SENATE DOCKET, NO. 2258        FILED ON: 2/19/2021

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1407

The Commonwealth of Massachusetts

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PRESENTED BY:

Julian Cyr

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act enabling pharmacists to prescribe, dispense and administer PrEP.

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PETITION OF:

SENATE DOCKET, NO. 2258        FILED ON: 2/19/2021

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 1407

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-Second General Court
(2021-2022)

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An Act enabling pharmacists to prescribe, dispense and administer PrEP.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Section 1 of Chapter 94C, as appearing in the 2018 Official Edition, is hereby amended by inserting after the definition of “Extended-release long-acting opioid in a non-abuse deterrent form” the following new definition:-

“HIV prevention drug”, means drugs approved by the U.S. federal drug administration for the prevention of HIV, including but not limited to preexposure prophylaxis. 

SECTION 2. Said section 1 of said Chapter 94C, as so appearing, is hereby further amended by inserting after the definition of “Practitioner” the following new definition:-

“Pre-exposure prophylaxis" means a drug or drug combination that meets the same clinical eligibility recommendations provided in CDC guidelines, as defined in section 12-280-125.7 

SECTION 3. Said Chapter 94C is hereby further amended by inserting after section 21B the following new section:-

Section 21C. (a) A licensed pharmacist may prescribe and dispense or administer HIV prevention drugs in accordance with regulations promulgated by the department as set forth in this section.

(b) A licensed pharmacist may prescribe and dispense or administer HIV prevention drugs according to federal Food and Drug Administration guidance and product labeling if all of the following conditions are met: 

(1) The patient is HIV negative, as documented by a negative HIV test result obtained within the previous seven days from an HIV antigen/antibody test or antibody-only test or from a rapid, point-of-care fingerstick blood test approved by the federal Food and Drug Administration. If the patient does not provide evidence of a negative HIV test in accordance with this paragraph, the pharmacist shall order an HIV test. If the test results are not transmitted directly to the pharmacist, the pharmacist shall verify the test results to the pharmacist’s satisfaction. If the patient tests positive for HIV infection, the pharmacist or person administering the test shall direct the patient to a primary care provider and provide a list of providers and clinics in the region.

(2) The patient does not report any signs or symptoms of acute HIV infection on a self-reported checklist of acute HIV infection signs and symptoms.

(3) The patient does not report taking any contraindicated medications.

(4) The pharmacist provides counseling to the patient on the ongoing use of preexposure prophylaxis, which may include education about side effects, safety during pregnancy and breastfeeding, adherence to recommended dosing, and the importance of timely testing and treatment, as applicable, for HIV, renal function, hepatitis B, hepatitis C, sexually transmitted diseases, and pregnancy for individuals of child-bearing capacity. The pharmacist shall notify the patient that the patient must be seen by a primary care provider to receive subsequent prescriptions for preexposure prophylaxis and that a pharmacist may not furnish a 60-day supply of preexposure prophylaxis to a single patient more than once every two years.

(5) The pharmacist documents, to the extent possible, the services provided by the pharmacist in the patient’s record in the record system maintained by the pharmacy. The pharmacist shall maintain records of preexposure prophylaxis furnished to each patient.

(6) The pharmacist notifies the patient’s primary care provider that the pharmacist completed the requirements specified in this subdivision. If the patient does not have a primary care provider or refuses consent to notify the patient’s primary care provider, the pharmacist shall provide the patient a list of physicians and surgeons, clinics, or other health care service providers to contact regarding ongoing care for preexposure prophylaxis. 

(c) The department shall promulgate rules to establish statewide drug therapy protocols for prescribing and dispensing preexposure prophylaxis and other HIV prevention drugs approved by the FDA that is consistent with CDC guidelines.