Newsom signs Senator Scott Wiener’s PrEP access bill into law

File photo of Governor Gavin Newsom signing legislation. (Photo Credit: Office of the Governor)

SACRAMENTO | Governor Gavin Newsom signed Senator Scott Wiener’s (D-San Francisco) Senate Bill 339 (SB 339), which improves access to PrEP, a powerful preventative HIV medication, by ensuring pharmacists can furnish PrEP without a prescription.

While there have been massive strides in HIV treatment, California still sees about 4,000 new infections per year, particularly among Black and Brown LGBTQ people. SB 339 builds on and improves Senator Wiener’s SB 159 (2019), the first-in-the-nation law that allowed pharmacists to distribute PrEP without a prescription.

“HIV continues to take a huge toll on public health in California, and SB 339 unlocks a powerful tool to prevent new infections,” said Senator Wiener. “PrEP is nearly 100% effective at preventing HIV transmission, but far too many Californians lack access to it. Allowing people to obtain this powerful anti-HIV tool at their neighborhood pharmacy will greatly expand access and is a big step toward a future free from new HIV cases.”

Senator Wiener was forced to pause the legislation last September after a poison pill amendment was added. The amendment has been removed and the bill restored to its previous form.

“PrEP and PEP prevent thousands of new HIV infections every year, but they are still far too difficult to access,” said Equality California Executive Director Tony Hoang. “SB 339 will make it easier for California pharmacists to provide these important medications without a doctor’s prescription and bring the state one step closer to ending the HIV epidemic. We were proud to partner with the California Pharmacists Association and San Francisco AIDS Foundation on this important bill, and we are grateful to Senator Wiener for his ongoing leadership on this issue.”

Despite significant public health advancements, HIV remains a major public health challenge in California, with nearly 4,000 new HIV diagnoses each year. Black and Latino gay and bisexual men, Black cisgender women, transgender women, and youth continue to be the populations most impacted by HIV. 

PrEP is a preventative drug taken orally or intravenously that reduces the risk of contracting HIV through sexual contact by more than 99%, making it more effective than any other measure to prevent HIV, including condoms. Despite its incredible efficacy, fewer than 25 percent of those who would benefit from PrEP are using these medications.

In 2019, Governor Newsom signed the first-in-the-nation Senate Bill 159 (Wiener, Chapter 532, Statutes of 2019) into law. The legislation authorized pharmacies to furnish up to a 60-day supply of PrEP without a prescription. It also banned health plans from imposing step therapy and prior authorization on PrEP.

However, few pharmacies have successfully used the law to furnish PrEP in California. In surveys, providers cited the fact that health plans do not cover the cost of pharmacists’ labor in preparing PrEP as a major obstacle, and that the 60-day window is too short to ensure referral to a primary-care physician.

Other states have successfully implemented pharmacy-provided PrEP programs modeled on SB 159 but without its limitations.  Colorado, Nevada, and Utah opted not to limit the amount of HIV-preventative medication a pharmacist can provide. In Colorado, plans must reimburse a pharmacist employed by an in-network pharmacy for prescribing and dispensing PrEP and PEP to a covered person, and to provide an adequate consultative fee to those pharmacists. In Nevada, both public and private plans must include coverage for PrEP and PEP and reimburse for laboratory testing, prescribing, dispensing, and administering these medications by a pharmacist at a rate equal to that of a physician. 

SB 339 takes lessons from other states to address the unforeseen obstacles of California’s first-in-the-nation effort of SB 159, opening pathways to the increased uptake envisioned when the bill was originally passed. SB 339 requires health plans to cover up to a 90-day supply of PrEP prescribed by a pharmacist, and an ongoing supply if the patient is ensured follow-up care and testing consistent with CDC guidelines. It also requires health plans to cover costs associated with pharmacist services when furnishing PrEP, including, but not limited to, testing. These measures will remove the most significant reported barriers to making PrEP available without a prescription. 

“On behalf of the members of the California Pharmacists Association, I want to thank Senator Wiener and our co-sponsors for their tireless efforts to remove barriers to pharmacists’ ability to independently initiate and provide PEP/PrEP, “says Michael Connor, PharmD, MBA, President of the California Pharmacists Association. “Every individual who chooses to receive this life-saving medication from their community pharmacy should be able to do so. I would also like to extend our gratitude to the Governor for signing this important piece of legislation.  Community pharmacies are important access points and his acknowledgment of this is truly appreciated.”

“The San Francisco AIDS Foundation thanks the Governor for signing SB 339,” said Dr. Tyler Termeer, PhD, Executive Director of the San Francisco AIDS Foundation. “Expanding PrEP access is essential to ending the HIV epidemic in California and achieving our goals of getting to zero new HIV infections. SB 339 represents an important step forward for the state. We are grateful to Senator Wiener for his leadership and persistence on this issue.

SB 339 is sponsored by California Pharmacists Association, Equality California, and the San Francisco AIDS Foundation.

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