§ 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.