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Health: PrEP and PEP Now Over-The-Counter Drugs In California

A new law just passed in California is going to make it easier for people to get access to the groundbreaking HIV prevention treatments, PrEP and PEP. Signed into law by California Governor Gavin Newsom last Monday, Senate Bill 159 allows pharmacists in California to dispense those HIV drugs even without a prescription starting next year.

Authored by San Francisco Senator Scott Wiener and co-authored by San Diego Assemblyman Todd Gloria, the bill allows pharmacists to provide up to a 60-day supply of pre-exposure prophylaxis (PrEP), even without a doctor’s prescription. They can also give patients all the drugs used for post-exposure prophylaxis (PEP).

The bill also requires insurers to cover the drugs, as well as preventing them from making the patient take cheaper alternatives of the prescribed drugs. Pharmacists will also be required to complete a training program approved by the California State Board of Pharmacy. They are also tasked with making sure that clinical criteria for use are met by the patient before providing them with the drugs.

The bill first caught attention back in August when it was still being discussed in the California Senate. Now that it has been passed into law, it makes California the first state in the United States to allow that arrangement.

The new law joins other positive developments that have happened over the year when it comes to PrEP and PEP availability. In May of this year, the Centers for Disease Control and Prevention entered into a partnership with the pharmaceutical company Gilead to make 2.4 million bottles of Truvada available to them over the next 11 years. A generic version of Truvada is going to available in 2020, thanks to Teva Pharmaceutical. In June of this year, private insurers were required by law to pay for PrEP.

CLARIFICATION:

Thanks to our Adam4Adam blog reader Brett, here’s clarification on the status of PrEP and PEP in California in light of the new law:

“This article inaccurately refers to medications used for PEP and PrEP as ‘over the counter.’ This is not true. The bill amends California business and professions codes and board of pharmacy law to permit a licensed pharmacist who has taken training courses specific to PEP / PrEP therapy to dispense a 30-60 day supply of medication without a prescription. The bill in effect lifts the legal requirement that a pharmacist obtain a prescription prior to dispensing a prescription medication (i.e., the state will turn the blind eye on legal requirements in this very specific circumstance). The medications used for PEP and PrEP *remain* legend (‘prescription only’) medications in California.

There are also restrictions in the bill that limit this to one time, per person, in any 365 day period. The bill does NOT make Truvada an ‘over the counter’ medication so much as grant people access to PEP and PrEP medication where access is a challenge (e.g. rural areas, on weekends, etc.), with the understanding that the individual follow-up and continue PEP / PrEP medication therapy, HIV testing, and other laboratory monitoring with a primary care physician or other healthcare provider. An ‘over the counter medication’ comes with no dispensing restrictions, legal requirements, etc.”

Thanks, Brett!


There are 11 comments

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  1. tek

    With all the potential side effects and the fact that prep isn’t a 100% prevention for HIV infection (let alone unsafe sex in general), what investment does a4a have to keep pushing with very little view into all the negative aspects and ramifications?

  2. Brett

    This article inaccurately refers to medications used for PEP and PrEP as “over the counter.” This is not true. The bill amends California business and professions codes and board of pharmacy law to permit a licensed pharmacist who has taken training courses specific to PEP / PrEP therapy to dispense a 30-60 day supply of medication without a prescription. The bill in effect lifts the legal requirement that a pharmacist obtain a prescription prior to dispensing a prescription medication (i.e., the state will turn the blind eye on legal requirements in this very specific circumstance). The medications used for PEP and PrEP *remain* legend (“prescription only”) medications in California.

    There are also restrictions in the bill that limit this to one time, per person, in any 365 day period. The bill does NOT make Truvada an ‘over the counter’ medication so much as grant people access to PEP and PrEP medication where access is a challenge (e.g. rural areas, on weekends, etc.), with the understanding that the individual follow-up and continue PEP / PrEP medication therapy, HIV testing, and other laboratory monitoring with a primary care physician or other healthcare provider. An “over the counter medication” comes with no dispensing restrictions, legal requirements, etc. Please amend your story to reflect the legal facts.

  3. nh_joe

    It is my understanding that the effectiveness or PrEP depends on the drug being used before HIV infection … taking PrEP after infection is both not effective for the PrEP user and not protective for their sexual partner. How is this action by California a step in the interest of either the gay or non-gay communities?

  4. Joe

    interesting why should insurers be REQUIRED to pay for PrEP when they don’t pay for the other lifestyle med viagra? what happens after the first 60 days? will a doctor’s prescription be required for refills?

  5. Doug

    Prep is not otc in Cali. Pharmacists are allowed to prescribe Truvada for 2 months then pt must see a doctor to extend treatment

  6. Jockn2cbt

    How is public health care going to survive forcing insurers to purchase name brand medications that can set its own price? Face it, this is the kind of crap that gives anti-socialists strong fodder for vilifying single payer health care. Let’s see, we could ask those people we can’t stand to own up to their own responsibility and wear condoms, or the taxpayer can subsidize bad behavior to the tune of a couple thousand dollars a month for brand name Lafruita all in the name of personal freedom. If an individual engages in risky behavior, be it unprotected sex, using heroin, riding a motorcycle without a helmut or even wingsuiting, you choose that behavior and should be at least in some part held financially responsible for any resulting health care. Scream all you want. Plain and simple, it is not fair to responsible people that pay into the system.

  7. Ken94110

    I don’t understand this new law. It’s not like you can self-prescribe Prep and regardless of whether insurance covers it or not, go pick up a bottle from your local pharmacy and start taking it w/o consulting a doctor or having your blood & kidney and liver enzymes monitored every few weeks?! I would not even take certain OTC meds without letting my doctor know first or google the drug interactions, etc.

    What the new law also needs to amend is to make Prep free for all and let our gov’t pick up that tab. Many of us pay taxes, our corrupt gov’t and self-serving Reps, like vultures, welcome themselves to our funds for their pet projects and many good law abiding citizens never receive proper healthcare or education. I know of many countries that have free healthcare and education and yet this is still a major issue in USA!!


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