The medical cannabis value chain
Stuart Lambie, who acts as Strategic Advisor for Medical Cannabis Europe, sits down with Block magazine for a look at the challenges of establishing a patient-focused regulatory framework for medicinal cannabis. Stuart also lent his voice as a VIP speaker to the October digital conferences for Med Tech and Med Cann.
Tell us a bit about the non-profit movement Medicinal Cannabis Europe and what it hopes to achieve over the next couple of years.
Medicinal Cannabis Europe is the only pan European multi-stakeholder organization that aims for patients’ fair access to safe, high-quality medicinal cannabis. It brings together patients, academic, scientific communities as well as industries. It aims to achieve patients’ fair access via the establishment of a regulatory framework at European level that would harmonize the production, distribution and use of cannabis-based treatments.
Is there a lack of harmonization of legislation governing medicinal cannabis across Europe?
Yes. In fact, Member States regulate the licensing, production, distribution and access to medicinal cannabis. Across the EU, the legislation governing medicinal cannabis is fragmented. This lack of harmonization is detrimental for patients’ access, and it also precludes proper research and innovation on the benefits of medicinal cannabis and hinders the development of the European medicinal cannabis sector. For instance, one country would allow prescription of medicinal cannabis but would not have any regulation in place for domestic production. Patients would then be obliged to rely on supply coming from abroad, which leads to a higher cost of the medicines. This example also emphasizes that a given country can be dependent on international suppliers, who may reduce their production or face regulatory hurdles for shipping their raw products, causing shortages which directly affect patients’ ability to get their treatment.
What are the key challenges the medical cannabis value chain faces within the European Union?
Patients are mainly struggling with accessibility and affordability of cannabis-based treatments, while the industry needs to adapt to different, fragmented rules and standards which hinder the smooth running of the EU internal market. Funding for research on medicinal cannabis is also limited within the EU, and that affects the ability of the scientific community to tap into the potential of cannabis-based treatments through new scientific evidence. Medicinal Cannabis Europe voices the concerns of the value chain towards EU decision-makers and advocates for a set of clear, minimum rules in the European Union.
the industry needs to adapt to different, fragmented rules and standards which hinder the smooth running of the EU internal market.
A number of policy makers have been calling on the EU to ensure fair patient access to medicinal cannabis in Europe – where do we stand?
In February 2019, the European Parliament adopted a resolution on the use of cannabis for medicinal purposes. The Parliament urged the European Commission and Member States to facilitate fair access to cannabis-based medicines, to agree on a common definition of medicinal cannabis and to boost research and innovation to develop more scientific evidence.
In April 2019, Medicinal Cannabis Europe launched a Policy Pledge addressed to Members of the European Parliament (MEPs) which calls for the establishment of a harmonized European regulatory framework and for the allocation of EU funding for research on medicinal cannabis. We have seen an increased support from MEPs from across the political spectrum over the past few months, but a lot remains to be done! In this context, on 13 October, MEPs Frédérique Ries, Tilly Metz and Alex Agius Saliba together with Medicinal Cannabis Europe will host a conference at the European Parliament to address the next steps and pave the way towards a European approach on medicinal cannabis.
Why do you think there is such mistrust shown by medical professionals when it comes to prescribing cannabis-based medical products?
Many healthcare professionals argue that there is not enough scientific evidence to substantiate and justify the safe prescription of medicinal cannabis as a treatment. In this regard, the allocation of research funds is paramount to identify and demonstrate the benefits of medicinal cannabis applications. Beyond research, healthcare professionals also need to be trained and educated on the already existing scientific evidence on medicinal cannabis. In this regard, some Medicinal Cannabis Europe’s members are actively involved in initiatives to train doctors and nurses, to develop knowledgeable medical professionals who could include cannabis-based medicines as part of a patient’s treatment for certain conditions (e.g. epilepsy, pain alleviation, fibromyalgia).
Patients are mainly struggling with accessibility and affordability of cannabis-based treatments
What key changes to the medical cannabis sector are going to define the next few years – particularly in terms of regulation?
At international level, there are ongoing negotiations to amend some cannabis classifications under the 1961 Single Convention on Narcotic Drugs. In particular, one recommendation suggests removing cannabis and cannabis resin from Schedule IV of the Convention, which includes substances liable to produce ill-effects and have little or no therapeutic use. If this recommendation passes, it would be an official acknowledgment of the therapeutic potential of cannabis at international level, hopefully opening the doors to more research on the topic. At EU level, there are several upcoming health-related initiatives where medicinal cannabis could play a role. For instance, the EU Beating Cancer Plan – expected by the end of the year – would encompass measures to improve the quality of life of cancer patients. The benefits of cannabis-based medicines to alleviate the side-effects of cancer treatments (e.g. nausea, lack of appetite) should be recognized and further promoted within the Plan.
We are strongly convinced that step by step, with the cooperation among the different players of the value chain and the support of policymakers, we will make tremendous steps ahead in ensuring patients’ fair access to cannabis-based treatments!
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