Title 27
Insurance

Chapter 18
Accident and Sickness Insurance Policies

§ 27-18-93. Dispensing and administration of HIV PrEP or PEP drugs.

(a) Notwithstanding any provision of law to the contrary and as authorized by the Rhode Island board of pharmacy (the “board”) in accordance with rules and regulations adopted under subsection (e) of this section, a pharmacist may prescribe, dispense, and administer HIV PrEP or PEP drugs (hereinafter sometimes referred to as “prevention drugs”) as described in § 27-18-91(a) pursuant to a standing order or collaborative practice agreement or to protocols developed by the board for when there is no prescription drug order, standing order, or collaborative practice agreement in accordance with the requirements in this subsection and may also order laboratory testing for HIV infection as necessary.

(b) Before furnishing an HIV PrEP or PEP drug to a patient, a pharmacist shall complete a training program approved by the board on the use of protocols developed by the board for prescribing, dispensing, and administering an HIV prevention drug; on the requirements for any laboratory testing for HIV infection; and on guidelines for prescription adherence and best practices to counsel patients prescribed an HIV prevention drug.

(c) A pharmacist shall dispense or administer a PrEP or PEP drug in at least a thirty-day (30) supply, and up to a sixty-day (60) supply, as long as all of the following conditions are met:

(1) The patient tests negative for HIV infection, as documented by a negative HIV test result obtained within the previous seven (7) days. If the patient does not provide evidence of a negative HIV test result, 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 primary care providers and clinics within a reasonable travel distance of the patient’s residence;

(2) The patient does not report any signs or symptoms of acute HIV infection on a self-reporting 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, consistent with CDC guidelines, on the ongoing use of a PrEP or PEP drug. The pharmacist shall notify the patient that the patient shall be seen by a primary care provider to receive subsequent prescriptions for a PrEP or PEP drug and that a pharmacist shall not dispense or administer more than a sixty-day (60) supply of a PrEP or PEP drug to a single patient once every two (2) years without a prescription;

(5) The pharmacist documents, to the extent possible, the services provided by the pharmacist in the patient’s record in the patient profile record system maintained by the pharmacy. The pharmacist shall maintain records of PrEP or PEP drugs dispensed or administered to each patient;

(6) The pharmacist does not dispense or administer more than a sixty-day (60) supply of a PrEP or PEP drug to a single patient once every two (2) years, unless otherwise directed by a practitioner; and

(7) The pharmacist notifies the patient’s primary care provider that the pharmacist completed the requirements specified in this subsection. 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, clinics, or other healthcare providers to contact regarding follow-up care.

(d) A pharmacist shall dispense or administer a complete course of a post-exposure prophylaxis drug as long as all of the following conditions are met:

(1) The pharmacist screens the patient and determines that the exposure occurred within the previous seventy-two (72) hours and the patient otherwise meets the clinical criteria for a post-exposure prophylaxis drug under CDC guidelines;

(2) The pharmacist provides HIV testing to the patient or determines that the patient is willing to undergo HIV testing consistent with CDC guidelines. If the patient refuses to undergo HIV testing but is otherwise eligible for a post-exposure prophylaxis drug under this subsection, the pharmacist may dispense or administer a post-exposure prophylaxis drug;

(3) The pharmacist provides counseling to the patient, consistent with CDC guidelines, on the use of a post-exposure prophylaxis drug. The pharmacist shall also inform the patient of the availability of a PrEP or PEP drug for persons who are at substantial risk of acquiring HIV; and

(4) The pharmacist notifies the patient’s primary care provider of the dispensing or administering of the post-exposure prophylaxis drug. 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, clinics, or other healthcare providers to contact regarding follow-up care.

(e) The board shall promulgate rules and regulations establishing standards for authorizing pharmacists to prescribe, dispense, and administer HIV prevention drugs in accordance with this section, including adequate training requirements and protocols for when there is no prescription drug order, standing order, or collaborative practice agreement.