Colorado Aims to Let Pharmacists Write Own Prescriptions for HIV Prevention Drugs

Colorado is on its way to become one of the first states in the country to allow people to skip the physician and get prescriptions for drugs that prevent HIV infection at the pharmacy.¹

House Bill 20-1061 HIV Infection Prevention Medications Bill was introduced by Representative Alex Valdez (D-5th) and Representative Leslie Herod (D-8th) to help reduce the rates of HIV infection in Colorado. The bill is intended to "prevent a health insurance carrier from requiring a covered person to undergo step therapy or to receive prior authorization before receiving HIV infection prevention drugs." ^2,3

In addition, the bill states that it will:

• Require carriers to cover HIV infection prevention drugs prescribed or dispensed by a pharmacist and to provide an adequate consultative fee to those pharmacists.
• Allow a pharmacist to prescribe and dispense HIV infection prevention drugs if the pharmacist fulfills specific requirements.³

Helen Burnside, director of the Prevention Training Center at Denver Health, feels that we need to start thinking differently about health and prevention services in our communities, and pharmacists can help end the HIV epidemic if House Bill 1061 is passed. "House Bill 1061 would allow pharmacists in Colorado to provide HIV prevention medications to patients, which has the potential to increase access to HIV prevention services between all 4 corners of our state," Burnside said in an email with Pharmacy Times®. "Pharmacists are well-poised to provide prevention and education to clients and already do so for other health conditions and could provide HIV prevention services with minimal disruption to their daily operations."

Although the once-per-day medication to prevent the virus has been available for almost a decade, more than 400 Coloradans are diagnosed with HIV each year, and public funding for HIV prevention and AIDS treatment has been cut.¹

In addition, the people who are most at risk for contracting HIV, including injectable drug users and people of color, are more likely to have difficulty accessing health care.¹

State legislation gathering bipartisan support would allow pharmacists to screen a customer for HIV via a blood test and consultation, followed by a prescription of either the daily prevention pill, pre-exposure prophylaxis, or the emergency pill, PEP, taken within 72 hours of potential exposure to the virus.¹

The legislation would require the state Board of Pharmacy to write training requirements for pharmacists following federal CDC guidelines regarding the HIV medications.¹

In 2016, Colorado passed a law that allowed the state health department, along with the state boards of medicine (pharmacy and nursing), to develop protocol allowing pharmacists to write prescriptions for commonly used medications, such as birth-control pills and patches.¹

In 2019, protocol was approved for medications to help people quit smoking. Pharmacists who want to prescribe smoking-cessation drugs must complete a 3-hour online training, whereas the customer must fill out a questionnaire and complete a short consultation with their pharmacist.¹

If this bill was taken on a national level, Burnside believes that giving pharmacists the ability to prescribe HIV prevention medications would significantly increase the uptake of prevention services. "We have to start thinking differently about our health and prevention services and giving communities more options in how they access and where they access these services," Burnside said in an email with Pharmacy Times®. "I believe House Bill 1061 is a step in that direction here in Colorado."

REFERENCES

• Brown, Jennifer. Colorado wants to let pharmacists write prescriptions for HIV prevention drugs. The Colorado Sun. https://coloradosun.com/2020/02/13/prep-without-prescriptions-at-pharmacies-colorado/. Published February 13, 2020. Accessed February 27, 2020.
• HIV infection prevention medications bill introduced during Colorado’s 2020 legislative session’s opening day. OneColorado. https://one-colorado.org/new/hiv-infection-prevention-medications-bill-introduced-during-colorados-2020-legislative-sessions-opening-day/. Published January 8, 2020. Accessed February 27, 2020.
• Prevention Medications House Bill 20-1061. Colorado General Assembly. https://leg.colorado.gov/sites/default/files/documents/2020A/bills/2020a_1061_01.pdf. Accessed February 27, 2020.