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<h3>Background and Importance</h3> Pre-Exposure Prophylaxis (PrEP) is a preventive strategy that significantly reduces the risk of HIV infection, although it does not protect against other sexually transmitted infections. Currently, only Tenofovir Disoproxil Fumarate/Emtricitabine (TDF/FTC) is reimbursed by the NHS in Spain. PrEP is indicated in Spain for men who have sex with men (MSM), transgender women, and sex worker s. In 2021, people who inject drugs, and cisgender men and women at risk of acquiring HIV. Dispensing through community pharmacies could increase accessibility. <h3>Aim and Objectives</h3> To identify PrEP drugs currently approved in different countries and examine their dispensation and financing mechanisms. Additionally, to estimate the economic impact of a potential transition from hospital to community pharmacy dispensing and to explore possible models to enable community pharmacy dispensing. <h3>Material and Methods</h3> Information on PrEP approval, access, and financing across countries was collected from publicly available sources, including official health reports, institutional websites, and scientific literature. The economic impact of TDF/FTC in Spain was assessed using tender and retail prices (PVP including VAT) as of August 2025. Potential models for community pharmacy dispensing were also reviewed. <h3>Results</h3> At the European level, most countries reimburse oral TDF/FTC, although dispensing channels vary. France, Germany, and Portugal allow community pharmacy dispensing, whereas Spain and Italy restrict access to hospital pharmacies. In the United Kingdom, broader access is provided through NHS clinics, which also include tenofovir Alafenamide/Emtricitabine and cabotegravir among available options. Based on public procurement data, the average net monthly cost of TDF/FTC in hospital pharmacies is approximately 75% lower than the retail price in community pharmacies (€10.61 vs €43.71). With an estimated 30,000 patients in 2025, this difference translates into a potential budget impact of around €993,000 per year. Transitioning to community pharmacy dispensing would require regulatory changes, such as drug reclassification of TDF/FTC, potential expansion of prescribing rights, and targeted training for prescribers and pharmacists. Potential implementation models include prescriptions issued in primary care with dispensing through community pharmacies. <h3>Conclusion and Relevance</h3> Community pharmacy dispensing of PrEP could improve accessibility and align Spain with other European models. However, the transition would entail regulatory adjustments and higher drug costs compared with the current hospital pharmacy system. <h3>Conflict of Interest</h3> No conflict of interest