The state of California now allows pharmacists to dispense HIV prevention drugs without the requirement for a prescription. This new arrangement will begin in the next year thanks to the bill signed into law by Governor Gavin Newsom.
This iconic setup is the first of its kind and is a huge win for the entire community. Not only is this about better access, but also about safe sexual health awareness. It is difficult to tackle HIV. It requires a certain amount of mental strength and emotional support to manage its symptoms. With increased accessibility, one can also hope that we converse more and remove the stigma around HIV and its patients.
The same thought backs Senate Bill 159
Obtaining a prescription can be a hurdle for many people. With the passing of the bill, pharmacists receive the authority to provide at least a 30-day supply. Which can extend to a 60-day supply of the drugs. According to a press release, these drugs can be used for pre-exposure prophylaxis or PrEP. And remember, without a prescription. The bill also allows the pharmacists to supply the complete course of drugs post-exposure to prophylaxis, or PEP.
But this is not the only level we should discuss PrEP and PEP. As a part of sex education, we only cover the topics of protection, safe sex habits, STDs, and puberty. But we rarely address the aftermath of any of these probabilities.
Who Should Use PrEP and PEP, and When?
PrEP drugs are to be taken on a daily basis. This is for people who are HIV-negative and to prevent infection from the virus in case of exposure. Gilead Sciences came out with two drugs. Truvada and Descovy. These are approved by the Food and Drug Administration as PrEP drugs. Later this year, a generic alternative to Truvada is expected to be available.
PEP is administered to prevent the HIV infection post-exposure to the virus. In this case, drugs have to be taken within the first 72 hours post-exposure and should be taken for 28 days. A combination of Truvada and Isentress are the recommended drugs for PEP. But there are other alternatives available for PEP.
There’s More To The Bill
The bill affects the usage and access to drugs on different levels. The bill has also prohibited insurance companies from subjecting anti-HIV drugs to prior authorisation. This includes the drugs used for PrEP and PEP, before ‘Step Therapy’. This requires the patient to opt for cheaper alternatives as against the prescribed drugs. An exception would be made for an equivalent drug if available.
Easy to access can sometimes mean the misuse of drugs.
So, the bill also requires pharmacists to complete a California State Board of Pharmacy approved training program. This is only if they want to dispense PrEP and PEP drugs without a prescription. The pharmacists should determine if a patient meets the clinical criteria. The criteria set according to the established federal government guidelines.
According to the California Health Benefits Review Program, the estimation is that the new law will push the usage of PrEP and PEP by 2 percent in its first year. As a consequence this would prevent 25 new cases of HIV.
Rural parts of the states, as well as the marginal population, still have limited access to the PrEP and PEP drugs. According to Equality California, Senate Bill 159 will also aid in the improvement of this situation.
Executive Director Rick Zbur said in the press release that “The HIV epidemic is still a pressing issue today — especially for LGBTQ people of color and folks in rural communities,” He went onto add,
“But with Governor Newsom’s signature, SB 159 is a giant step forward in getting to zero transmissions, zero deaths, and zero stigmas.
He also said that the increase in access to lifesaving HIV prevention medication, the state of California leads in the country in the race to eliminate HIV. He also thanked Senator [Scott] Wiener and Assemblymember [Todd] Gloria who were lead authors of the bill for their leadership and tireless advocacy.
Co-sponsoring the Senate Bill 159
Equality California, the San Francisco AIDS Foundation, the Los Angeles LGBT Center, APLA Health, and the California Pharmacists Association co-sponsored the bill. Apart from the lead authors, it was authored by Sens. Steven Glazer and Jeffrey Stone, and Assemblymembers Mike Gipson and David Chiu. The bill successfully passed both chambers of the legislature with bipartisan and nearly unanimous support.
APLA Health CEO Craig E. Thompson said in a press release from his organization, “Use of PrEP and PEP in California remain far too low, particularly in communities most affected by HIV,” and also said
“SB 159, which passed the California Legislature with overwhelming bipartisan support, will increase the places where people can access these medications, increase the number of healthcare professionals who can provide them and remove onerous and unnecessary insurance barriers. We applaud Governor Newsom for signing SB 159 into law.”
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https://www.theguardian.com/us-news/2019/oct/07/california-law-hiv-prevention-pills-prescription-gavin-newsom https://www.desertsun.com/story/news/politics/2019/10/07/can-you-get-prep-pep-without-prescription-yes-in-california/3903793002/ https://www.advocate.com/health/2019/10/07/california-makes-prep-and-pep-available-without-prescription