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Missouri pharmacists could administer HIV medication if licensure bill approved by governor

JEFFERSON CITY, Mo. — Amid a bevy of licensing reforms passed by the legislature this year, one measure would allow easier access to life-saving HIV medication

Among other things, the bill would allow pharmacists to dispense HIV post-exposure prophylaxis (PEP) medications, provided the pharmacist has completed the necessary training program. PEP treatments are used within the critical three-day period following exposure to the virus. 

Sen. Greg Razer

The amendment from Sen. Greg Razer was attached to Rep. Derek Grier’s HB 476 during its time in the Senate; the bill was finally passed the week before session ended and awaits the governor’s signature. 

“For an individual who may be able to access PEP, it keeps them from a lifetime of being HIV positive and on medication,” Razer told The Missouri Times. “I think it’s a win for the taxpayers of Missouri. I believe last year we spent around $25 million in HIV medication through Medicaid so everyone that we can keep from needing that medicine for a lifetime also helps the taxpayer.” 

Razer said PEP — along with pre-exposure prophylaxis (PREP), a preventative treatment for those at a high risk of exposure to the virus — is a crucially important tool in the fight against HIV. While PEP is covered by most insurers as an emergency treatment, PREP usually is not. Both treatments were originally included in the language, but PREP was removed during the measure’s time in the Senate Health and Pensions Committee with input from across the aisle. 

“There was some conversation about taking PREP out so that we kept this as an emergency issue,” he said. “We made that compromise and worked through some scope of practice issues between physicians and pharmacists and found a solution — thanks in large part to Sen. Bob Onder — that I think everyone was happy with, and we were able to get it across the finish line.”

The bill itself began with language expanding Missouri’s licensing reciprocity laws to cover those issued by the military but grew to include broader licensure reforms as it progressed through the General Assembly. The final version of the bill includes a myriad of provisions, covering everything from pesticide dealers’ licenses to occupational therapists, dieticians, and architects. 

While Grier wasn’t involved in the conversations surrounding the amendment, he told The Missouri Times he “was pleased to have it included on the bill and thought it was a good addition.”

Missouri would be one of only three states to allow pharmacists to administer the medication, joining California and Colorado. If passed, Razer said the new law would put the state at the forefront of a movement to battle the virus. 

“Missouri is now on the frontline of ending the last great pandemic,” he said. “A lot of people look at COVID and before that the flu of 1918, but people tend to forget about HIV and AIDS. There are two ways of ending this pandemic: One way is to find a cure, which seems to be far off, and the other is to get everyone who is currently positive to an undetectable status where they can no longer transmit the virus. This is the way to do that.”