Illinois Legislature Empowers Pharmacists

Pharmacy Times, July 2022, Volume 88, Issue 7

New state law allows dispensation of HIV meds, distribution of fentanyl test strips starting in 2023.

In April 2022, the Illinois General Assembly passed a bill that allows pharmacists to administer or dispense preventive HIV medication, and Governor J.B. Pritzker signed it into law on June 10, 2022.1

The law will be effective January 1, 2023.2

Additionally, the Illinois General Assembly passed another bill regarding fentanyl testing strips, which is a public health initiative intended to help curb the overdose rate associated with the illegal spread of this drug. Pritzker signed this into law on June 2, 2022, and it is effective immediately.3

HIV Prevention

Pharmacist authority to dispense has been increasing nationally. There is a trend across the nation that is broadening pharmacist prescribing authority in a variety of treatment settings, with HIV being the most recent. Illinois House Bill 4430 permits pharmacists to order and conduct testing and dispense pre- and post-exposure HIV medications to those at high risk for HIV infection. Pharmacists would need to have a standing order issued by a licensed physician or county health department that would allow them to offer care for the individual seeking help. However, once established, the pharmacist is positioned to exercise independent professional judgment in ordering this treatment protocol.1 The medications, referred to as “PrEP” for the preexposure drug and “PEP” for the post exposure one, aim to reduce the risk of HIV infection among at-risk individuals.

The law’s chief sponsor was Illinois Senator Mike Simmons of Chicago, who thinks that the measure will reduce waiting times, providing potentially lifesaving care to thousands.1 The AIDS Foundation Chicago has estimated that approximately 45,000 individuals are living with HIV/AIDS in Illinois and that 1300 each year learn that they have AIDS or HIV.4

The law also lays out insurance reimbursement requirements for pharmacists offering the services. As a result, pharmacies can be reimbursed by third-party insurers for engaging in the provision of such therapy.

Throughout debate in both chambers of the Illinois General Assembly, representatives raised concerns about legal issues regarding emancipated minors being allowed to access such medication and receiving the medication on multiple occasions for their own personal use.5 In Illinois, a legal emancipated minor must be 16 years or older and have court documentation proving that they are legally emancipated.5 For emancipated individuals to receive HIV medical care from pharmacists, they must show documentation that they are emancipated, according to Illinois state law.5

Not all members of the Illinois General Assembly supported this initiative.

Some such as Senator Darren Bailey of Xenia thought that the language has “too many loopholes” for minors, whether emancipated or not, to go to different pharmacies and refill their medications several times. However, Simmons responded that the medication has no addictive properties and no adverse effects. He also advocated that individuals be required to receive laboratory testing prior to receiving a prescription.5

The law requires pharmacists to complete a training program related to HIV care before they can dispense the drugs. Individuals requiring another prescription for the medication must obtain follow-up lab tests to determine if they are still at risk for infection or are HIV positive.5

Fentanyl Strips

In addition to the HIV law, House Bill 4556 was passed unanimously by both chambers and signed into law by Pritzker. The bill expands access for pharmacists and other health care professionals to distribute fentanyl testing strips to help reduce opioid overdoses, which have been increasing nationally. The testing strips can detect fentanyl in counterfeit drugs and pills.3

The law is intended to expand on the Overdose Prevention and Harm Reduction Act, which was passed in 2019.6 That law provides for government agencies and nongovernment entities to create needle-access programs aimed at reducing HIV and other blood-borne diseases.6 The new law is intended to supplement existing community-based programs that provide a range of preventive services, as well as educational information on overdose intervention and prevention, monitoring programs for opioids, and safe drug disposal of unused medications.3 All testing supplies for fentanyl are required to be stored in a licensed pharmacy, clinic hospital, or other health care facility.3 In passing the bill in the General Assembly, Illinois representatives expressed concern that many opioid deaths occur in people who did not know an additional substance had been put into the fentanyl.3 Fentanyl is a synthetic opioid derivative that is not expensive and is lethal when ingested in high doses.

There were nearly 3000 opioid overdose deaths in 2020—more than twice the number of homicides—and nearly 20,000 emergency responses to opioid overdoses, according to the Illinois Department of Public Health.7

Both the laws aimed at stemming the tide of HIV transmission and opioid overdose deaths empower pharmacists to play a significant role in addressing these public health concerns. Pharmacies also continue to play a more central role in patient access and health care and are gaining increased opportunities to engage in patient treatment and prescribing.

About The Author

Ned Milenkovich, PharmD, JD, is chair of health care practice at Much Shelist PC in Chicago, Illinois.

References

1. Governor Pritzker signs bills expanding access to HIV and AIDS-related care and prevention. News release. Office of Governor JB Pritzker. June 10, 2022. Accessed July 7, 2022. https://www.illinois.gov/news/pressrelease.25032.html

2. Bill Status of HB4430. Illinois General Assembly. Accessed
July 7, 2022. https://www.ilga.gov/legislation/BillStatus. asp?DocNum=4430&GAID=16&DocTypeID=HB&SessionID=110&- GA=102

3. Gov. Pritzker signs legislation to further combat national opioid crisis. News release. Office of Governor JB Pritzker. June 2, 2022. Accessed July 7, 2022. https://www.illinois.gov/news/press-release.24995.html

4. About HIV. AIDS Foundation Chicago. Accessed July 7, 2022. https://www.aidschicago.org/page/about-hiv

5. Kinnicutt G. Session Recap: Bills allow pharmacists to administer preventive HIV meds, fentanyl test strips. Capitol News Illinois. April 14, 2022. Accessed July 7, 2022. https://www.capitolnewsillinois.com/NEWS/session-recap-bills-allow-pharmacists-to-administer-preventive-hiv-meds-fentanyl-test-strips

6. Public Act 101-0356. Illinois General Assembly. Accessed July 7, 2022. https://www.ilga.gov/legislation/publicacts/fulltext.asp?Name=101-0356

7. IDPH data. Illinois Department of Public Health. Accessed July 7, 2022. https://dph.illinois.gov/topics-services/opioids/idph-data-dashboard.html