Medical – Page 4 – International Cannabis Business Conference

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Switzerland Moves Forward On More Medical Cannabis Reform

Written by Marguerite Arnold on March 24, 2021. Posted in Medical.

The Swiss Parliament has approved an amendment to the Narcotics Act allowing doctors to prescribe cannabis without special permission and to set up a formal cannabis licensing infrastructure in the country.

Things are looking up for more patient access in Switzerland. Last week the Swiss parliament approved an amendment to the Narcotics Act which will allow doctors to prescribe cannabis more easily. At present, they must still report all cannabis treatments to the Federal Office of Public Health before writing prescriptions. Obviously, this makes the entire process much more burdensome for both doctors and patients.

The Council of States adopted the law last week.

The bill also regulates the cultivation, production, and trading of medical cannabis.

What Does This Mean?

Switzerland so far has played a highly important role in the development of the overall discussion of cannabis reform. It is outside of the EU, even though it is in Europe. Beyond this, the country is also part of the so-called DACH trading partnership, between Switzerland, Austria, and Germany. This means fast entry into the bloc for cannabis and cannabis products – even though price is still going to be a consideration (generally everything is far more expensive in Switzerland in part because of the country’s existence outside of the EU trading alliance).

Domestically, however, what this means is that the Swiss are starting to increase access to medical cannabis via prescription as the country readies itself for a medical-recreational trial next year, to be run out of the nation’s pharmacies.

This means that all cannabis-related sales that are legit, even for adults without a prescription, are currently being channeled into the pharmacy system.

Impact on The Export-Import Discussion

What Switzerland is in effect doing is creating the first standard for the selling of both medical and recreational use cannabis that is pegged on GMP standards. This is an inevitable result in a world where the only high-percentage THC to cross borders so far (legally at least) has been GMP certified.

However, the implications are huge. While there is not enough GMP product in the room right now for the medical market, this will begin to change as more facilities now become funded and come online (particularly after Covid). What this means in effect, however, is that the Swiss are in the process of creating not only Europe’s first GMP standard market (for everything) but further will attract producers globally looking to sell products to both markets. As a result, this is likely to be a model adopted in newly legalizing states who are also looking at the continued failure of the Dutch project.

For an up-to-the-minute update on changing regulations and European markets, be sure to book your tickets now for the International Cannabis Business Conference’s return to in-person conferences!

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Canada Wants To Know What You Think About Home Cultivation

Written by Johnny Green on March 24, 2021. Posted in Medical.

Canada is an international leader when it comes to cannabis policy, and that was true prior to the country becoming the first G-7 nation to legalize cannabis for adult use.

Canada’s top court ruled that medical cannabis was a constitutional right back in 2000, and a year later lawmakers in Canada passed legislation implementing the ruling into public policy.

Since that time patients have been allowed to cultivate medical cannabis at home, however, Canada is now looking to tighten up medical cannabis home cultivation rules and has launched a ‘consultation on guidance on personal production of cannabis for medical purposes.’

The consultation, which can be found at this link here, opened on March 8th and goes through May 7th and is open to:

All interested Canadians, including Indigenous Peoples
Patients and patient associations
Provincial, territorial, and local governments
Cannabis industry licence holders and associations
Law enforcement and first responders and associations
Health care practitioners and health care practitioner regulatory bodies and associations

The goal of the consultation is to craft criteria that can be used for refusing or revoking a medical cannabis cultivation registration to help combat unregulated cannabis sales.

Canada has a robust legal framework in which people can cultivate cannabis and sell it legally, however, the unregulated market still exists post-legalization.

Rather than putting resources and effort into taking away the rights of patients to cultivate medical cannabis, Canada’s government should be dedicating those same resources to improving the current legal framework in a way that makes the regulated market more competitive with the unregulated market.

Canada’s lawmakers and industry regulators need to figure out how to create a business environment in which the price for cannabis flower and other cannabis products are closer to unregulated prices.

The main reason that consumers point to as to why they still purchase unregulated cannabis in Canada is that regulated cannabis costs too much. If legal options were more affordable, presumably more customers would make legal purchases instead of purchasing unregulated cannabis.

With that being said, the unregulated market for cannabis will always exist to some extent, just as it does for cigarettes and alcohol, which is a fact that seems to often be missed by lawmakers bent on clinging to failed prohibition policies.

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Portuguese Authorities Set Retail Price For Medical Cannabis

Written by Marguerite Arnold on March 3, 2021. Posted in Medical.

Infarmed, the Portuguese medicines and medical devices agency, has now set a reference retail price for medical cannabis patients in pharmacies that equals the black-market price – but still no word on whether health insurers will reimburse the costs.

Portuguese patients can look forward to a more regulated retail price for medical cannabis at pharmacies as of April this year. Infarmed, the Portuguese version of the FDA, has set the price for 15-gram bags of medical cannabis at the point of sale in pharmacies at €150 per bag of 18% THC flower. This means that retail prices for cannabis in pharmacies is now set at widely set black market rates across Europe.

This price point is also roughly equivalent to what insurers are reimbursing pharmacies for in Germany – which begins to create a regional, not just in-country reference price for the industry.

The next problem is, however, is that unlike Germany, the list of conditions the drug will be prescribed for is much narrower than in Deutschland (basically six conditions commonly seen in MS, cancer, AIDS and chronic pain). Further, there is no discussion (yet) as to whether national health will cover the cost (as is true in Germany, even if it is still a major bureaucratic, paper strewn fight). In Germany, those patients who are able to obtain coverage face a bill of €12 a month.

How Will This Help the Overall Legalization Discussion?

While the formal price setting is certainly a good step, and further one which takes real market conditions into consideration, a terrible price gap is still in the room for the most vulnerable of patients – in other words, precisely the people who are likely to get a prescription in the first place. Three hundred euros a month is about the amount of disposable cash a person on disability benefits gets to spend every month on food and other essentials. There is no way such people can afford the new “legal” channel of cannabis unless they get some kind of additional help.

Regardless of the immediate impact on the ground in Portugal however, this is a clear sign that the commercial medical market is in fact beginning to normalize – not only in country but across the region.

This also means that GMP producers, for example, can begin to have a much clearer idea of returns, costs and margin throughout the supply chain. This in turn will have a stabilizing impact on the industry – and allow investors to have a much better idea of potential returns.

As a result? 2021 and beyond should begin to see the kind of serious investment in the infrastructure of the industry that it actually needs. And that is good news for everyone.

Be sure to book your tickets now for the upcoming investment and business networking International Cannabis Business Conference in Austin and Berlin!

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As Cannabis Insurance Reimbursements Spread Across Europe, Where Does That Leave US And Canada?

Written by Marguerite Arnold on February 10, 2021. Posted in Medical.

Across Europe, patients are winning battles for their right to free or insurance-reimbursed cannabis care. What does this mean for North America?

According to the Italian press, a Sicilian woman with MS, Loredana Gullota, received her first fully reimbursed cannabis prescription recently. She is the first patient in the region to obtain the same, despite the fact that the decree to mandate coverage was approved by the regional health system a year ago. According to doctors, this means there are now 5,000 patients across the island they can start to prescribe for – their reluctance so far being cost. The average patient could not afford the monthly fees ranging from 300-1,500 euros.

In Germany, right next door, cannabis prescriptions continue to increase, in part because there is a growing understanding about the drug – and thanks to a national training program that has now been launched on the municipal level to target doctors. This is also true of Luxembourg, where the medical training program is clearly also paving the way for a recreational market to start presumably sometime next year. France is running its medical trial. And other countries are now being pulled along – even the beleaguered NHS is considering ways to make good on the prescriptions it has issued so far (even though there are few of these in the UK either).

But with all this growing enthusiasm on the continent, where does this leave the question of reimbursed cannabis in the United States and Canada – the home of cannabis reform, broadly.

Broader Healthcare Provision Is One Avenue To Greater Reform

There is a certain amount of good news here that can fairly easily bounce internationally if the Biden Administration is bold enough to seize it. Namely, the United States specifically has an opportunity to create a state-based agricultural market that can supply and fund its own healthcare funds. In turn, more people being included again in a semi-public option that also includes cannabis care might be just the ticket that the rest of this conversation really needs to get recreational over the line in the coming years.

In Canada, the lack of enthusiasm for including the drug as part of normalized healthcare provision so far has mostly come from doctors and mostly because of the lack of studies and information available. That is likely to also begin changing as more data is available from Europe.

Ultimately, it will be the medical market in Europe that undergirds other kinds of reform – as elsewhere. And so far, with the exception of the Dutch, this is happening, even if achingly slowly, country by country.

Be sure to book your tickets to the next International Cannabis Business Conference – returning to Europe Summer 2021!

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French Government Picks Six Companies For National Medical Cannabis Trial

Written by Marguerite Arnold on February 10, 2021. Posted in Medical.

For all the foot-dragging, the French appear to be on track for what appears to be the largest, organized national trial in Europe.

It is hardly surprising, and for a number of reasons, that the French have finally stepped up to the plate on the medical cannabis discussion. After all, the WHO ruled that the drug was not a Schedule IV last December, right around the time that the European Commission voted that CBD is not a narcotic. This is now an unavoidable topic in every European capital.

However late they may be to this particular discussion, however, the French also seem to have learned a few lessons from neighbouring countries (including right next door in Germany) on how to proceed with this perennially sticky wicket.

As the Dutch government retreats in a fumbled recreational trial, and the German cultivation license holders have (yet) to produce at full speed, the French decided to take a different tact. Namely, they announced the launch of a national trial (much delayed) at the end of last year. There are to be 3,000 patients. And, here is the rub, participating companies must provide both product and vapes, for free.

Which Companies Will Be Participating?

There are six companies who have now been picked for selection in the French trial as announced in late January by the ANSM (the French agency of Medicines and Medical Devices). Their names will sound familiar to anyone who has paid attention to the global industry over the last few years. Like the German tender, several of the participants are from Canada (Aurora and Tilray/Aphria which are also both German bid winners). Australian firms Althea and Little Green Pharma were also chosen, along with the Israeli Panaxia and the UK based Emmac Life Sciences.

All of the product will be imported as the cultivation of cannabis is currently still illegal in France.

European Implications

With France now admitting that cannabis has medical efficacy, the second-largest economy in the EU has now signed up to moving forward on reform. Even if behind other places in Europe.

This also means that the next question is now, inevitably, in the room, and across Europe. When does recreational reform finally come here?

That topic is also on the table, inevitably, as COVID-19 restrictions begin to lift.

Be sure to book your tickets to the International Cannabis Business Conference this summer, when the conference returns to Berlin.

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Bedrocan To The Rescue! British Cannabis Patients Get 6 Months Relief

Written by Marguerite Arnold on January 27, 2021. Posted in Medical.

Post-Brexit scrambles by British patients on imported medical cannabis from Holland gets six-month reprieve with Dutch authorities and UK Home Office both agreeing on a short-term solution

British cannabis patients, who have fought for their children and relatives for years now, were given a sudden victory over cannabis prescriptions in October 2020. Only to have it taken away in December. Now a new government initiative is putting temporary measures in place for the next six months.

It seems like it all should have been taken care of, but like many things related to Brexit, cannabis was just one more thing that fell off the table.

Luckily, the highly vocal activists, according to the Edinburgh News, have managed to step into the breach and an import company in Glasgow has been able to restart cross channel supply. The Dutch government has concurred that as a temporary measure, it can export again, for six months, in a special deal with the British Home Office.

Of course, since the NHS is not yet authorizing the use of cannabinoid oil as the British Paediatric Association has not yet approved the same, families are at the harsh end of costs – around $1,200 a month.

This is not a new story, of course. What is unique, however, is how “fast” relatively speaking, authorities have moved, and in several countries – while failing of course to remedy the financial impact.

It sounds so Germany, with the exception of course that in Europe, this frenzied dance around cannabis started almost four years ago – and so far nobody has a lifetime prescription (as a few patients were beginning to get in the UK as of last fall).

Regulatory Hell In Several Directions

There is no guarantee of course that the myriad levels of red tape will be cleared even in the next six months – for anything, let alone cannabis specifically.

In the meantime, this is surely a boost for the domestic British cannabis industry, no matter how nascent it may be. It is also a wake-up call, globally, that the issue of cannabis regulations, in every country and region, needs a massive modern update if not reboot.

If the world is to change, dramatically, post-Covid, cannabis will undoubtedly be part of that mix.

In the meantime, look for continued bumpy waters, in almost every jurisdiction and renewed activism from every quarter, including the industry for the next 12 months. As the threat of the Pandemic recedes, in other words, there is a very real possibility that frustrated proponents will make real the inevitability of history, finally, that full reform has always been.

Be sure to attend the International Cannabis Business Conference when it returns to Berlin in summer 2021!

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Medical Cannabis Associated With Prolonged Reductions In Opioid Use

Written by Johnny Green on January 13, 2021. Posted in Medical.

When it comes to cannabis reform, one of the biggest opponents to legalization, even medical legalization, has historically been the pharmaceutical industry.

It is a fact that when medical cannabis legalization comes to a particular state or country, the use of prescription drugs reduces because people replace some or all of their prescriptions with medical cannabis.

One area of the pharmaceutical industry that is particularly hit hard post-medical cannabis reform is the opioid sector of the pharmaceutical industry. Below is more information about it via a news release from our friends at NORML:

Patients who initiate the use of medical cannabis experience sustained reductions in their use of opioids, according to data published in the journal Cureus.

A pair of investigators assessed survey data from over 500 patients registered with three state-licensed medical cannabis practices in the northeastern region of the United States. Those surveyed had been prescribed opioids for chronic pain treatment for at least three months.

Forty-five percent of those surveyed reported decreasing their opioid usage following the initiation of cannabis therapy and another 40 percent of respondents acknowledged ceasing their use of opioids altogether – findings that are consistent with dozens of other studies. The majority of respondents (65 percent) reported that they sustained these changes for over one year.

Authors reported: “To our knowledge, this is one of the largest surveys of chronic pain patients who used opioids continuously for a minimum of three months and combined it with medical cannabis. Our results show a remarkable percentage of patients both reporting complete cessation of opioids and decreasing opioid usage by the addition of medical cannabis, with results lasting for over a year for the majority. … We believe our results lend further support that medical cannabis provided in a standardized protocol can lead to decreased pain and opioid usage, improved function, and quality of life measures, and even complete cessation of opioids in patients with chronic pain treated by opioids.”

Full text of the study, “A survey on the effect that medical cannabis has on prescription opioid medication usage for the treatment of chronic pain at three medical cannabis practice sites,” appears in Cureus. Additional information is available from the NORML fact sheet, “Relationship Between Marijuana and Opioids.”

Brexit Interrupts Dutch Supply Of Medical Cannabis To British Patients

Written by Marguerite Arnold on January 13, 2021. Posted in Medical.

The new cross Channel “order” splitting the UK from the continent hits cannabis patients first and hard

As was easy to predict, Brexit interrupted vital supplies of medical cannabis (from Holland’s Bedrocan) from reaching British patients. The news hit families on December 15 – less than two weeks before the implementation of new rules and regs. Indeed, the families involved, well used to the need for a highly visible public campaign, made such a stink that the political repercussions are already forcing the government to look for alternatives.

They are not that hard to find – if you know the industry.

But the question remains, since this was so predictable, why wasn’t this thought about before?

In the short term, at least according to the Independent in the UK who picked up the story after The Guardian broke it, government officials are trying to find solutions and they should not be that hard to find.

Dutch law, however, as some media are reporting, most certainly does not “prohibit” the export of medical cannabis – see Germany right next door. If that were true, indeed most EU GMP compliant German medical cannabis flos could not have been dispensed via pharmacies so far.

The process had previously been certified via “issuing British prescriptions” in Holland and having them filled this way.

All the British government actually has to do, in fact, is follow the lead already set by Germany and indeed by Israel in the past. Buy in bulk, flos if necessary, and extract it in the UK. There are already facilities that are being set up to do the same.

But that kind of thinking, if not process creation is so far sadly absent in just about all things Brexit. Just look at the mess of Channel crossings. Cannabis was always going to be an early victim of the melee.

The question now, among those who work in complex supply chain issues like this all the time – and for many reasons – is how to mend the gap, not only in the short term, but permanently.

Make sure you book your tickets to the International Cannabis Business Conference when it returns to Europe in the summer of 2021!

Cannabis And Privacy On Collision Course In The UK?

Written by Marguerite Arnold on December 29, 2020. Posted in Medical.

As Brexit confuses matters, and the NHS considers a patient registry, what is on the agenda for the protection of cannabis patient rights?

The NHS has now announced a new cannabis patient database, even as the island sets sail for a general regulatory free environment in the aftermath of whatever Brexit will be. Beyond tens of miles of lorries on either side of the Channel, however, what does this mean for patient privacy generally in the UK? Will it merely follow the path of North American users, who are also caught up in the conversation about big tech and privacy rights?

Privacy and cannabis use has been a big issue just about everywhere, particularly since 2014 when Canada and the United States both began to move towards recreational reform. So far, at least in North America, the problems remain contentious, widely undressed, and as a result, in limbo, for now.

Europe is another matter. The medical market here has matured along with a renewed interest in both privacy rights and online shopping. In Europe proper, as a result, GDPR, or general data protection legislation is a big deterrent to getting it wrong.

Such trends are also unlikely to go away as Europe in particular, finally begins to challenge American big Tech and as of next year.

Even the newly brexited island off the west coast of the Channel has some kind of GDPR protection also known as the United Kingdom will be affected.

So far, beyond the proposed NHS database, a non-profit research organization is also gathering data under the rubric of ProjectTwenty21, which presumably will also then share such data with the companies that sponsor it.

It might be a “dodge,” but in a country with many issues about reconstituting itself as an independent actor, and further one after Covid, everyone is looking for a new way of doing things.

The question remains, however, whether the new solutions will be any less problematic as the old ones?

Hemp Advertising Does Not Obviate The Issues

As much as the recent European Commission decision on the regulation and advertising of hemp creates many opportunities for both brands and canna media, in particular, many jungles remain. This includes understanding how a recreational cannabis market is different from a medical one. In an environment where most patients are still caught in the black market and are unable to afford any legitimate channel for their drug, this entire debate means nothing.

Who Should Have Access To Cannabis Patient Databases?

The discussion about access to new drug and patient databases has been in the room since the establishment of the pharmaceutical industry in the last century. However, in a world where social media and marketing have redefined whole industries, starting with advertising itself, there are no easy answers. And while the cannabis industry in the UK may feel they have just been given a pass while Europe shoulders on with more challenges to big tech (far from cannabinoids), it will not be that easy, even next year.

Be sure to attend the International Cannabis Business Conference when it returns to Europe in 2021.