Colorado lawmakers are pondering a bill which would let pharmacies dispense HIV prevention drugs without a prescription. The bill’s supporters say this would lower infection rates by giving people easier access to the drugs, known as PrEP (pre-exposure prophylaxis) drugs.
Truvada and Descovy are the two PrEP drugs currently approved by the FDA. Truvada was approved for HIV prevention by the U.S. Food and Drug Administration (FDA) in 2012. Descovy was approved for HIV prevention by the FDA in October 2019. The drugs are also known as PEP (post-exposure prophylaxis) drugs when taken for infection prevention within 72 hours of HIV exposure.
One Colorado’s executive director Daniel Ramos said, “We want to make sure there are no new infections.” One Colorado is an LGBTQ advocacy group who is lobbying in support of the bill.
Scales Pharmacy owner Dan Scales said, “When you’re having someone who has an exposure late on a Friday night … there’s just not the availability of prescribers to get them treatment in that short tight window.” Scales Pharmacy’s website states that they “focus on treating the whole patient, especially those with HIV and other complicated disease states.”
“This is just really about access to medication and not trying to take away the services that the physicians and the nurse practitioners … can do,” Scales said.
Pharmacists in Colorado will require new training if the bill passes. Pharmacists will need to determine patients are HIV negative before dispensing PrEP without a prescription. Regular blood draws will be necessary for PrEP patients to ensure their kidney health. A pharmacist training curriculum has not yet been developed.
The bill was introduced on January 8th and so far appears to lack opposition. People would be able to go to pharmacies for PrEP and PEP within a year if the bill is signed into law.
Truvada was recently in the news when Facebook began deleting misleading advertisements about tenofovir disoproxil fumarate (TDF) medications such as Truvada. The advertisements misleadingly implied that some of TDF’s side effect risks are the same for PrEP use as they are for treatment of HIV positive individuals.
TDF use for treatment of HIV positive people was linked to osteoporosis and decreased bone density by a 2010 study. TDF use for treatment of HIV positive people was linked to renal failure and kidney damage by a 2018 study. A 2016 study found that TDF use for treatment of HIV positive patients was more likely to lead to bone density loss or kidney damage than TDF use as PrEP medication.