Supply and demand

Move pharmacy to the forefront of medicinal cannabis supply as obstacles continue to block patient access, MPs argue

More needs to be done to ensure Australian consumers can access approved and affordable medicinal cannabis products via pharmacy, parliamentarians have argued.

The House of Representatives was last week debating the Narcotic Drugs Amendment (Medicinal Cannabis) Bill 2021.

While both major sides of Parliament supported the bill, opposition MPs, and some government backbenchers, called for more to be done to remove some of the obstacles preventing Australians from accessing these products. 

Mark Butler (ALP, Hindmarsh, SA), the Deputy Manager of Opposition Business in the House said Labor was supporting the bill, but he had concerns over the ongoing lack of available products and patient access.

“So far as the bill goes it is worthy legislation, but I do make the point ‘only so far as it goes’. There still remains much to be done in the emerging area of the therapeutic use of medicinal cannabis,” he said.

“The government has been dragging its feet for years in this area, most notably when it continued to resist the opposition’s calls in the other place for a Senate inquiry into barriers against patient access to those safe, effective and affordable medicinal cannabis products”.

Products available through the government’s Special Access Scheme were not only not on the ARTG, they are “obviously” not on the PBS, Mr Butler said.

“The patients are paying for these products out of their own pocket…. it was indicated that the average cost is somewhere between $5 and $15 per day for patients accessing medicinal cannabis products through the Special Access Scheme.

If you have conditions, such as epilepsy, that require relatively high doses of CBD, or medicinal cannabis, in your therapeutic good, then you are paying substantially more than $15 per day, day in, day out. This
is a very substantial impost on families and patients across the country”.

Mr Butler also questioned the current recommendations for downscheduling products to S3 and the lack of available products in this category.

“A decision was taken by the TGA, after a draft decision and then a further consultation process in December last year, to down-schedule registered CBD products only—not THC products, which have a psychoactive element, but the CBD-only products, which would only be allowed to be, at a maximum, one per cent THC,” he said.

The decision allowed for adults to access up to 150 milligrams a day, an increase on the initial draft decision that limited it to 60 milligrams a day. 

However a range of patient advocacy groups have indicated that that is a subtherapeutic dose, he said.

“I make no criticism of the TGA for this…. all I do is make the observation that that simply doesn’t do the job for many thousands of patients across the country”. 

“The other point I’d make is that, even though this decision has now been made and is in operation, there are actually no products on the register that activate the decision.

There actually are no approved products that would be able to be sold by a pharmacist to a patient in accordance with this decision. So, until there is, this is very much an abstract decision of no particular impact for patients across Australia”.

Brian Mitchell (ALP, Lyons, Tas) went further, saying “In my personal view, the current system for patients needing to access medicinal cannabis is far too complicated, and it has been for too many years.

“Hurdles have been put in the way of accessing this treatment that have been entirely unnecessary and served little purpose, other than to burden people with costs and inconvenience.

We know that medicinal cannabis is already being used by hundreds of thousands of Australians… the anecdotal evidence… is overwhelmingly positive. Yet we, as legislators, and the medical community, as regulators, have continued to disbelieve those people for too long”.

“I do note that the Therapeutic Goods Administration recently approved low-dose cannabis oil to be bought over the counter at pharmacies. Again, this is a welcome step. Theoretically, it will mean that patients will no longer require a referral, specialist approval or a prescription to be able to legally acquire and use low-dose CBD,” he said.

“While this is a welcome change, it does not necessarily solve the wider problem of access. With no products approved to date for over-the-counter use, it could be another 12 months before patients are buying medicinal cannabis products from their local pharmacy.”


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