Pharmacists in California authorized to dispense HIV prevention meds without prescription

California became the first state to authorize pharmacists to dispense HIV prevention medications, including both pre-exposure prophylaxis (PrEP) and postexposure prophylaxis (PEP), without a physician’s prescription. The groundbreaking legislation was made official on October 7 after Gov. Gavin Newsom signed into law SB 159.

Under the new law, patients will be able to access PrEP medications at their local community pharmacies without prescriptions. These PrEP medications will include emtricitabine plus tenofovir disoproxil fumarate (Truvada—Gilead) and emtricitabine plus tenofovir alafenamide (Descovy—Gilead). PEP medications, such as Truvada with either raltegravir (Isentress—Merck Sharp Dohme) or dolutegravir (Tivicay—ViiV Healthcare), will also be available without prescriptions. PrEP meds without a prescription will be limited to a 60-day supply.

Proponents of the new law say that it will greatly improve access to the HIV prevention medications, decrease the spread of infection, and help reduce the stigma surrounding the drugs, especially among minorities and in rural communities. According to the California Health Benefits Review Program, nearly 30,000 people in California currently use PrEP, and 6,000 use PEP.

“Moving PrEP and PEP out of the clinic and into the community and allowing a pharmacist to dispense them without a prescription is a good step forward,” said Carlos del Rio, MD, of New England Journal of Medicine Journal Watch Infectious Diseases, in a statement. “However, we need to be sure that people are tested for HIV and confirmed to be negative before they start PrEP in order to avoid giving the medication to someone who is already infected. For PEP, we also need to conduct testing, but drugs can be started without waiting for results because it is a fully suppressive regimen that is given.”