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Governor Newsom Signs Groundbreaking Legislation to Increase Access to PrEP and PEP

Cosponsored by APLA Health, SB 159 authorizes pharmacists to furnish PrEP and PEP without a physician prescription and eliminates insurance barriers to obtaining these medications

October 7, 2019 — Governor Gavin Newsom today signed into law groundbreaking legislation to increase access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for HIV prevention. Senate Bill (SB) 159, authored by Senator Scott Wiener (D-San Francisco), is the first law of its kind in the nation to authorize pharmacists to furnish PrEP and PEP without a physician prescription. The legislation also prohibits insurance companies from requiring patients to obtain prior authorization before using their insurance benefits to obtain these critical HIV prevention medications.

“Use of PrEP and PEP in California remain far too low, particularly in communities most affected by HIV,” said APLA Health CEO Craig E. Thompson. “SB 159, which passed the California Legislature with overwhelming bipartisan support, will increase the places where people can access these medications, increase the number of healthcare professionals who can provide them and remove onerous and unnecessary insurance barriers. We applaud Governor Newsom for signing SB 159 into law.”

PrEP and PEP are critical tools to ending the HIV epidemic in California and across the country. PrEP is a once-daily pill for HIV-negative people that almost entirely eliminates the risk of acquiring HIV. PEP is medication that a person takes after a potential exposure in order to prevent the virus from taking hold. PEP must be started within 72 hours and continued for 28 days to prevent HIV acquisition.

Despite the importance of these HIV prevention interventions, recent data suggests that less than 25 percent of people who could benefit from PrEP are currently taking it. PrEP uptake has been lowest among populations most affected by HIV, including black and Latinx gay and bisexual men, transgender people, women, and youth.

“We cannot end the HIV epidemic until we ensure that all Californians have access to PrEP and PEP,” said APLA Health Director of HIV Prevention Services Terry Smith. “SB 159 will help to increase awareness of PrEP and PEP, make it easier for people to access these medications from trusted community pharmacists and prevent insurance delays that can put people at greater risk of acquiring HIV.”

With the passage of SB 159, pharmacists will be able to provide a 60-day supply of PrEP, after which the patient will need to see a physician for ongoing PrEP prescriptions. For PEP, pharmacists will be able to furnish the full 28-day medication regimen. Prior to dispensing PrEP and PEP, pharmacists will be required to receive appropriate training and provide necessary testing and counseling consistent with guidelines from the Centers for Disease Control and Prevention. SB 159 directs the California Board of Pharmacy to adopt regulations to implement the legislation by July 1, 2020.

PrEP and PEP are covered by most private insurance plans, as well as by Medicare and Medi-Cal. For individuals who need help paying for PrEP and PEP, California recently launched a statewide PrEP Assistance Program (PrEP-AP). The program is run by the California Office of AIDS and provides financial assistance with PrEP medication and related medical expenses.

SB 159 is co-sponsored by APLA Health, San Francisco AIDS Foundation, Los Angeles LGBT Center, Equality California, and the California Pharmacists Association. SB 159 is also co-authored by Senators Steven Glazer (D-Orinda) and Jeffrey Stone (R-La Quinta), and Assembly members Todd Gloria (D-San Diego), Mike Gipson (D-Carson), Lorena Gonzalez (D-San Diego), and David Chiu (D-San Francisco).

For full text of the bill, please click here.