serious health concern that affects so many of your constituents.
The New Hampshire Lyme Legislation Committee
Representative Gary Daniels, Hillsborough 6, co-sponsor
Representative Carol Vita, Strafford 3, co-sponsor
-------------------- "To Dream The Impossible Dream" Man of La Mancha Posts: 2638 | From New Hampshire | Registered: Oct 2006
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