P. Travis Harker MD | Oppose HB1734

Dear Committee members, As a practicing family physician I oppose HB 1734 for several reasons: 1. More information needed: HB 701 was just signed into law last year and we need to better understand how it is working for patients with terminal illnesses before expanding access to experimental drugs to chronic medical conditions. This expansion would potentially expose a very large group of people in NH to drugs that are not fully tested and may lead to severe side effects or harm. 2. Uncertain efficacy: I am concerned that many patients may overestimate hope effective an experimental drug may be. Conducting rigorous research to obtain statistically significant results is the purpose of our drug approval process. Increasing access to untested drugs may leave patients with the impression that we know they are effective even in the absence of credible evidence. 3. Safety: I am concerned about the safety of these investigational drugs as they have not been adequately studied as they have only passed early testing standards. More research is needed to ensure safety so that patients can make truly informed decisions about these medications. 3. Research integrity: Opening up access to experimental untested drugs will undermine the integrity of research by introducing uncertainty in the results of the clinical trials. Individual anecdotes can be equity powerful but individual stories are insufficient to determine if a drug will be effective across larger populations. You might imagine that for those who see improvements who use the drug will say the drug worked for them while those who do not improve will conclude the medication is not effective. For any individuals with any drug, we know that results may vary and we rely on high quality science to determine if they are indeed are effective or not. Having people share individual anecdotes about their individual experience may impact future patients’ confidence in high quality research. Please oppose HB 1734 Sincerely, P. Travis Harker MD, MPH