The landscape for access to PrEP for HIV prevention is changing. While scope of practice varies by state, all states permit pharmacists to prescribe under collaborative practice. However, research has shown it is difficult to create collaborative practice agreements and has been a barrier to expanding medication access. To that end, some states have established procedures to allow pharmacists to prescribe PrEP. Below is a list of of states in the U.S. that currently have legislation or have published guidance to encourage pharmacists to prescribe PrEP and/or PEP.
Prepared by Maria Lopez, Pharm.D., CBA Specialist & President of Mission Wellness Pharmacy.
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States with Pharmacy PrEP/PEP legislation and/or guidance |
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| State | Year passed | Bill | Unlimited Quantities | Main points on training, days allowed & reimbursement |
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| AK | 2023 | HB1007 | Initiate, dispense or administer HIV PrEP (30-60 days) and PEP (30 days) under state protocol (not released yet)
State approved training required to include financial and federal guidelines |
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| CA | 2019 | SB159
AB317 |
PrEP & PEP
Up to 60 days PrEP per 2 year period PEP 30 days, unlimited times Mandates reimbursement from Medicaid (not specific to labs, visits) at 85% physician rate Requires insurers to cover PrEP and PEP medication without PA AB317 passed in 2023 requires insurance companies to reimburse for pharmacists’ services within scope of practice at an in network pharmacy or out of network pharmacy if the plan has an out of network plan. Training program required on the use of PrEP and PEP and financial assistance: Board determined minimum 90 minutes ACPE |
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| CO | 2020 | HB1061 | X | PrEP & PEP
2021 update created statewide protocol for PrEP & PEP Most recently, CO updated their practice act to allow pharmacists to prescribe drugs for a wide variety of conditions. Requires private insurers to reimburse pharmacists for PrEP and PEP and requires payment of consultative fee for pharmacist at 100% rate of physician fee Training Required:90 minutes CE approved by the board |
| CT
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2023 | SB1102 | PrEP (up to 60 days) & PEP
Board of pharmacy to establish and identify training and requirements for prescribing according to package insert and in confirmatory of state law. |
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| ID | 2018 | HB351 | Legislation covers a broad array of disease states. Permits pharmacists to prescribe drugs for conditions that have a test used to guide diagnosis or clinical decision-making and is CLIA waived.
No specific training requirements, but must be within pharmacist training |
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| Il | 2022 | HB4430 | X | Pharmacist must have a standing order by licensed MD or county health dept. Mandates payment by Medicaid + payors for patient care services provided by a pharmacist at min 85% of the rate that the services are covered and reimbursed when ordered or administered by physicians.
Training approved by the board; shall include: on the administration of PrEP & PEP, and related laboratory tests, assessments, referrals and consultations |
| ME | 2021 | LD1115 | Can prescribe, dispense or administer HIV prevention drugs pursuant to a statewide protocol, standing order or CPA. Requires insurers to cover PrEP and PEP medication without PA or step therapy requirements.
Training on protocols, lab testing, guidelines for adherence and best practices of HIV prevention counseling. |
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| MI | 2023 | HB 476 | PrEP and PEP according to physician or Missouri Department of Health and Human Services protocol.
Training and requirements as outlined by state protocol requirements |
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| NM | 2021 | State protocol | Pharmacist PrEP and PEP protocol
Reimburse 100% physician rate Training on mechanisms of action contraindications, identifying indications for the use of protocol formulary drug therapy, patient screening, history and assessment criteria, counseling and training patient and care-giver regarding the safety, efficacy and potential adverse effects of prescribed protocol formulary dangerous drug(s), evaluating patient’s medical profile for drug interactions, patient referrals; |
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| NV | 2021 | SB325 | X | PrEP & PEP according to board of pharmacy protocol
NV Medicaid- must pay pharmacist for services at rate equal to MD, PA, advanced RN Laboratory services covered Training per board of pharmacy |
| NC | 2021 | S.L.2021-110 | Immunizing pharmacist can administer PEP (up to 30 days) in accordance with CDC guidelines. Law includes nicotine replacement, prenatal vitamins, oral contraceptives and glucagon. Must use state protocol. | |
| NY | 2017 | State guidance | 7 days PEP protocol | |
| OR | 2021 | HB2958 | Pharmacists can prescribe, dispense, and administer PrEP (up to 30 days) and PEP in accordance with Board rules. Must have negative HIV test.
Pharmacist must complete a comprehensive training program related to the prescribing and dispensing of HIV prevention medications, to include related trauma informed care. Training to be determined by pharmacist Must complete a training program as determined to be suitable by the pharmacist. Training should be “comprehensive training program related to prescribing and dispensing of HIV prevention medications, to include trauma informed care.” Reimbursed in “same manner as any other healthcare provider.” |
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| UT | 2021 | HB0178 | X | Unlimited PrEP and PEP prescribed via statewide protocol, 100% reimbursed
Training within scope and experience |
| VA | 2021 | HB2079 | X | Initiate treatment, dispense and administer PrEP and PEP via statewide protocol. Includes controlled substances for prevention of HIV
Payment at 100% reimbursement Must complete a comprehensive training program related to the prescribing and dispensing of HIV prevention medications, to include related trauma-informed care. |
(Updated 12/12/23)
