Governor Gavin Newsom signed into law groundbreaking legislation to increase access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for HIV prevention. Senate Bill 159, authored by Senator Scott Wiener (D-San Francisco), is the first law of its kind in the nation to authorize pharmacists to furnish PrEP and PEP without a physician prescription. The legislation also prohibits insurance companies from requiring patients to obtain prior authorization before using their insurance benefits to obtain these critical HIV prevention medications.
Malinda Wheeler, NP, Owner/Director, Forensic Nurse Specialists, Long Beach had long recognized the problem affecting sexual assault victims, and brought SB 159 to the attention of the CALSAFE Board. CALSAFE contacted Senator Scott Wiener, wrote a letter of support, and informed the California Pharmacists Association about their collegial recognition and support for the bill.
SB 159, 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.
PrEP and PEP are critical tools to ending the HIV epidemic in California and across the country. PrEP is a once-daily pill for HIV-negative people that almost entirely eliminates the risk of acquiring HIV. PEP is medication that a person takes after a potential exposure in order to prevent the virus from taking hold. PEP must be started within 72 hours and continued for 28 days to prevent HIV acquisition. With the passage of SB 159, pharmacists will be able to provide a 60-day supply of PrEP, after which the patient will need to see a physician for ongoing PrEP prescriptions. For PEP, pharmacists will be able to furnish the full 28-day medication regimen. Prior to dispensing PrEP and PEP, pharmacists will be required to receive appropriate training and provide necessary testing and counseling consistent with guidelines from the Centers for Disease Control and Prevention. SB 159 directs the California Board of Pharmacy to adopt regulations to implement the legislation by July 1, 2020.
PrEP and PEP are covered by most private insurance plans, as well as by Medicare and Medi-Cal. For individuals who need help paying for PrEP and PEP, California recently launched a statewide PrEP Assistance Program (PrEP-AP). The program is run by the California Office of AIDS and provides financial assistance with PrEP medication and related medical expenses.
SB 159 was co-sponsored by APLA Health, San Francisco AIDS Foundation, Los Angeles LGBT Center, Equality California, and the California Pharmacists Association. SB 159 was co-authored by Senators Steven Glazer (D-Orinda) and Jeffrey Stone (R-La Quinta), and Assembly members Todd Gloria (D-San Diego), Mike Gipson (D-Carson), Lorena Gonzalez (D-San Diego), and David Chiu (D-San Francisco).
For full text of the bill, please click here.