A first-of-its-kind medical cannabis pilot is expected to launch by the end of March 2021. Cannabis Health speaks to one of the companies recently selected as an official supplier.
This week, the French Agency for the Safety of Medicines and Health Products (ANSM) revealed the companies that will supply cannabis products for a landmark medical cannabis trial.
Four main suppliers from Australia, Canada, Israel and the UK will partner with French pharmaceutical distributers to provide a total of nine cannabis-based medical products for up to 3,000 patients. With no funding from patients or the French government, the participating companies will have to cover the production and distribution costs themselves.
Taking place over a two-year period, patients with one of five medical conditions, including chronic pain, epilepsy, oncology and spasticity will be eligible for the pilot.
Physicians, nurses and pharmacists will be selected for the programme and will undergo special training for issuing and dispensing medical cannabis prescriptions to patients.
The concept of the trial was first suggested in 2018 when the ANSM brought together a committee to consider the feasibility of making medicinal cannabis available to French patients.
Over the past two years, the French government has been accused of dragging its feet in putting the pilot in motion, however after finally opening applications in October 2020, the long-awaited trial is set to commence by the end of March 2021.
Aurora Europe, a subsidiary of Canadian company, Aurora Cannabis Inc., has been selected to provide the entire supply of cannabis flower for the trial, which includes three types: high-THC, balanced THC to CBD and high-CBD flowers. The company is partnering with French-born pharmaceuticals company, Laboratoires Ethypharm.
Aurora’s managing director for France, Hélène Moore, told Cannabis Health: “This is what we wanted, we decided to offer the product for which we are already a leader in Europe. We went for what we do well, and we won all the [flower] lots; we were very proud of that.
“It really shows how we have mastered the art of growing pharmaceutical-grade medical cannabis.”
Flower is a difficult product to develop when it comes to medicinal cannabis. Ensuring that the plant contains the same concentration of cannabinoids from batch to batch can be challenging and relies on precisely controlling the growing environment.
“All of our cannabis is grown indoors where every single variable that you can think of for growing a plant is controlled to the [letter; it takes a long time to get it right.
“You need to have it validated, you have to demonstrate to the authorities that you can do the same batch after batch, and we have done that.”
At the end of the pilot, the French government will decide on permitting the use and sale of medical cannabis products, however Moore stresses that the pilot’s purpose is not to test the efficacy of cannabis-based medicine.
“The intention is really to test the distribution system, to test prescribers; the whole machine. The pilot is not a clinical trial, and this has to be very clear.” Moore added.
“What’s going to be assessed is the feasibility of putting together a larger scale medical cannabis programme for patients in France.
“If this pilot is successful, and there are no big roadblocks, the understanding is that they will generalise the offering of medical cannabis to a larger scope of patients.”
Although participating companies are not offered any guarantee as to whether they will remain as official suppliers after the trial, Moore says Aurora’s intention is to continue working with French stakeholders and be “part of the equation in the long run”.
“Our partner is well established, they want to get into this market, and we will do this together,” Moore said. “Now we have a partner that knows how to do things in France, our goal is to extend the relationship from a post-pilot perspective.”
In addition to the four main suppliers, French authorities also selected a number of substitute suppliers to cover any gaps.
Canadian company, Tilray, will supply two sublingual oils as a main supplier and two types of flower as a substitute.
Meanwhile, Israel’s largest manufacturer of medical cannabis, Panaxia, will supply four products, two as a main supplier and two as a substitute. In partnership with Neuraxpharm, the company is providing two cannabis-based oils in various doses of THC/CBD and two types of sublingual tablets.
Deemed a “huge success” for the company, Panaxia’s CEO, Dr Dadi Segal believes the trial is the first step towards France becoming one of the world’s “most advanced medical cannabis markets”.
Dr. Malgorzata (Gosia) Meunier, VP Innovation at Panaxia, added: “Being personally linked to France, I’m especially proud that Panaxia will participate in this prestigious experiment and provide a response to the enormous need of patients in France […] this is an amazing regulatory achievement for us.”
The Australian company Little Green Pharma will be a main supplier for two CBD-dominant sublingual oils and a substitute for a balanced CBD-THC oil.
Other substitute suppliers include Australia-based, Athlea, and UK-based independent cannabis company, EMMAC Life Sciences Group, which will supply two types of orally administered cannabis medicines together with Paris-based distributor, Boiron.
CEO of EMMAC, Antonio Costanzo, hopes the company’s involvement with the trial will “advance the industry’s understanding of the benefits of medical cannabis”.
Due to the country’s strict regulations surrounding cannabis, none of the chosen suppliers are French companies, however partnering with a French distributor was mandatory for all participants. Moore believes that involving the existing pharmaceutical ecosystem could be a key factor in the success of France’s future cannabis sector.
“This is really unique. There are no other countries in Europe that have made that distinction. I think this is something that could provide a key success factor for France in the long run.”
Grow Pharma launches new low-priced flower range for UK patients
The new range will introduce ratio-related pricing and includes four strains not before seen in the UK
Grow Pharma, has launched a new range of low-priced flower products, with the hopes of broadening access to prescriptions for patients.
Grow Pharma has today [Friday 27 May] announced the launch of a new range of flowers for patients in the UK and Channel Islands, cultivated by licensed producer PHCANN in North Macedonia.
In recent years, Grow Pharma, alongside pharmacy partner IPS, have developed a reputation as a reliable and responsible supplier of prescribed cannabis medicines in the UK.
The company now imports and distributes all premium and quality brands available in the UK including those from Aurora, Tilray, Spectrum and Columbia Care.
With this new range of medical cannabis flowers from PHCANN it hopes to further broaden access to prescription cannabis flower medication for patients who need and would benefit from it.
The new range will see the introduction of ratio-related pricing, at £6.50 per gram for flowers under 18 per cent THC, £7.50 per gram for 18 to 22:1 ratios and £8.50 for any higher THC flowers.
The flowers are non-irradiated and non-GMO and will include high THC indica, sativa and hybrid cultivars.
Grow Pharma is well known for its outstanding service to patients and prescribers, says Pierre van Weperen, Grow Pharma CEO.
He commented: “We have long recognised that patients and prescribers would benefit from a lower priced quality flower to complement our range, it has just taken us a while to find a GMP licensed range that
lives up to our standards, including supply integrity.”
The PHCANN range, cultivated in North Macedonia, will initially include four strains not before seen in the UK including Gelato, LA S.A.G.E, Herijuana and Strawberry Glue and will be expanded to include more cultivars later this year.
A new range of GROW oils, also from PHCANN, is in the pipeline to be launched soon.
A reliable source
Last October, Grow Pharma launched a range of flowers under the same brand, but the range was discontinued.
Clare Holliday, head of medical cannabis at IPS Pharma, explained: “At Grow Pharma and IPS, we prioritise quality, consistency and reliability in the supply of cannabis medicines. This means working with only the best “premium” brands, which are often higher priced. After a long search, we believe PHCANN can provide a great range of quality flower medicines at our lowest price to date.
She added: “The flowers we launched in October weren’t from PHCANN, they were being grown elsewhere and it turned out that the supply just wasn’t reliable. Rather than strive on with those medicines going in and out of stock, we discontinued the range until we could source a supply that both we as a pharmacy and, more importantly, patients can rely on.”
Low prices for patients
Patients often ask which clinic to go to in order to access certain medicines or brands.
The truth is that, whilst some clinics have a preferred pharmacy (often owned by the same parent company as the clinic), any medicine from any pharmacy can be prescribed by any doctor at any clinic.
This is really important for patients to understand as many report being offered limited options and having to be quite assertive in order to use their pharmacy of choice.
“UK patients aren’t used to paying for medicines and understandably look for the lowest-priced option that works for them,” said Alex Fraser, patient access lead at Grow Pharma.
“I think what we’ve seen historically is that, when cheaper ranges are imported into the UK there are often issues around stock levels and inconsistent quality.
“We’re hopeful that, with this new range from PHCANN, we can ensure consistent, reliable supply of quality medicines at a lower price. That doesn’t take anything away from the high-quality portfolio that we already have for patients. It might enable patients to mix and match, something that we have been seeing quite a lot recently.”
Grow Pharma understands that some patients wish to avoid radiation, so are adding a non-irradiated range to their extensive formulary that now boasts 27 flower cultivars alongside a range of capsules, cartridge vapes and the ability to formulate sublingual oils with bespoke THC and CBD ratios.
Information for doctors
Pierre Van Weperen, Grow Pharma CEO, commented: “One of the things that makes us the supplier of choice for doctors prescribing cannabis medicines is that we provide the widest range from multiple leading producers.
“This means the doctors we support can make the best decisions for their patients and we can ensure consistency in the supply of patient’s medicines. We make sure that all doctors at the cannabis-prescribing clinics are aware of our formulary and any additions that are made as they happen.
“At Grow Pharma we knew from the start that no single brand could possibly cater for the wide array of symptoms and conditions that can be treated with cannabis medicines, which is why we have worked hard to develop the most comprehensive formulary of cannabis medicines in the UK.
“We set up the Doctor Portal so healthcare professionals can access the information for all our medicines at the touch of a button.”
Doctors can find information on the medicines GROW supplies by contacting them directly or by signing up to their Doctor Portal where they can also speak privately to other doctors in the field, find out about the latest educational events on medical cannabis and speak directly to Grow’s medical cannabis expert MSLs.
Why patients in Europe are accessing medical cannabis
New data gives an insight into the demographics of medical cannabis patients across Europe.
New data gives an insight into the demographics of medical cannabis patients across Europe – and the conditions they are being prescribed for.
Cannabis industry experts at Prohibition Partners, have assembled one of the most comprehensive breakdowns of demographics in the European medical cannabis space.
The data analytics company has compiled multiple sources to determine insights such as the age and gender of patients across Europe, and what health issues they are using medical cannabis for.
While the UK‘s medical cannabis patients are more similar to those in developed markets like the US and Israel, patients in Germany, Italy and Denmark tend to be older and more predominantly women, the report found.
“The medicalised nature of cannabis distribution in Europe means the balance of patients who are using for purely medical purposes rather than mixed medical/adult-use is lower,” the authors of the report said.
“More familiar product formats such as oils and capsules are more common in Europe than most other medical cannabis markets. [This] is one of the most comprehensive views on the characteristics of medical cannabis patients and products available anywhere.”
How old are medical cannabis patients in Europe?
The report showed that Europe’s medical cannabis patients are slightly older than those in more developed markets such as the US or Canada, where many patients also use cannabis recreationally.
Data sourced from Project Twenty21 revealed that the average age of patients in the UK is 40.
In Germany, the continent’s largest medical cannabis market, the average age of patients stands at around 56.
However, Prohibition Partners anticipate that the true average age is lower due to the underreporting of patients using cannabis flower rather than oils or capsules.
Meanwhile, in Denmark, Czechia and Italy where medical cannabis regulation is more restrictive, the average age of patients is between 55 and 60.
More women are taking medical cannabis than men
Contrary to other developed markets, medical cannabis patients in Europe are predominantly female. In Denmark, Czechia and Italy more than 60 per cent of patients are women, while Germany has an almost even split with 51 per cent of patients being men.
The UK follows similar patterns to advanced markets like Australia, Israel and the US where the majority of medical cannabis patients are male.
What are patients taking cannabis-based medicines for?
As in other markets, European patients are mostly prescribed medical cannabis for severe and chronic pain. This is to be expected given the prevalence of pain conditions. It is estimated that up to one in three people suffer from pain in some form.
Spasticity, which is often associated with multiple sclerosis is another common condition highlighted by Prohibition Partners. Although it is far less common than pain conditions, MS is notoriously difficult to treat which could explain why so many people turn to medical cannabis for relief.
Thanks to high profile media coverage for patients such as Alfie Dingley, medical cannabis is strongly associated with severe forms of epilepsy. The data shows, however, that the proportion of the population using THC and CBD for epilepsy is relatively low due to the rarity of these conditions.
Experts on everything you need to know about medical cannabis in the UK
Key takeaways from The Medical Cannabis Clinicians Society event earlier this month.
Key takeaways as industry professionals and patients discuss all aspects of legally prescribing and consuming medicinal cannabis in the UK.
Earlier this month, the UK Medical Cannabis Clinicians Society (UKMCCS) hosted an insightful panel event exploring many aspects of medical cannabis in the UK.
The event was well attended by professionals, patients, and other interested parties. Jeremy Stull was there and summarised the key takeaways for Cannabis Health.
Taking place at The Midland Hotel in Manchester, the panel led by Professor Mike Barnes, chair of the UKMCCS and consultant neurologist, featured Katya Kowalski, head of operations at Volteface, Ryan McCreanor, founder of Sativa Learning and Emdad Khan, a medical cannabis patient in the UK.
The event covered topics including the history of medical cannabis use, controversial issues within the UK, the legality of prescribing medicinal cannabis, how cannabis affects the body, the evidence behind it, who can prescribe or be prescribed cannabis, the cost benefits to the patient, as well as a patient’s point of view.
History of cannabis
Professor Barnes briefly spoke to the fact that cannabis has a long history of medicinal use dating back to China, over 5,000 years ago.
Shen Nung, the father of Chinese medicine, wrote about cannabis for medical purposes, making it the oldest known medicine to man.
Also important to note was the propaganda campaign led by Harry Anslinger, head of the Federal Bureau of Narcotics (FBA) in 1930, while seeking to retain his budget after the US Prohibition.
Anslinger made false claims that caused public hysteria surrounding marijuana (cannabis), pushing a view that Mexicans who consumed the substance were violent and needed to be controlled.
The lasting effects of this campaign are still being felt today and remain prevalent amongst medical professionals, as well as the general public.
The endocannabinoid system
Professor Barnes went on to summarise the workings of the human endocannabinoid system (ECS), a system that covers a broad range of important roles within the body such as appetite, motor control, neurogenesis, neuroplasticity, memory, and analgesia to name a few.
He presented detailed neuroscientific information on how cannabis interacts with the ECS to help with these functions.
As cannabis is a “multi-chemical plant” it is difficult to run in a double-blind study, as opposed to a one to one compound test common in the pharmaceutical industry, Professor Barnes pointed out.
Some cite cost as a major concern when it comes to prescribing cannabis. However, Professor Barnes noted with cannabis prices currently sitting around £5 -£7 per gram and production costs around 40p per gram, it comes in much cheaper than other medications.
The NHS could negotiate the cost down further, making it a much more affordable solution than some of its counterparts.
Cost issues are being addressed through a scheme called Project Twenty21, a Drug Science-led observational study on the safety and efficacy of medical cannabis.
If enrolled in the project as a patient, you would receive subsidised medical cannabis prices in exchange for filling out a questionnaire every few months.
A patient on the panel, Emdad Khan, who is currently using prescribed medical cannabis shared how cannabis has significantly helped him with his depression and brought his creative side back.
Khan spoke of his experience of the process of joining a medical cannabis clinic and how he had found it fairly smooth and issue-free.
Katya Kowalski, head of operations at Volteface, an independent research and advocacy organisation that seeks to reduce the harm drugs pose to individuals and society, through evidence-based policy reform, talked about its recent work and the implications of its findings.
It seems that cannabis does not fit easily into the current healthcare system and that a lack of information about the practicalities of prescribing is affecting progress, as well as the long-term subconscious stigma not being addressed.
Volteface also found that early education is key to raising awareness amongst medical students. Training programmes and governance could be promoted and streamlined and appropriate prescribing must be a priority.
Ryan McCreanor, founder of Sativa Learning shared how the organisation is providing trusted education about cannabis and offering CPD accredited online courses in connection with industry experts.
The courses include CBD industry professional and medical cannabis. McCreanor played an important part in the rollout of the Canadian medical cannabis programme.
The UKMCCS, Volteface, Sativa Learning, and Drug Science are working to spread information and affect more positive policy change around prescribing medical cannabis in pursuit of helping patients improve their lives.
Barnes said the event was a “great day” with “a good turnout of a whole interested audience from many different backgrounds and specialties” and he “looks forward to doing it again in Belfast.”
If you are a professional or patient interested in more information about how to help move the industry forward or how to prescribe or receive a medical cannabis prescription, more information and support can be found through UKMCCS, Drug Science’s Project Twenty21, Volteface, and Sativa Learning.
The UKMCCS will also be hosting a similar event in Belfast in July 2022, tickets can be found here.
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