Access for Patients too restrictive - Alicia Maher
Currently under Irish legislation, there are only two ways that a patient can legally access cannabis medicines - Alicia Maher, of Patients For Safe Access writes.
Both schemes are highly restrictive and most patients that could benefit from medicinal cannabis, cannot apply.
1. Ministerial Licence Route
It is open to the Minister for Health to consider granting a license to an Irish registered medical practitioner to treat their patient with cannabis for any condition. The application must be endorsed by the patients General Practitioner (GP) and consultant, the license will not be granted to the GP alone. https://www.gov.ie/en/publication/e35cb4-ministerial-licence-application-process/
This is the template for applying: https://assets.gov.ie/19966/8a13118a3d9e4ac5863dfa4788557fbe.pdf
Every patient who is being prescribed cannabis in Ireland is currently going down this route and only have access to Bedrocan products.
The issue with this route is that you will only be refunded if you suffer from one of 3 conditions:
· Intractable nausea and vomiting associated with chemotherapy
· Severe treatment-resistant epilepsy that has failed to respond to standard anticonvulsant medications and
· Spasticity associated with multiple sclerosis resistant to all standard therapies.
For any other condition which falls outside these three conditions, you have to cover the cost of it yourself (even if you hold a medical card which means you are usually refunded for all medications) which can mean costs of up to €4,000 every 3 months in Kenny Tynan’s case.
Under the recommendations of the HPRA report – Cannabis, A Scientific Review, patients who do not qualify under these 3 conditions, will not get reimbursement. The fact that the report does not consider the number one use of medicinal cannabis – chronic pain, suggests it is flawed.
Reimbursement is currently done through the PCRS Scheme. Applicants have been refused for reimbursement under the Treatment Abroad Scheme, and the Hardship Scheme, leaving many of these patients unable to afford their medicine.
2. Medical Cannabis Access Programme
This program is based on a 2017 Report that was conducted by the Health Products Regulatory Authority and was rushed through in a matter of weeks. Most of it is based on older research for which much more relevant evidence is available today. You will only be able to access the program if you suffer from one of three conditions:
· Intractable nausea and vomiting associated with chemotherapy
· Severe treatment-resistant epilepsy that has failed to respond to standard anticonvulsant medications and
· Spasticity associated with multiple sclerosis resistant to all standard therapies.
And these are the products that are available under the scheme:
Aurora – High CBD Oil Drops – 60% CBD < 3% THC
CannEpil – 10% CBD < 0.5%THC
Tilray Oral Solution – THC 10% CBD 10%
The issues with the scheme are as follows:
· No patient that is currently being prescribed cannabis will be allowed on the MCAP because the Bedrocan products which everyone is currently using are not available under the programme
· Limited products
· All of the products that have been approved are isolates
· The programme is extremely limited, chronic pain is not included
· Parents of young children are scared to change from Bedrocan products in case of a return of symptoms and hospitalization.
Funding for the medicinal cannabis scheme started in January 2021 – There has yet to be a single approved applicant.