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HOUSE DOCKET, NO. 2238 FILED ON: 1/19/2023
HOUSE . . . . . . . . . . . . . . . No. 2225
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Jack Patrick Lewis
_________________
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.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Jack Patrick Lewis7th Middlesex1/18/2023Natalie M. Higgins4th Worcester1/20/2023Lindsay N. Sabadosa1st Hampshire1/22/2023Rebecca L. RauschNorfolk, Worcester and Middlesex1/22/2023James K. Hawkins2nd Bristol1/27/2023Joanne M. ComerfordHampshire, Franklin and Worcester1/30/2023Carol A. Doherty3rd Bristol1/31/2023Susannah M. Whipps2nd Franklin1/31/2023David Paul Linsky5th Middlesex2/1/2023Vanna Howard17th Middlesex2/3/2023Sean Garballey23rd Middlesex2/8/2023Kay Khan11th Middlesex2/8/2023Colleen M. Garry36th Middlesex2/8/2023Steven Ultrino33rd Middlesex2/8/2023David Allen Robertson19th Middlesex2/8/2023Tram T. Nguyen18th Essex2/8/2023Christine P. Barber34th Middlesex2/9/2023James C. Arena-DeRosa8th Middlesex2/9/2023 2 of 2
Michelle M. DuBois10th Plymouth2/13/2023James Arciero2nd Middlesex2/16/2023Shirley B. Arriaga8th Hampden2/22/2023Simon Cataldo14th Middlesex2/23/2023Danielle W. Gregoire4th Middlesex3/10/2023James B. EldridgeMiddlesex and Worcester3/13/2023 1 of 4
HOUSE DOCKET, NO. 2238 FILED ON: 1/19/2023
HOUSE . . . . . . . . . . . . . . . No. 2225
By Representative Lewis of Framingham, a petition (accompanied by bill, House, No. 2225) of
Jack Patrick Lewis and others relative to enabling pharmacists to prescribe, dispense and,
administer pre-exposure prophylaxis. Public Health.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Third General Court
(2023-2024)
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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:
1 SECTION 1. Section 1 of chapter 94C, as appearing in the 2020 Official Edition, is
2hereby amended by inserting after the definition of “Extended-release long-acting opioid in a
3non-abuse deterrent form” the following 2 definitions:-
4 “HIV”, human immunodeficiency virus.
5 “HIV prevention drug”, a drug approved by the United States Food and Drug
6Administration for the prevention of HIV, including, but not limited to, pre-exposure
7prophylaxis.
8 SECTION 2. Said section 1 of said chapter 94C, as so appearing, is hereby further
9amended by inserting after the definition of “Practitioner” the following definition:- 2 of 4
10 “Pre-exposure prophylaxis”, a drug or drug combination that is taken or administered to
11reduce the risk of HIV acquisition and meets the same clinical eligibility recommendations
12provided in current guidelines of the federal Centers for Disease Control and Prevention.
13 SECTION 3. Said chapter 94C is hereby further amended by inserting after section 21B
14the following section:-
15 Section 21C. (a) A licensed pharmacist may prescribe, dispense or administer HIV
16prevention drugs in accordance with regulations promulgated by the department as set forth in
17this section.
18 (b) A licensed pharmacist may prescribe, dispense or administer HIV prevention drugs
19according to United States Food and Drug Administration guidance and product labeling if the
20patient:
21 (i) is HIV negative, as documented by a negative HIV test result obtained within the
22previous 7 days from an HIV antigen and antibody test or antibody-only test or from a rapid,
23point-of-care fingerstick blood test approved by the United States Food and Drug
24Administration; provided, however, that if the patient does not provide evidence of a negative
25HIV test in accordance with this clause, the pharmacist may order an HIV test prior to
26prescribing, dispensing or administering the drugs; provided further, that if the test results are not
27transmitted directly to the pharmacist, the pharmacist shall verify the test results to the
28pharmacist’s satisfaction prior to prescribing, dispensing or administering the drugs; and
29provided further, that if the patient tests positive for HIV infection, the pharmacist or person
30administering the test shall direct the patient to a primary care provider and provide the patient
31with a list of providers and clinics in the region; 3 of 4
32 (ii) does not report any signs or symptoms of acute HIV infection on a self-reported
33checklist of acute HIV infection signs and symptoms; and
34 (iii) does not report taking any contraindicated medication.
35 (c) A licensed pharmacist that prescribes, dispenses or administers HIV prevention drugs
36shall:
37 (i) provide counseling to the patient on the ongoing use of pre-exposure prophylaxis,
38which may include education about side effects, safety during pregnancy and breastfeeding,
39adherence to recommended dosing and the importance of timely testing and treatment, as
40applicable, for HIV, renal function, hepatitis B, hepatitis C, sexually transmitted infections and
41pregnancy for individuals of child-bearing capacity;
42 (ii) notify the patient that the patient is required to be seen by a primary care provider to
43receive subsequent prescriptions for pre-exposure prophylaxis and that a pharmacist shall not
44furnish a 60-day supply of pre-exposure prophylaxis to a single patient more than once every 2
45years:
46 (iii) document, to the extent possible, the services provided to the patient by the
47pharmacist in the patient’s record in the record system maintained by the pharmacy and maintain
48records of pre-exposure prophylaxis furnished to each patient; and
49 (iv) notify the patient’s primary care provider that the pharmacist completed the
50requirements specified in this subsection; provided, however, that if the patient does not have a
51primary care provider or refuses consent to notify the patient’s primary care provider, the 4 of 4
52pharmacist shall provide the patient a list of physicians and surgeons, clinics or other health care
53service providers to contact regarding ongoing care for pre-exposure prophylaxis.
54 SECTION 4. The department of public health shall promulgate regulations to establish
55statewide drug therapy protocols for prescribing, dispensing and administering pre-exposure
56prophylaxis and other HIV prevention drugs approved by the United States Food and Drug
57Administration that are consistent with federal Centers for Disease Control and Prevention
58guidelines not later than 6 months after the effective date of this act. The regulations shall
59include, but not be limited to, rules stating that a pharmacist shall not furnish a 60-day supply of
60pre-exposure prophylaxis to a single patient more than once every 2 years.