Health: Senate Bill Would Make PrEP And PEP Over-The-Counter Drugs

Image credit: NIAID

PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) have been life-changing for members of the community, and if a bill in the California Senate gets passed, it could change the lives of even more people.

According to a report by Capitol Public Radio, a bill authored by San Francisco Senator Scott Wiener and co-authored by San Diego Assemblyman Todd Gloria would make limited amounts of PrEP and PEP available over the counter.

PrEP is a treatment system that prevents HIV infection through a pill taken once a day. PEP, on the other hand, is a course of HIV medications taken within 72 hours after possible exposure. Both PrEP and PEP require prescriptions and sometimes even approval from insurance companies before doctors can even write the prescriptions. If the bill is passed, patients no longer need those requirements.

If the bill becomes law in California, patients will only need to be tested for HIV a week before they plan on purchasing PrEP. Pharmacists are required to inform them of the possible side effects, as well as to inform the patient’s primary care provider. Patients can also get a 30-day supply of the treatment.

The bill is yet another step in making PrEP and PEP available to the people who need them most. Earlier this year, the Centers for Disease Control and Prevention partnered with pharmaceutical company Gilead to make 2.4 million bottles of Truvada available to them over the next 11 years. Teva Pharmaceutical is also set to release a generic version of Truvada in 2020. Just two months ago, the United States Prevention Services Task Force (USPSTF) gave PrEP a Grade A recommendation, meaning private insurers are now required by law to pay for PrEP.

Adam4Adam blog readers, especially the ones living in California, how do you feel about this bill? Share your thoughts and opinions with us in the comments below!

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  1. Nathan

    Nathan writes:

    I applaud the distinct reality that PrEP & PEP will be available over-the-counter.

    However, as seemingly always, it will remove a certain responsibility to the sexually-active, to take personal responsibility for their sexual activities.

    Preventing one, distinct, socially-transmitted-disease, is admirable, however, it encourages the continued sexual practices of other socially-transmitted-diseases; it is the “proverbial” catch-22: prevent one thing but, either, encourage or lessen the realities of another thing.

    The problem still remains that the responsibility of a sexually-active person remains and is to be noted and respected.

    Certainly, there will be those who will continue their responsibilities to themselves and to others, but, those who haven’t or won’t, will still remain irresponsible and continue the trend.

    Ultimately, it remains: “of-the-people”; “by-the-people”; and “for-the-people.” Such is the cornerstone of Democracy ———->responsibility.

    • Barry-NJ

      “Preventing one, distinct, socially-transmitted-disease, is admirable, however, it encourages the continued sexual practices of other socially-transmitted-diseases; … ”

      That statement presumes that all STIs are “equal”. But, in reality, a small uptick in Gonorrhea is a small price to pay if the result is a significant decrease in HIV.

      You are also making the assumption that before they went on PrEP, the guys were using condoms. But, many weren’t. They were just going without any protection whatsoever.

      • Nathan


        Most Americans did not use condoms back-in-the-day; neither in Vietnam nor America. American soldiers were warned of a extremely virulent “Gonorrhea” which was resistant to virtually any anitbiotic, then, available.

        Many American Soldiers had their “Urinary Meatus” eaten away by this “Gonorrhea” and had to have a part of the penises amputated.

  2. Jer

    I think this would’ve been amazing years ago as an over the counter medication offered I think that it would be really great but I sort of I’m concerned that is it going to enable game in to really wore out because of all the open relationships and nonsense that they think that there like entitled to do getting around getting it in with multiple days and again commenting on any topic related to this this is the reason esp HIV and (other STDs) have spread like they have since the early 80s
    But it is a really great weapon in our arsenal against HIV so I do hope that it is something that happens and I hope minute and general more responsible than I have been in the past especially this idea of getting around getting it in there open relationships they’re married but play on the other side so hopefully it’ll make a bit more responsibility so it doesn’t ruin somebody else’s life

  3. Crazysexycool

    I live in Cali and am excited that the passing of this bill is becoming an reality! Many ppl can’t afford PrEP/PEP.
    A excellent move in the right direction!!

    • Barry-NJ

      I wouldn’t expect any sudden price reductions. Why would Gilead give up any profits? In fact, as others have pointed out, there may be issues because many insurance companies don’t cover OTC medications (although, some do if the medication is obtained with a prescription).

      Hopefully, the real advantages will come by 2021. Six months after the introduction of the first generic (in 2020), other generic houses can start producing generic Truvada, too. That’s when we’ll see significant price reductions.

    • Joe

      I agree. So, even if Gilead lowers the price a little bit, the insurance companies are off the hook. For an example, look at antacids like Zantac, which used to be available by presription.

      • Tx

        Exactly. And a source of federal funding for the uninsured (340b) would disappear too if the drug is over the counter. Really bad idea.

  4. Edward

    There is a reason we do frequent blood tests while on these meds. Making prep OTC is a political talking point, not a medically sound decision.

    Not to mention resistances that develop from starting / stopping medication, etc etc etc.

    This is politics, not medicine. People won’t be better served by this.

    • Barry-NJ

      “Not to mention resistances that develop from starting / stopping medication, etc etc etc.”

      PrEP is taken by people without HIV. There is no underlying disease that can gain resistance. Of course, there are risks if someone stops PrEP and then has sex, but that’s a different issue. If I abstain from sex, there’s no problem with starting/stopping PrEP as often as I want.

      And, making PEP available without a prescription is a great advance. There are undoubtedly many guys who are put off by the requirement to go into an ER or try to get an appointment with their MD (if they even have one) within 72 hours in order to receive PEP and just don’t get it. Now, PEP will be more like Plan B.

  5. Santino

    For the gay men that only think with their “smaller head” be Warned. READ the side affects from Truvada. Listen to the TV ads WARNINGS of possible SIDE EFFECTS – “Bone Breakage” – sounds less harmful than saying AVN -Avascular Nicrosis -a Hideous side effect that restricts blood flow to the Bone Joints and they CRUMBLE. ‘Kidney problems” sounds less SCARY than KIDNEY DISEASE. They are NOT pitching PREP to young STRAIGHT people just as Sexually Active.
    Gay people are still considered to be of Less Value than Hetros and make great GUINEA PIGS.
    Making this drug available over the counter is NOT doing you a Favor ! all it is doing is RELEASING INSURANCE COMPANIES from PAYING for it.
    The Absolute Horror of this story is you are going to have gay men in their late 30’s and 40’s that have taken Truvada for several years they WILL develop KIDNEY DISEASE and have JOINT REPLACEMENTS, but unlike HIV / Aids patients they WILL NOT have any LEGAL PROTECTION because they will be Negative. This is going to be a HUGE BLOW UP in the Medical / Insurance Industries in the coming years.
    Final note- for those ready to label this as HATE message – I have had 3 Hip Surgeries (2 Replacements and I now have Kidney Disease, I don’t want ANYONE to SUFFER what I have.

    • Dave

      I’ve taken PrEP for 10 years and have nothing of what you mention. Of course if you eat McDonalds and drink Pepsi all day long, it’s possible, but I eat very well, take supplements of vitamins, do lots of sports and gym, I dont drink or take drugs and my health is great! I guess it’s all about what you put the blame on.

      • Lamar

        Diet does have a lot to do with over-all health. However, Dave, Santino does raise some valid points, I have myself, read about-heard about these side-effects that men are suffering from of their meds. I keep saying, “keep yourself out of the hands of these pharms in the first damn-place” it’s like being gang-banged over and over again, the pharms are just passing you along to each other, getting wealthier all the time, ’cause folks can’t-won’t glove-up, use more discretion-using better judgement…

  6. Alan H.

    This bill if passed will be wonderful especially to those who do not have my medical insurance. Gilead should be able to provide free PrEP based on the company’s profits.

    • Joe

      Yes. When a med goes over-the-counter (OTC), the insurance companies no longer have to pay for it. I doubt Gilead will give out the brand version for free. The good news is that the generic version will be available soon… and that usually results in lower prices from free market competition.

  7. glenn

    you know this is not a good thing, some people dont have the brains they were born with. this would allow the manufacturers to charge whatever they wanted because they would not be under the atf rules anymore because they would be otc products. Your insurance would not pay for them and they would be so expensive on the desperate could afford them

  8. Brad

    Ummm, okay. Can we have funding for education on how this works so at-risk persons understand? Is this going to be made available in Brazil and countries in Africa so that those suffering and dying are protected? Making it available OTC only in the US is a step, but not yet enough. Signed, an educator and health professional (gay and HIV neg, but still concerned about all of humanity)

    • Barry-NJ

      The headline is misleading. They’re talking about the California Senate, not the federal senate, so the OTC change would only be in that state unless other states follow their lead (which I expect will happen).

      If Brazil and other countries wish to make the drug OTC, that is up to them. PrEP is already remarkably cheap in many developing countries.

  9. Richard Hoehn

    Finally. Don’t want to “soap box” this too much, but think it’s a good idea…and when are we going to get universal health care? “Cause everybody just loves their insurance companies, right?

  10. Etrit

    Ugh, such a BAD idea. Truvada is such a horrible medication! I’ve been on it for over 6 years. I’m pretty sure I have major bone density loss and kidney issues. I know people that have been on it for less, have been tested for BOTH and have confirmed issues in both realms.

    Gilead is being sued in multiple different cases for both downplaying the potential side effects AND for withholding BETTER less harmful medications willfully so they can milk the cash cow that is Truvada.

    We need to focus on suing Gilead and forcing them to make the better medications OTC instead of Truvada.

    • Barry-NJ

      You’re “pretty sure”? You’re making assertions about the side effects of the medication and you don’t even know if you’ve been affected? And, if you’re so concerned, why are you apparently still on it?

  11. LEO

    The question is HOW MUCH will OTC ( over the counter ) Prep and Pep cost? My prediction is Astronomical, and unaffordable for most California’s citizens.

  12. Seth

    My concern about a bill like this, if it’s even a real thing, is that prescription drug benefits do not cover over-the-counter medications. Unless the bill addresses that issue, an OTC version of Gilead’s Truvada will likely cost around $600-1,000. If and when Teva comes out with a generic, and I believe 2020 is a highly optimistic outlook on that, they’ll be allowed to charge whatever they want for it. I don’t think people ought to be treating themselves acutely, on a month-by-month basis, for HIV prevention, and the medication(s) used for this should remain on prescription so it is covered by insurance & can be monitored by a healthcare provider.

  13. hardtopftl

    my insurance company (the one with the big rock) is self-insured and can pick and choose what meds it pays for. this year they are using a new mail-order pharmacy and I am having trouble getting almost every rx,,, they find a reason to deny it, delay it, change it or not automatically refill it. hope it works in CA

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