A FORMER Minister believes UK doctors will not prescribe cannabis medicine on the NHS until the data exists to prove its safe and effective, a Conservative Party fringe meeting heard.
Robert Wilson, Former Cabinet Office Minister and MP, says no ‘sensible’ Minster will bow to the wishes of the medical cannabis community and treat is as a ‘special case’.
However, in an often feisty debate, Mr Wilson was taken to task by Mike Abbott, Executive Chairman of US cannabis firm Columbia Care.
Mr Abbott pointed out the data was available from hundreds of world-wide trials demonstrating the safety and efficacy of medical cannabis for a variety of conditions.
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Dr Mikael Sodergren, of Imperial College London, and co-founder of the Sapphire Medical Clinics, says the reason there has been so few NHS prescriptions is less to do with the lack of evidence, and more to do with UK regulatory guidelines.
He said: “The way medicines in the UK are evaluated is very straight-forward and transparent, and it’s essentially based on cost-effectiveness.
“In relation to chronic pain, NICE (National Institute for Health and Care Excellence) looked at the evidence from trials around the world – whilst the quality of the evidence is not very high, it shows there is no doubt that cannabis-based medicines work for chronic pain.”
However, he went on to say that NICE determines that a medicine costing over £30,000 a year is above its allowance threshold.
He believes regulators will approve cannabis medicines for chronic pain once there is ‘better evidence and the medicines cost less’.
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Mr Abbott pressed further on the way cost-effectiveness metrics are evaluated, saying that from his own experience in the US, when additional detrimental factors such as addiction to opiate-based pain-killers were factored-in, the metrics shift in favour of cannabis.
The online fringe meeting chaired by Henry Hill, the Assistant Editor of Conservative Home, also featured Tony Diver, a journalist for The Telegraph, and Charlotte Caldwell, Patient Advocacy Lead, Centre for Medicinal Cannabis.
Dr Sodergren said the UK medical community was ‘caught off guard’ by the November 2018 law change which had been driven by mothers like Ms Caldwell demanding access to cannabis for her son Billy’s epilepsy.
“When the law changed it became clear patients would not be able to access cannabis medicine. No doctors have been trained and there is no undergraduate or and postgraduate teaching programme,” he said.
He went on to say that for the vast majority of indications it is prescribed as an unlicensed medicine, highlighting how the medical community is uncomfortable with that path.
He added: “The UK is in a completely unique situation … A large volume of patients want to access medicines which have not been through the traditional drug development pipeline. We have never been in this situation before.”
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He went on to say efforts are underway to gather UK-generated evidence of the effectiveness of cannabis medicines, and a national health service means it’s viable to collect this data at scale.
Ms Caldwell called for the creation of a national task force to galvanise the NHS prescribing process, which should embrace worldwide data on its medical efficacy.
A number of the panellists said they had witnessed, at first hand, an emerging political will at Cabinet level to deliver on the UK’s medical cannabis promises but these had been sidelined by Brexit and Covid-19.
Mr Wilson called for industry-wide efforts, backed by cash from the Covid-19 rebound fund, for the creation of a centre for medicinal cannabis research at a designated UK university.
He added: “It was political momentum that got approval and it really stopped quite quickly after that, as it disappeared into the morass of the NHS, the Department of Health, NICE and the Trusts and all the hurdles you have to jump to get it approved as a drug.
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“The medical community regard this as a drug that has to be properly tested – in all its elements before it’s tried on patients. That is something that cannot be jumped past. It needs a large scale research and development programme that the industry supports.”
Mr Abbott, an ex-pat Brit, once more countered concerns on the safety of cannabis medicines saying the evidence exists.
He agreed that cannabis medicines needed to be made consistently, with accepted safety protocols and countered, again, that reputable data already exists to support the efficacy and safety of those currently on the market.
He said additional capital to support the growth of the industry will arrive once regulatory clarity solidifies.
“The UK has an incredible and rich history in scientific research…and there will be a real benefit to the economy if it can become a leader,” he added.
The panel discussion was sponsored by The Centre for Medicinal Cannabis and took place on the evening of Sunday, October 4. To view the discussion click here.
