Pharmacists in California can now dispense PrEP for HIV prevention without a prescription

Pharmacists in California can now dispense PrEP for HIV prevention without a prescription
Vicky Wongbi, PharmD, Community University Health Care Center (CUHCC)

Legislation signed by Governor Gavin Newson in September 2019 marks a milestone in the health of Californians. California is the first state in the country to authorize pharmacists to dispense Human Immunodeficiency Virus (HIV) pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) without a prescription. This was an effort, as seen by proponents in removing the barriers that exist in obtaining PrEP and PEP, which are highly efficacious in the prevention of the spread of HIV infection. PrEP is a way for people who do not have HIV but who are at very high risk of getting HIV to prevent HIV infection by taking an antiretroviral pill every day.PEP means taking antiretroviral medicines after being potentially exposed to HIV to prevent becoming infected. PEP is used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV.

Like most new laws, this advance was not without concerns. The California Medical Association originally opposed this bill, citing concerns for inappropriate use and lack of monitoring. To address this concern, the legislature limits the number of PrEP pills a patient can get without a prescription to a maximum of 60 days. In conjunction, this legislation prohibits insurance companies from requiring a PA to receive PrEP. This will further eliminate some of the barriers individuals may face in obtaining PrEP medication.

This legislation is evermore expanding the scope of practice for pharmacists. Pharmacists are considered valuable members of the healthcare team and by expanding their role, certain medications can become more accessible to patients who have trouble obtaining medications. For example, pharmacists in many states are already dispensing other medications without a prescription, including naloxone and emergency contraceptives. This expansion of the profession promotes patient access to medications and healthcare.

References:

  1. The Associated Press.. California OKs Prescription-Free PrEP for HIV Prevention. NBC News.https://www.nbcnews.com/feature/nbc-out/california-oks-prescription-free.... Published October 9, 2019. Accessed November 8, 2019.