Expedited Partner Therapy in Michigan

by Brian Palmer, 2016 Pharm.D. candidate, Ferris State University College of Pharmacy

As of Jan. 14, 2015, Expedited Partner Therapy (EPT) is legal in Michigan. For readers who are unaware, EPT is the indirect treatment of a patient’s partner who has been diagnosed with a sexually transmitted infection (STI) through dispensing or prescribing of an antibiotic or other treatment that is the standard of care for STIs according to the guidelines. If you knew about this, you may have many questions just like I did. If you didn’t know about this, you may have even more questions. In this post, I will summarize for you the answers that I uncovered for the many questions I had such as:

• Who qualifies for EPT? 
• How do I know which STIs this applies to?
• What if the patient does not know their partner’s name?
• What does this mean for pharmacists?
• What is the pharmacist’s liability?

Know the Facts

Who qualifies for EPT and which STIs are of concern?

Many patients qualify for EPT. For instance, any patient who has an existing relationship with a provider may inquire about EPT for their sexual partner(s). In order for the partner to be covered, the patient has to have a laboratory confirmed or suspected case of a STI. Specifically covered under this law are gonorrhea and chlamydia. The Michigan Department of Health and Human Services (MDHHS) is to distribute information about which STIs are covered, treatments and warnings and precautions. To access more information, you may visit their Web site online. The patient must indicate that he or she has a partner who they have engaged in sexual activity with 60 days prior to the diagnosis. There is no limit to the amount of partners who are covered under the EPT law. The patient must also indicate that his or her partner is unable or unwilling to get treatment within a reasonable amount of time. The health professional does not have to have a relationship with the partner to prescribe or dispense the medication. It should be stressed to the patient that they should inform their partner of their diagnosis and for them to seek medical examination and further treatment. Men who have sex with men are not covered under EPT due to lack of demonstrated efficacy and risk of missing STI/HIV co-infections. If abuse or assault is suspected, EPT should not be used. In addition, pregnancy and EPT is of concern, and should be considered last resort.

How could EPT prescriptions impact pharmacy?

Receiving EPT prescriptions may be a little confusing at first. However, MPA has worked with MDHHS to create best practices for pharmacists who receive EPT prescriptions. Below you will find tips and resources. This guidance has not been finalized, but we want you to be aware of upcoming changes.

What if the name of the partner is unknown? 

If the partner’s name is unknown, the provider may dispense or prescribe to “Expedited Partner Therapy.” If this is the case, the date of birth should be Jan. 1 of the current year.

What does EPT mean for pharmacists?

Pharmacists should counsel patients to inform their partner of a need for a complete STI evaluation and to read the medication handout thoroughly. Pharmacists should be aware that the partner may have an allergy to the medication and should address this with the patient. EPT should be used as a last line in pregnancy, and so pharmacists should check to make sure that pregnancy is not of concern. If pregnancy is possible, the patient or partner should seek care from their provider. Counseling on abstaining from sex for at least seven days after treatment is essential to prevent reinfection. Pharmacists should advise patients to be reevaluated at three months after treatment to rule out reinfection. It is important to note that a pharmacist can change everything on the prescription for EPT except the patient’s name, with consent from the doctor.

What liability does the pharmacist have?

There is little to no liability, unless gross negligence is suspected. The health professional who provides EPT as authorized by law is not liable for damages in a civil court or subject to administrative action for personal injury, death or other consequence arising from or related in any way.

Online resources:

·        If you would like to read the law yourself, click here.

·       To find out more information about pharmacy and pharmacy law, visit the Michigan Pharmacists Association Web site.

For further questions contact: Amanda Lick, M.A., MPA manager of advocacy, governmental and regulatory affairs, at (517) 377-0254 or Amanda@MichiganPharmacists.org. Eric Roath, Pharm.D., MPA director of professional practice, at (517) 377-0224 or Eric@MichiganPharmacists.org