NHS reimburses cost of unlicensed cannabis treatment in ‘rare’ adult case

The NHS has reimbursed the cost of a UK patient’s private medicinal cannabis treatment, in what has been described as a ‘rare’ case. 

A patient at Zerenia Clinics has successfully attained full reimbursement of the costs of unlicensed cannabis-based medication and clinic fees through the NHS. 

The clinic, which is owned by Khiron Life Sciences, first announced the news in a press release last week. 

While the company is unable to release many details about the case due to confidentiality, a spokesperson for the team told Cannabis Health that the individual is an adult patient with a ‘debilitating’ but ‘common’ condition.

The patient is said to have been referred to Zerenia Clinics by their specialist consultant for ‘advice and consultation’ on cannabis-based treatment options. They were then prescribed an unlicensed cannabis-based product containing ‘medical grade’ levels of CBD and THC. 

Khiron has delivered bespoke education and training to doctors and nurses, at a private hospital that holds contracts with NHS England, on cannabis-based medicines. It is said to have a number of ‘influential doctors’ taking part in its current CPD-accredited training academy. 

While NHS England will not reimburse the costs of prescribing unlicensed cannabis-based medicines, individual trusts can apply for funding through the local Clinical Commissioning Group (CCG), which is responsible for allocating funds for health services in that area. 

The clinic confirmed that an Individual Funding Request (IFR) was made to the CCG in this case, but it was not directly involved in this process. 

Very few IFRs for unlicensed cannabis-based medicines have been successful to date, and it is thought this may be the first time medication and clinic fees have been reimbursed through this route. 

A ‘step in the right direction’ 

Figures from NHS Business Services Authority released this month revealed that fewer than five patients have obtained prescription cannabis through the NHS, three of whom are known to be children with severe epilepsy. 

Speaking to Cannabis Health, Khiron described the development as a ‘step in the right direction’ but advised that this route would not be open to most cannabis patients at this stage. 

It hopes, however, to continue working towards a more widespread patient reimbursement scheme, such as the one it has secured in Colombia, where the costs of cannabis treatment are now covered by the country’s healthcare system. 

Will cannabis be a postcode lottery?

Patients and advocates for medicinal cannabis in the UK have welcomed the news but warned of a need to ‘manage expectations’. 

In 2018, Hannah Deacon successfully obtained an NHS prescription for her son Alfie Dingley, who is one of a few boys in the world with a genetic condition that causes severe epilepsy. She is now executive director of the Medical Cannabis Clinicians Society and Maple Tree Consultants and has continued to campaign for NHS access on behalf of others.

Ms Deacon welcomed this as a ‘positive step forward’ but cautioned that we could end up with a ‘postcode lottery’, with some trusts willing to fund cannabis medicines and others not. 

“This is a really positive step forward but, with the prescribing of unlicensed medicines not widely supported, we may end up with a situation where some hospital trusts will support the funding of unlicensed cannabinoids and some won’t,” she told Cannabis Health.

In 2021, the MS Society published a report that revealed only 49 out of 106 CCGs were funding Sativex, a licensed cannabis-based medicine which can be prescribed through the NHS for spasticity in MS.

Ms Deacon added: “The NHS needs to issue stringent, openly available guidance to doctors about the prescribing of unlicensed cannabinoids through their trust, otherwise we are in danger of access becoming a postcode lottery, and that is simply unfair on many severely ill patients.”

This is a sentiment echoed by Zach Thompson, chair of PLEA (Patient-led Engagement for Access), who highlighted the injustice of NHS access for some but not all.

“Khiron Life Sciences has achieved a major milestone, receiving reimbursement from the NHS for costs of a cannabis-based treatment for a patient, and PLEA is very happy for this patient and their loved ones,” he commented.

“The very fact of this validates the efficacy and safety of cannabis for chronic conditions. However, access to a medicine should not be dependent on where you live or other external factors. The NHS should be covering the costs of cannabis treatment for all those who are eligible, as was intended when the law changed in November 2018. Allowing some to access this through the NHS and not others is against the very foundations of our national health service.”

Mr Thompson added: “We know patients are paying hundreds of pounds a month for their prescriptions privately, during a time of economic hardship. We hope this is a step towards fair and equal access to prescription cannabis on the NHS across the UK, but until then we must work to lower the costs and provide financial assistance to those who need it and whose only route to cannabis treatment is through the private sector.”

‘Managing expectations’

Matt Hughes, who co-founded Medcan Support with Ms Deacon, applied for funding through his local CCG for his son Charlie, who has West syndrome, but was unsuccessful.

“This is a great achievement and a step forward, but we need to manage expectations,” he said. 

“As awareness grows and patient numbers increase, there will inevitably be unique cases where exceptional circumstances meet criteria to access funding or be reimbursed through the NHS. I’m sure, over the coming years, we will see more cases like this. However, for the general population, the narrative remains that NIHR and the NHS wish to see further clinical trials conducted on cannabis-based products.”

Mr Hughes added: “Until we see these happening, the NHS should provide a clear path to the funding and prescribing of unlicensed cannabis medicines when in the vast majority of cases exceptional need is not met.”

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