DENVER — State lawmakers are considering legislation that would allow pharmacists to dispense HIV prevention medications without a provider prescription. Supporters say the move will help decrease infection rates by providing people with easier access to drugs that can prevent HIV.
The Food and Drug Administration approved Truvada for HIV prevention in 2012, but getting the drug to people when they need it is still a concern for pharmacists.
Currently, Truvada and Descovy — when taken once a day to prevent an HIV infection — is called PrEP (pre-exposure prophylaxis).
Antiretroviral treatment is called PEP (post-exposure prophylaxis) when taken as directed to prevent infection within 72 hours after HIV exposure.
A provider must prescribe the PrEP and PEP medications in Colorado.
“We want to make sure there are no new infections,” said One Colorado executive director Daniel Ramos.
One Colorado is an advocacy group for LGBTQ Coloradans and their families. The organization is lobbying in support of House Bill 20-1061 to allow pharmacists to dispense PrEP and PEP on the spot. Time is a huge factor for someone who has been exposed.
“When you’re having someone who has an exposure late on a Friday night … there’s just not the availability of prescribers to get them treatment in that short tight window,” said Scales Pharmacy owner Dan Scales.
Scales Pharmacy focuses on HIV care and prevention. Scales is working to build support for the bill — something he’s been pushing for about five years.
“This is just really about access to medication and not trying to take away the services that the physicians and the nurse practitioners … can do,” Scales said.
In some capacity, easier access to PrEP and PEP has already been approved in California, Iowa and Washington. Colorado could be next. If approved, new training would be required for pharmacists.
“The hope is enough pharmacies will participate in the training programs to really understand how to do this well,” Scales said.
To dispense the prevention medications without prescriptions, pharmacists must first determine a patient is HIV negative. For PrEP treatment, blood draws are needed on a regular basis to ensure kidney health. Scales says the goal is for a patient to be monitored through a pharmacy full-time.
The bill — introduced on Jan. 8 — does not have visible opposition yet. The Colorado Medical Society routinely objects to bills taking control away from doctors. That society says it is still reviewing the legislation.
“This is not a partisan issue,” Ramos said. “It impacts us as a state and us as a country.”
If passed and signed by Gov. Jared Polis, people could start going straight to pharmacies for PrEP and PEP within a year.
The curriculum used to train Colorado pharmacists has not yet been developed. Scales would be part of that curriculum development along with the Colorado Pharmacists Society.