NOTE: The following information describes how to access to HIV Pre-Exposure Prophylaxis (PrEP) for prevention of HIV infection.

Overview: HIV PrEP Prescription Process

Eligibility

Clients are enrolled in the HIV Drug Treatment HIV PrEP Program at the time of the first request for medication. Initial enrolment for HIV PrEP medication requires completion and submission of the HIV PrEP Enrolment & Prescription Request Form by a licensed BC physician, or nurse practitioner who has successfully completed the BC-CfE’s “Nurse Practitioner Training in HIV Treatment and Prevention | Tier 1: Treatment for HIV Prevention”, documenting baseline eligibility criteria and baseline laboratory work (including negative HIV serology from a 4th generation assay within the previous 15 days). The form may be downloaded in PDF format from this website.

HIV PrEP enrolment & prescription request form (PDF)

Re-Enrolment

If more than 6 months elapses beyond the expected refill date for HIV PrEP medication or if the patient moves out of BC, re-enrolment is required at the time of medication restart or return to BC, by physician completion of the HIV PrEP Enrolment and Prescription Request Form (PDF).

Submitting the HIV PrEP Enrolment & Prescription Request Form:

Any physician licensed to practice in BC, or nurse practitioner who has successfully completed the BC-CfE’s “Nurse Practitioner Training in HIV Treatment and Prevention | Tier 1: Treatment for HIV Prevention” may enroll clients and prescribe HIV PrEP medication. (Both physicians and nurse practitioners may authorize prescription refills for HIV PrEP).

Forms must be completed in their entirety:
Provide client’s legal name as written on the BC health card and/or other government-issued identification, address, date of birth and BC health card number (Personal Health Number).
Specify patient risk factor(s) for HIV infection
Document date of recent negative 4th generation HIV Ag/Ab test (within previous 15 days)
Provide Hepatitis B surface antigen (HBsAg) status. If client is HBsAg positive, additional monitoring or consultation with a specialist is advised (See HIV PrEP Guidelines).
Provide serum creatinine, estimated glomerular filtration rate (eGFR). HIV PrEP with emtricitabine-tenofovir DF is contra-indicated if eGFR < 60 mL/min.
Identify the follow-up prescriber: The physician or nurse practitioner who will provide ongoing care and monitoring and authorize prescription refills. If no follow-up prescriber is specified, the Drug Treatment Program will send prescription refill forms and other documents to the initial prescribing physician.
Specify where the patient will pick up the medication: St. Paul’s Hospital Ambulatory Pharmacy in Vancouver, or the prescriber’s office, or other healthcare site, if outside Vancouver (see Medication Dispensing). Discuss the proposed pick-up location with the patient prior to submitting the request.

Submit the prescription request:

Fax or mail the HIV PrEP enrolment & prescription form, to the BC-CfE HIV Drug Treatment Program office. Note: Privacy requirements do not allow the BC-CfE to accept emailed patient information.

Fax (preferred):	604-806-9044
Mail:	Drug Treatment Program Room 687, 1081 Burrard Street Vancouver, BC V6Z 1Y6
Telephone inquiries:	604-806-8515

Notification of Authorization

The HIV PrEP Enrolment and Prescription Request Form will be reviewed by the BC-CfE to ensure the client is eligible for HIV PrEP. The prescriber will be contacted if clarification is required. This review usually takes one or two business days.

When an initial HIV PrEP prescription request is authorized, a notification will be sent to the physician who submitted the request and the follow-up prescriber specified. The initial HIV PrEP prescription will be filled and must be picked up within 30 days of the date of authorization.

After receiving the authorization notification, it is the responsibility of the prescriber to inform the patient or the patient’s caregiver where to pick up the medication.

Medication Dispensing

Dispensing Locations The BC HIV PrEP Program provides HIV PrEP medication to eligible BC residents, free of charge. BC HIV PrEP Program medication dispensing is centrally provided through St. Paul’s Hospital Ambulatory Pharmacy. For persons residing outside Vancouver, HIV PrEP medication may be sent from St. Paul’s Pharmacy to the prescriber’s office, or a healthcare site of the client’s choice, provided the site has agreed to receive the shipment. Prescribers should specify on the prescription where the client will be picking up medication (St. Paul’s Hospital, prescriber office, or other healthcare site) *For any questions, please call 604-806-8081 (or toll-free 1-800-547-3622 ext.5) It is the responsibility of the prescriber to ensure the patient knows where to go to pick up the medication.

Vancouver

St Paul’s Hospital Ambulatory Pharmacy

Address: Telephone: Fax: Hours: Mon, Thu, Fri Tue, Wed	163-1081 Burrard Street, Vancouver V6Z 1Y6 1-800-547-3622 604-806-8675 7:30 am- 4:30 pm 7:30 am – 7:30 pm
Closed weekends and statutory holidays

Outside Greater Vancouver

If outside Vancouver, HIV PrEP medication can be delivered to the prescriber’s office, or a healthcare site of the client’s choice, if specified, and provided the site has agreed to receive the shipment. If there are concerns with delivery to a prescriber’s office, alternative arrangements may be discussed by calling St. Paul’s Hospital Ambulatory Pharmacy 1-800-547-3622, extension 5.

Dispensed Quantity of HIV Medications For patients starting HIV PrEP for the first time, the initial fill quantity is a 30-44 day supply. Prescription refill quantity for all stable clients is up to a maximum of 90 day supply.

Refills of ongoing medication

A new, signed and dated prescription is required each time HIV PrEP medication is dispensed. The prescriber is responsible for ensuring that HIV serology (4th generation HIV Ag/Ab test) and other monitoring bloodwork is performed in keeping with HIV PrEP guidelines, and the client remains HIV negative prior to authorizing each HIV PrEP prescription refill. HIV PrEP prescriptions must be filled within 30 days of authorization, otherwise a new dated prescription will be required for dispensing medication.

In order to support continuity of care, the HIV Drug Treatment Program will mail pre-printed HIV PrEP prescription refill forms to the follow-up physician or nurse practitioner specified on the prescription request. These prescription refill forms are provided for prescriber convenience. Any legal prescription format may be used. Prescribers who do not wish to receive pre-printed refills may make this request to the Drug Treatment Program office 604-806-8515.

Fax or mail the completed and signed refill prescription to the BC-CfE Drug Treatment Program office. Specify pick-up date on the refill prescription, if known:

Fax (preferred):	604-806-9044
Mail:	Drug Treatment Program Room 687, 1081 Burrard Street Vancouver, BC V6Z 1Y6

To request refill of HIV PrEP medication

If pick-up date specified on HIV PrEP refill form, no additional pharmacy notification is required
If pick-up date NOT specified on HIV PrEP refill form, client or provider calls HIV PrEP reorder line (1-800-547-3622. ext.5) and leaves a voicemail with the following information:
- Client’s full name
- Client’s Personal Health Number (or Date of Birth)
- Date medication is required
- A contact number

Please note:

A minimum 5 business days notice is required for requests for courier to prescriber’s office, and 2-3 business days for picking up at St. Paul’s Hospital Ambulatory Pharmacy
The pharmacy will only return phone calls if there is an issue with the prescription refill

Alternately, the signed prescription may be given directly to the patient to present to the designated pharmacy. If the prescriber requires the patient to pick up a prescription from the prescriber’s office prior to each medication refill, please ensure the patient understands this expectation.

HIV PrEP Prescription Refill Form

In order to support continuity of care, the BC Centre for Excellence in HIV/AIDS (BC-CfE) mails preprinted HIV PrEP Prescription Refill Forms to the follow-up provider specified on the original prescription.

Prescribers may use these pre-printed prescriptions or any other legal prescription format. A new signed and dated refill prescription is required each time HIV PrEP medication is dispensed.