Testimony in Support of Georgia SB 195, authorizing pharmacists to dispense preexposure prophylaxis and postexposure prophylaxis

Testimony from:

Mazen Saleh, Policy Director, Integrated Harm Reduction, R Street Institute

In SUPPORT of Senate Bill 195, “Pharmacies; pharmacists are authorized to dispense preexposure prophylaxis and postexposure prophylaxis under certain conditions.”

February 24, 2025

Senate Health and Human Services Committee

Chairman Watson and members of the committee:

My name is Mazen Saleh, and I lead the Integrated Harm Reduction policy department of the R Street Institute (RSI), which is a nonprofit, nonpartisan, public policy research organization. Our mission at RSI is to engage in policy research and outreach to promote free markets and limited, effective government in many areas, including public health and harm reduction. That is why Senate Bill 195 is of interest to us.

Pharmacies play an integral role in health care delivery in the United States, one that has evolved considerably from medication dispensing. Today, pharmacies often fill a primary care access gap by providing specific primary care services like vaccinations and counseling patients on both medication adherence and risk reduction counseling.^[1] It is perhaps no surprise that the general public is welcoming this shift. According to a national survey in 2022,the majority of Americans (72 percent) would be open to having medications prescribed by a specially-trained pharmacist instead of a doctor.^[2] 

An estimated 1.2 million Americans are living with HIV and progress in reducing the number of new infections (~38,000 per year) has stalled.^[3]  One of the key challenges in curbing the spread of HIV is that for every 100 people with HIV, only 87 people know their HIV status.^[4]  Launched by President Donald J. Trump in 2019, the Ending the HIV Epidemic in the U.S. (EHE) initiative aims to end the HIV epidemic in the United States by 2030. The innovative plan focuses the nation’s public health response on 57 prioritized jurisdictions where more than 50% of HIV diagnoses occur. Although Georgia is not a priority state, it does contain priority jurisdictions: Cobb, DeKalb, Fulton, and Gwinnett counties are all high priority areas.^[5] In 2021, the Atlanta metropolitan area had the third-highest rate of new HIV diagnoses among U.S. metro areas.^[6] Given the high incidence of new HIV infections in Georgia and the increasing scope of (and support for) pharmacist-prescribing nationwide, there is a prime opportunity to increase access to proven medications that help stop the spread of HIV in Georgia.

Increasing access to HIV preventive medications by leveraging pharmacist-prescribing is becoming more common practice, especially in southern states as Arkansas, Louisiana, and Florida have all passed similar efforts in the last two years. Preliminary research indicates that such legislation is having a positive public health benefit. Given the recency of enacted pharmacy-initiated HIV preventive medication policies, the limited amount of studies that do exist found that about one-third of participants remained in treatment after 12 months with no new documented cases of HIV. ^[7]

While not the only solution to reducing HIV, preliminary findings of enacted policies similar to SB 195 suggest a demonstrable improvement in prevention. Coupled with the national expansion of pharmacists’ scope of responsibilities – and also crucially, American consumers’ support of it – this legislation will help to fill a primary care access gap by leveraging pharmacies across Georgia. For these reasons, we appreciate Sen. Hufstetler’s leadership on this issue and urge your support for SB 195.

Respectfully,

Mazen Saleh

Policy Director, Integrated Harm Reduction

R Street Institute

(202) 253-1450