EXPEDITED PARTNER THERAPY

To affirm that the pharmacy workforce improves patient access to therapies that prevent and treat sexually transmitted infections in all settings; further,

To support legislation that authorizes pharmacists to provide expedited partner therapy (EPT) while addressing barriers; further,

To encourage dispensing entities and payers to adopt internal policies that facilitate dispensing of EPT medications in alignment with public health guidance; further,

To advocate and affirm that drug products for EPT should be provided to individuals in a manner that ensures safe and appropriate use; further,

To encourage surveillance of EPT as a public health effort.

Rationale

Expedited Partner Directed Therapy (EPT) is an approach to treating sexual partners of patients who are seeking therapy for a sexually transmitted infection (STI).  According to the Center for Disease Control and Prevention (CDC), chlamydia, gonorrhea, and syphilis are on the rise throughout the United States and are a source of significant morbidity and mortality. EPT has demonstrated to be an effective tool in combating the spread of STIs by treating the sex partners of patients with an STI by providing prescriptions or medications to the patient to take to their partner without the health care provider first examining the partner.

EPT is a generally accepted approach to treating certain STIs, but legislation across the United States varies from state to state with 47 states identifying EPT as permissible and three states that identify it as potentially allowable.  “Permissible” is described as allowable for certain practitioners and conditions while “potentially allowable” means that EPT is potentially allowable subject to additional actions or policies. Relevant legal provisions include: existing statutes and regulations that specifically address the ability of authorized health care providers to provide a prescription for a patient’s partner(s) without prior evaluation for certain STDs, specific judicial decisions concerning EPT, laws that incorporate via reference guidelines as acceptable practices, and statutory or regulatory provisions that relate to prescription drug laws in each jurisdiction – to the extent they may impact EPT. 

Because the variety and complexity of these policies could present potential barriers to care, ASHP supports model legislation that articulates the authorization of a pharmacist to voluntarily offer preventative services, patient assessment, and patient care for sexual and reproductive health conditions, including EPT. When appropriate, pharmacists may recommend a referral to seek a higher level of care through the use of counseling and clinical decision-making tools. The proposed model legislation authorizes appropriately trained pharmacists to provide these services when consistent with the standard of care.

Finally, ASHP recognizes that any legislation should define these services, provide clear authority for pharmacists to provide person-centered health services independently and through collaboration, create a mechanism for state and commercial insurance companies to pay for these services, include federal preemption and severability language, and should remove any pre-existing state barriers to pharmacist provision of health services.