Testimony: HB 798
On September 14, 2007, the following testimony was submitted to the Pennsylvania House of Representatives’ Health and Human Services Committee. The testimony was written by Mark A. Piasio, MD, MBA, President of the Pennsylvania Medical Society.
The Pennsylvania Medical Society wishes to thank Chairman Oliver and the members of the Pennsylvania House of Representatives Health and Human Services Committee for allowing our organization to submit the following on House Bill 798.
In a nutshell, HB 798 attempts to come to the aid of those with Lyme Disease. If passed, this bill would create the Lyme and Related Tick-Bourne Education, Prevention, and Treatment Act.
The desire to help these patients is well intended; however, as the bill is written, it may actually be harmful to those with Lyme Disease, and thus, the Pennsylvania Medical Society opposes it.
Within the bill is language that would statutorily endorse the use of long-term antibiotic therapy for the treatment of Lyme Disease.
Unfortunately, research on this type of treatment is not proven and the overwhelming consensus of the medical community does not agree with it. Please consider the following two excerpts from an article entitled “Inaccurate Information About Lyme Disease On The Internet,” published in The Pediatric Infectious Disease Journal, Volume 23, Number 12, December 2004:
Persistent B. burgdorferi infection in patients with chronic Lyme encephalitis has not been demonstrated. Chronic subjective problems such as fatigue, headache, irritability, poor concentration, poor memory, arthralgias or myalgias do not indicate chronic Lyme disease. Some of these subjective symptoms may occur after Lyme disease and may be termed “post-Lyme syndrome.” These symptoms may be unrelated to Lyme disease and have not been shown to respond to antibiotic treatment. The Infectious Diseases Society of America practice guidelines do not include treatment options for chronic Lyme disease because persistent infection has not been demonstrated.
Combinations of antibiotics, prolonged courses of antibiotics or unusually high antibiotic doses should not be used to treat Lyme disease, because they may be harmful and have not been shown to be more effective than standard therapy.
Information from the Centers for Disease Control and Prevention’s Division of Vector-Bourne Infectious Diseases indicates that while patients treated with antibiotics in the early stages of the infection usually recover and a few patients may benefit from a second 4-week course of therapy, “longer courses of antibiotic treatment have not been shown to be beneficial and have been linked to serious complications, including death.”1
So, up front, if we want to do what’s best for the patient, we better be sure that we prescribe the right treatment that’s been clearly proven. Until then, this bill holds great potential of putting patients at risk.
Furthermore, legislative attempts to practice medicine should be avoided. The medical community must have the flexibility to prescribe treatments as new medications and procedures are discovered and then proven. Dictating medical treatment plans through legislation for Lyme Disease or any other disease will only slow down appropriate newer protocols to patients as physicians and other providers will have their hands tied by previously passed legislation.
Let’s not put a wedge between patients and physicians through legislation dictating medical procedures that eventually will be outdated. Physicians need to act in the best interest of their patients without barriers.
On a more positive note, there is one element within HB 798 that the Pennsylvania Medical Society would support with some changes. The bill calls for the establishment of a task force focused on education and prevention of Lyme Disease. The Pennsylvania Medical Society applauds that section and would welcome being a resource to help educate both the public and physicians.
However, we are concerned with the provision that requires the panel’s two physicians to be members of the International Lyme and Associated Diseases Society (ILADS). To our knowledge this is the only group that supports the use of long-term antibiotic therapy for the treatment of Lyme Disease. It is also an organization that, according to the above-cited article in The Pediatric Infectious Disease Journal, provides inaccurate information about Lyme disease on its website in five of the eight categories examined. In order to assure that the majority viewpoint is adequately represented, we recommend that the task force include at least three physicians, with no more than one affiliated with ILADS.
In conclusion, the Pennsylvania Medical Society looks forward to working with the House Health and Human Services Committee to shape good legislation to help Lyme Disease patients.
Thank you.
1 CDC, August 31, 2007
Last Updated: 11/14/2007