Pharmacists may dispense HIV prevention drugs under listed conditions

A Georgia pharmacist may issue an order for, dispense, or administer preexposure or postexposure HIV prevention medicine under a written physician-pharmacist protocol agreement. This applies to pharmacists practicing in Georgia and to HIV prevention drugs that meet the State Board of Pharmacy’s clinical standards based on federal guidelines. The pharmacist must complete an approved training program before dispensing or administering the medicine. For preexposure prevention, the patient must have a recent negative HIV test, report no conflicting medicines, and meet recordkeeping and care-notification requirements. If the patient lacks a primary care provider or refuses notification, the pharmacist must provide a list of doctors, clinics, or other health care providers. Postexposure prevention requires the pharmacist to determine that the patient meets federal clinical guidelines and to notify the patient’s primary care provider or provide a follow-up care list. The State Board of Pharmacy must approve the required training program no later than January 1, 2027.

A pharmacist may administer long-acting HIV prevention injections under a written protocol agreement in which a physician delegates authority. The agreement covers preexposure and postexposure injections for eligible patients. The physician must practice in Georgia, and the pharmacist must hold current Basic Cardiac Life Support certification. The agreement must require patient screening, current medicine information, primary-care information, dose records, consent, adverse-event follow-up, and notification of the patient’s primary care provider within 72 hours when reasonably possible. The pharmacist must use a private area, observe the patient for at least 15 minutes afterward, and maintain at least $250,000 in liability coverage. A pharmacist may delegate administration only to a pharmacy intern or a qualified pharmacy technician under direct supervision, with the physician’s approval included in the agreement. The agreement cannot authorize other drugs, and a physician may not sign such an agreement with more than 10 pharmacists at one time. Each protocol agreement must be renewed and updated when needed every two years; an agreement that is not renewed expires.

The State Board of Pharmacy may penalize pharmacists who administer long-acting HIV prevention injections without the required agreement or who fail to meet specified safety, insurance, notice, or filing duties. Penalties apply to pharmacists operating under the long-acting injection protocol rules, including failures involving insurance, patient information, posted agreements, or required affidavits. Penalties may include written warnings, fines, and temporary or indefinite bans on administering these injections under the program. Fines may reach $2,500 for missing insurance or an agreement, $500 for some information failures, and $5,000 for failing to file the required affidavit. The listed penalties are in addition to any other penalties that may apply. The rules do not require physicians to sign agreements, and health plans and similar entities may not require such agreements for participation or reimbursement.