Delivery models of pharmacy-led HIV pre-exposure prophylaxis (PrEP)

Key take-home messages

• PrEP prescription by pharmacists is the most common intervention activity in pharmacy-led HIV PrEP delivery models.
• The scope of practice of pharmacists varies widely across local jurisdictions. Under some jurisdictional regulations (U.S. state level or federal) or under collaborative agreements, pharmacists may gain authorization to prescribe PrEP and take responsibility for ordering tests for monitoring and adherence.
• In some pharmacy-led HIV PrEP delivery models, pharmacists may provide PrEP services across the PrEP cascade which may include activities related to improved PrEP awareness, uptake, adherence, and retention.
• Funding models of pharmacy-led PrEP initiatives (e.g. assessment fees, testing fees) rely on a variety of sources, such as out-of-pocket, private and public insurance plans, and financial assistance programs.
• Accessibility, convenience, and pharmacists’ expertise are found to be common benefits, while lack of pharmacist training or pharmacy resources, regulatory barriers, and concerns with compensation for services could be common challenges in pharmacy-led PrEP delivery programs.
• Common outcome measures reported by pharmacy-led PrEP programs include (but are not limited to) the number and age of individuals enrolled, the number of new HIV infections (HIV incidence), the number (incidence) of new sexually transmitted infections (STIs), adherence to PrEP medications, PrEP retention, and drug tolerance.
• Some pharmacy-led PrEP delivery models demonstrate similar, if not better, outcomes (e.g. PrEP adherence) compared to physician/nurse practitioner-led programs, indicating the value of this delivery model to increase access to PrEP without compromising the quality of care.
• There remains a gap in the literature on the associated costs and cost-effectiveness of pharmacy-led PrEP delivery models across high-income countries.

• Epidemiology and Determinants of Health
  • Determinants of Health
• Determinants of Health
  • Health services
• Population(s)
  • General HIV- population
• Prevention, Engagement and Care Cascade
  • Engagement and Care Cascade
  • Prevention
• Engagement and Care Cascade
  • Linkage/engagement in care
• Prevention
  • Biomedical interventions
• Testing
  • Testing
• Health Systems
  • Delivery arrangements