California law enables pharmacists to dispense PrEP and PEP without a prescription

A newly enacted California law is putting pharmacists on the front lines of HIV prevention.

California Governor Gavin Newsom on Monday signed SB 159, which authorizes pharmacists to furnish pre-exposure prophylaxis, or PrEP, and post-exposure prophylaxis, or PEP, to patients without a physician prescription. PrEP is a once-daily pill for HIV-negative people that reduces the risk of infection by up to 99%, and PEP is a 28-day preventive course for people who may have been exposed to HIV.

The law, which goes into effect on Jan. 1, 2020  is the first law in the nation to authorize pharmacists to furnish PrEP and PEP without a physician prescription.

The bill, authored by Sen. Scott Wiener, D-San Francisco, and Asm. Todd Gloria, D-San Diego, was written as a way to expand access to life-saving HIV prevention medication.

“To end new HIV infections, we must dramatically expand access to PrEP and PEP, yet far too many Californians who need these drugs struggle to access them. SB 159 will keep more Californians HIV-negative and help us end this epidemic," Wiener said. "I applaud Governor Newsom for signing this first-in-the-nation legislation to remove barriers to these critical HIV-preventatives,” said Wiener.

SB 159 is supported by a broad coalition and sponsored by Equality California, San Francisco AIDS Foundation, APLA Health, Los Angeles LGBT Center, the California Pharmacists Association, and California Society of Health-System Pharmacists. Pharmacists already are authorized to furnish emergency contraceptives and the birth control pill without a physician prescription

Regarding PrEP, pharmacists will be able to provide a 60-day supply, after which the patient will need to see a physician to continue. The legislation also prohibits insurance companies from requiring patients to obtain prior authorization before using their insurance benefits to obtain PrEP or PEP.

“Use of PrEP and PEP in California remain far too low, particularly in communities most affected by HIV,” said APLA Health CEO Craig Thompson. “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.”

“We cannot end the HIV epidemic until we ensure that all Californians have access to PrEP and PEP,” said APLA health director of HIV Prevention Services Terry Smith. “SB 159 will help to increase awareness of PrEP and PEP, make it easier for people to access these medications from trusted community pharmacists and prevent insurance delays that can put people at greater risk of acquiring HIV.”

Equality California, the nation’s largest statewide LGBTQ civil rights organization and a co-sponsor of SB 159, released the following statement from executive director Rick Zbur:

“The HIV epidemic is still a pressing issue today — especially for LGBTQ people of color and folks in rural communities. But with Governor Newsom’s signature, SB 159 is a giant step forward in getting to zero transmissions, zero deaths and zero stigma. By increasing access to life-saving HIV prevention medication, California — unlike the White House — is leading the country in the race to eliminate HIV. We owe a debt of gratitude to Senator Wiener and Assemblymember Gloria for their leadership and tireless advocacy.”