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Researchers outline statewide study to map pharmacy access to oral and injectable PrEP
Summary
A university research team told the board it will conduct a representative, statewide pharmacy survey this spring to measure availability of oral and long‑acting injectable PrEP, pharmacists' readiness to furnish injectables and implementation preferences; researchers sought input on measures and dissemination.
Researchers from UC Berkeley, Chapman University and UCLA presented plans to study statewide access to pre‑exposure prophylaxis (PrEP) at community pharmacies and requested the board's input on study design and dissemination.
The research team described a two‑part approach. First, a pharmacy‑level "secret shopper" survey will contact a stratified sample of about 1,000 community pharmacies to determine whether pharmacist‑initiated PrEP services are available and whether oral and/or injectable formulations are offered. Second, the team will invite pharmacists, managers and owners at sampled pharmacies to complete longer surveys on barriers and facilitators to furnishing PrEP.
Investigators said they will also run a discrete choice experiment with a subsample of about 500 pharmacists to measure how implementation attributes (for example, private space, payment models, integration into workflow) affect willingness to administer long‑acting injectable PrEP. They plan targeted interviews with pharmacists and people who use or could benefit from PrEP to contextualize quantitative findings.
Presenters noted California's 2019 law allowing pharmacist‑initiated PrEP (SB 159) and more recent changes expanding pharmacist furnishing. They said the goal is to identify priority areas lacking access and to inform a future pilot for new injectables such as lenacapavir, pending regulatory approval.
Board members and public commenters emphasized reimbursement and billing as central barriers. Several participants said insurers sometimes assign long‑acting products to a medical benefit instead of a pharmacy benefit, complicating community‑pharmacy provision. Researchers requested the board's suggestions for channels that should receive study findings and offered to coordinate with the board's public‑education committee.
Why it matters: State law permits pharmacist‑initiated PrEP, but uptake at community pharmacies remains limited. The proposed representative study aims to produce actionable data on where pharmacies are prepared to provide PrEP, and what implementation models would work.
What happens next: Investigators plan to begin data collection in the spring and asked board staff and members for input on measures and dissemination. Board members suggested sharing results with legislative champions, Medi‑Cal administrators and professional associations. Researchers said the study will inform targeted pilots and education.
