State policies on pharmacist-initiated PrEP and PrEP usage

Area of Science:

• Public Health
• Pharmacology
• HIV Prevention

Background:

• Several US states now allow pharmacists to prescribe pre-exposure prophylaxis (PrEP) to increase HIV prevention access.
• Policies vary, with some permitting limited-duration prescribing and others allowing unlimited prescribing by pharmacists.

Purpose of the Study:

• To evaluate the impact of state policies enabling pharmacists to provide PrEP on overall PrEP usage.
• To determine if the duration of pharmacist prescribing authority (limited vs. unlimited) influences PrEP usage rates.

Main Methods:

• A time-series, cross-sectional regression analysis was conducted across all 50 US states and DC.
• PrEP usage per 100,000 residents was the dependent variable, analyzing the effect of specific pharmacist PrEP policies.
• Models controlled for state-level fixed effects and state-specific/national time trends.

Main Results:

• States with policies allowing pharmacists to prescribe PrEP without time limitations saw an increase of 25 users per 100,000 population.
• This represents a 14% increase in PrEP usage compared to the 2023 mean.
• Policies authorizing pharmacists for temporary PrEP provision were not associated with increased PrEP usage.

Conclusions:

• Allowing pharmacists to initiate PrEP without time restrictions is an effective strategy to boost PrEP utilization.
• This policy approach shows promise for advancing public health goals in HIV prevention.