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Barriers to accessing to medicinal cannabis
Interest in cannabis-based medicines (CBMs) has increased in Australia, but while recent policy and legislative changes have enabled health practitioners to prescribe CBMs, many patients still struggle to access them.
The question of how to regulate medicinal cannabis has been a major source of debate in many countries and continues to divide the public health community.
A team of researchers from Griffith University, Australian National University, University of Newcastle, University of Melbourne and University of Wollongong have come together to investigate multi-stakeholder views on the use of, and access to medicinal cannabis in Australia.
Focusing on three key areas, the study looked at public and industry preferences for medicinal cannabis, possibility of having medicinal cannabis products registered with the Pharmaceutical Benefits Scheme (PBS) and clinical trials to determine the baseline effectiveness of different cannabinoids and cannabis medicines.
Lead researcher Dr. Daniel Erku from Griffith University said he was primarily looking at access for advanced cancer patients for management of pain and other symptoms.
"Poor symptom control, or intolerable adverse effects from PBS-listed medicines such as opioids has led to an increased interest in medicinal cannabinoids in supportive care in cancer," he said.
"The use of medicinal cannabis is quite distinct because it's usually people who have tried other medications listed on the PBS, but haven't seen any benefit from those.
"These patients are usually nearing end of life, so there are compassionate grounds to gaining access to these products, but they are still bound by very strict and specific state and federal rules."
Many submissions from patients or family members stated they had experienced obstacles in accessing medicinal cannabis products, pointing to various supply, regulatory, legislative, financial, and dispensing challenges that hindered timely access to medicinal cannabis products.
Some even admitted they had resorted to illicit markets (also referred to as the "black," "gray" or "green" market) to source their medicinal cannabis products, or self-producing for personal use, while holding concerns about the legal repercussions and safety issues associated with these actions.
The stigma and prejudice associated with cannabis was also described as a challenge, with health professionals hesitant to openly discuss or prescribe medicinal cannabis products.
"While the government has made a series of reforms to the way these products are accessed, the current model is still not fit for purpose because it puts a lot of pressure on both prescribers and patients," Dr. Erku said.
"The lack of regulatory harmonization across states and territories, limited access to health professionals willing to prescribe cannabis medicines, inequalities relating to participation in clinical trials, and costs associated with access are all contributing to urban–rural and interstate disparity in access to prescribers and medicinal cannabis."
"In the short term we want to see at least some approved cannabis-based medicines accessible to patients for a reasonable price."
This research has been published in Plos One, titled "From growers to patients: Multi-stakeholder views on the use of, and access to medicinal cannabis in Australia."
More information: Daniel Erku et al, From growers to patients: Multi-stakeholder views on the use of, and access to medicinal cannabis in Australia, PLOS ONE (2022). DOI: 10.1371/journal.pone.0277355