As early as November 14, pharmacists in Colorado will be able to prescribe and dispense HIV prevention medications, making it one of the first states in the nation to allow patients to receive pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) treatment directly from a pharmacist. More than 14,000 people are reported to be living with HIV or AIDS in the state of Colorado; a number which has been rising over the last five years.
PrEP and PEP therapies are used to prevent high-risk patients from contracting HIV. “Despite their effectiveness, and their strong endorsement by the CDC, USPTF (United States Preventive Services Taskforce) and other medical entities, PrEP and PEP are underused. For many in the high-risk categories, including the LGBTQ community, navigating the complex healthcare system to obtain PrEP/PEP is a huge barrier to access,” said Emily Zadvorny, PharmD, Executive Director of the Colorado Pharmacists Society (CPS). Studies have shown that PrEP reduces the risk of getting HIV from sex by about 99% when taken daily. Among people who inject drugs, PrEP reduces the risk of getting HIV by at least 74%. Research suggests that PEP can reduce the risk of getting HIV, post exposure, by more than 80%.
In the past, securing a prescription for PrEP and PEP treatments was a multi-step process which began with a traditional office visit to a medical doctor. The HIV Infection Prevention Medications Bill (HB20-1061) which was signed into law by Governor Jared Polis on July 13, prevents a health insurance carrier from requiring a covered person to undergo step therapy or to receive prior authorization before receiving HIV infection prevention drugs prescribed and dispensed by a pharmacist.
Although other states, such as California and Oregon, have passed similar measures, Colorado will be the first state to translate the law into actionable state-wide drug therapy protocols – the final step before pharmacists can begin prescribing and administering the treatments. The process was vetted by the Colorado Department of Public Health and Environment (CDPHE), and the Boards of Medicine, Nursing and Pharmacy.
“One of the reasons that we have been able to move so quickly on this is because we have robust and agile pharmacy advocates, along with a close partnership with CPS,” said Jodie Malhotra, PharmD, Director of Practitioner & International Development, CU Skaggs School of Pharmacy and Pharmaceutical Sciences. “We’re already gearing up to launch a state-wide PrEP/PEP continuing education (CE) course so that pharmacists can be ready to provide the treatment as soon as the protocols are approved.”
According to Malhotra, this initiative is another example of the nationwide movement pushing for pharmacists to assume more healthcare responsibilities. Colorado leads the nation in these efforts. In recent years, state legislation has given pharmacists the authority to prescribe and dispense smoking cessation therapies, as well as oral contraception via similar statewide protocols.
“Pharmacists are the most accessible healthcare professional. More than 90% of people in the U.S. live within five miles of a pharmacy. Our goal is to provide greater access to healthcare with fewer barriers, leading to improved outcomes and healthier populations,” Malhotra said.
Exactly which pharmacies in the state will be the first to provide the HIV prevention therapies is still being determined.
The CU School of Pharmacy will offer the PrEP/PEP CE course as an online module beginning November 1, with the goal of training a cadre of pharmacists who can begin offering the therapies as soon as the state-wide protocols go into effect November 14.