紐瑟姆州長週二簽署了一項法案，大大增加了愛滋病預防藥物的取得。
尼爾‧布羅弗曼 / 2024/02/06 / HIV Plus Mag
美國人口最多的州加州剛剛頒布了一項新法律，確保更多人獲得暴露前預防 (PrEP) 服務，該方法在預防愛滋病毒傳播方面幾乎 100% 有效。
SB 339 由同性戀州參議員 Scott Weiner 提出，週二由民主黨州長加文‧紐瑟姆 (Gavin Newsom) 簽署。五年前，加州通過了一項類似的法律，增加了PrEP 的獲取，但領導人和衛生官員認為，該法律在改善藥物獲取方面還遠遠不夠，特別是在與男性發生性行為的黑人和棕色人種男性以及其他邊緣群體。
維納辦公室的一份聲明稱：「[2019]立法授權藥局在沒有處方的情況下提供最多 60 天的 PrEP 供應。它還禁止健康計畫對 PrEP 實施分步治療和事先授權」。「然而，在加州，很少有藥局成功地利用該法律提供 PrEP。在調查中，供應商指出，健康計畫不包括藥劑師準備 PrEP 的勞動力成本，這是一個主要障礙，而且 60 天的窗口期時間太短，無法確保轉診至初級保健醫生」。
新法案旨在修復先前的漏洞並減少該州的愛滋病毒感染病例——該州每年新增感染病例約 4,000 例。 SB 339 要求健康計畫承保藥師規定的最多 90 天的 PrEP 供應，如果確保患者得到後續照護和檢測，則需要持續供應。為了鼓勵藥局選擇加入，SB 339 也要求健康計畫在分發 PrEP 時承擔與藥師服務相關的費用，包括檢測服務。
維納辦公室表示：「這些措施將消除據報在無需處方的情況下提供 PrEP 的最重大障礙」。
SB 339 也允許藥師在沒有處方的情況下發放 PEP（暴露後預防）。 PEP 可以阻止過去 72 小時內接觸過 HIV 的人的 HIV 傳播。
「PrEP 和 PEP 每年可預防數千例新的愛滋病毒感染，但它們仍然很難獲得，」加州平等組織執行董事 Tony Hoang 在一份聲明中表示。「SB 339 將使加州藥劑師更容易在沒有醫生處方的情況下提供這些重要藥物，並使該州距離結束愛滋病毒流行又近了一步。我們很榮幸能夠與加州藥劑師協會和舊金山愛滋病基金會合作制定這項重要法案，我們感謝維納參議員在這一問題上的持續領導」。
科羅拉多州、內華達州，甚至猶他州等州也採取行動，在沒有醫生處方的情況下提供 PrEP，並消除那些阻礙藥劑師參與配藥的障礙。
「我謹代表加州藥劑師協會的成員，感謝維納參議員和我們的共同發起人為消除藥劑師獨立啟動和提供PEP/PrEP 能力的障礙所做的不懈努力」，Michael Connor，藥學博士、工商管理碩士、加州藥劑師協會主席在聲明中表示。「每個選擇從社區藥局取得這種救命藥物的人都應該能夠這樣做。我還要感謝總督簽署了這項重要的立法。社區藥房是重要的鍵接點，我們非常感謝他對此的認可」。
PrEP without a prescription now a reality in California
Governor Newsom signed a bill on Tuesday greatly increasing access to the preventative HIV medication.
Neal Broverman / FEBRUARY 06 2024 / HIVPlusMag
PHOTO BY RDNE STOCK PROJECT VIA PEXELS
California, the nation’s most populous state, just enacted a new law ensuring more access to pre-exposure prophylaxis, or PrEP, which is nearly 100 percent effective at preventing HIV transmission.
SB 339, introduced by pioneering gay state senator Scott Weiner, was signed on Tuesday by Democratic governor Gavin Newsom. Five years ago, California passed a similar law increasing access to PrEP, but leaders and health officials believed it did not go far enough in improving access to the medication, especially among Black and brown men who have sex with men and other marginalized groups.
“The [2019] 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,” according to a statement from Wiener’s office. “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.”
The new bill aims to fix the prior’s loopholes and cut down the state’s HIV cases — the state sees about 4,000 new infections annually. SB 339 requires health plans 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. To encourage drug stores to opt-in, SB 339 also requires health plans to cover costs associated with pharmacist services when distributing PrEP, including testing services.
“These measures will remove the most significant reported barriers to making PrEP available without a prescription,” Wiener’s office states.
SB 339 also allows pharmacists to dispense PEP, post-exposure prophylaxis, without a prescription. PEP can stop HIV transmission for those exposed to HIV within the past 72 hours.
“PrEP and PEP prevent thousands of new HIV infections every year, but they are still far too difficult to access,” Equality California Executive Director Tony Hoang said in a statement. “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 the 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.”
States like Colorado, Nevada, and even Utah have also moved to make PrEP available without a doctor’s prescription and remove barriers that discourage pharmacists from taking part in dispensing the medication.
“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, “Michael Connor, PharmD, MBA, President of the California Pharmacists Association, said in a statement. “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.”