Accessing Medical Cannabis

A prescription for medical cannabis can be obtained in three different ways:

1. A GP can request permission to prescribe. In every state except Tasmania, a GP can request to prescribe medical cannabis. So getting a prescription can be as simple as asking your GP, as long as you meet the eligibility criteria. (Some GPs may not want to get this permission to prescribe as it can be a lengthy process).
2. An Authorised Prescriber can prescribe. This is a doctor who has already applied to the TGA for authorisation to prescribe CBD. Authorised Prescribers (AP) are not a special type of doctor – they can be a GP or specialist who has been granted AP status.
3. You can take part in clinical trials. Becoming part of a clinical trial is the third pathway to access medical cannabis.

In order for doctors to prescribe CBD products, they must have TGA approval through one of the following pathways:

• Special Access Scheme (SAS)
• or become an Authorised Prescriber (AP)

There are also many Cannabis Clinics in different areas. Their prices and products vary so it may be worth comparing.  Click Here to search for a doctor or clinic in your state.

Will I have to pay?

Currently there are no medicinal cannabis products listed on the Pharmaceutical Benefits Scheme (PBS). This means there is no Commonwealth Government subsidy and the patient bears the full cost of the medication. The TGA expects this may change in the future.

Unfortunately medicinal cannabis is prohibitively expensive for many people, which has driven many Australians to the black market to access the product. These products aren’t assessed for safety, quality and effectiveness and may differ from different batches and manufacturers.

Tasmania is the only state that bears the cost of prescribed medicinal cannabis, however, very few patients have managed to gain approval. Various states have funded compassionate access schemes for a limited number of children with severe intractable epilepsy, and a limited number of people may get access via clinical trials. For more information

Are costs likely to ever come down?

According to the TGA, the process of listing cannabis products under the PBS is underway but may take some time.

In Australia, doctors are not permitted to advertise that they prescribe specific medications. This is in line with the Therapeutic Goods legislation and the professional and ethical standards of the Medical Board of Australia and Australian Health Practitioner Regulation Agency (AHPRA).

For privacy reasons the details of authorised prescribers, or doctors who are willing to prescribe medicinal cannabis products, are not publicly available. However, a number of private medicinal cannabis clinics have opened facilities in multiple locations across Australia, slightly easing access issues.

Many clinics require a referral or letter from your treating doctor before an initial assessment is undertaken to determine if you meet the criteria to become a medicinal cannabis patient. Completing the C4E Epilepsy Patient History Form will assist your doctor with the necessary paperwork.

The fees for consults, assessments and the application process vary between clinics and it is worth exploring the clinics situated in your state or territory.

A number of hospitals also have authorised prescribers for specific medicinal cannabis products, often linked to a compassionate access scheme or clinical research study.

To search for a prescribing Doctor or Clinic near you, Click Here

Why can’t I find suppliers advertising medicinal cannabis?

With the exception of one product (nabiximols), medicinal cannabis products are not registered medicines in Australia, so they must be accessed through special pathways available for unapproved medicines.

State and Commonwealth laws only allow the advertising of medicinal cannabis products to wholesale, medical and pharmaceutical professions only; not to the general public.

The Regulation specifies that price lists, advertisements and promotional material must only be accessible to the wholesale drug trade, medical or pharmaceutical professionals, or through professional or trade journals. Any advertising on a company website directed at potential patients is a contravention of the Regulation and may be subject to penalties.

The Office of Drug Control (ODC) publishes and regularly updates a list of manufacturers and suppliers of medicinal cannabis products, with links to their websites.

Unapproved medicinal cannabis products warehoused in Australia can only be accessed via Special Access Scheme (SAS) Category B, however, unapproved medicinal cannabis products not already in Australia can be imported with the appropriate Office of Drug Control permits.

How can my doctor help?

Some patients undertake extensive research before their initial discussion with their doctor and have a particular formulation or product already in mind; others look to their doctor for guidance.

Because the area of medicinal cannabis is reasonably new and changing rapidly, many medical practitioners have limited understating of, and experience with, cannabinoid-based therapeutics.

Finding a doctor who is an Authoriser Prescriber of medicinal cannabis will ensure you are speaking with a medical professional with expertise and interest in cannabinoid-based therapeutics.

The endocannabinoid system, endocannabinoids (such as anandamide), CB1 and CB2 receptors and phytocannabinoids are relatively recent discoveries and many higher educational institutions are only just including this in their curriculums for medical and allied heath students.

In Australia, there is only one medicinal cannabis product approved and registered with the Therapeutic Goods Administration which means it has product information for both prescribers and patients. Unapproved therapeutic goods brought into Australia are not permitted to contain product information leaflets, even if they exist, as it is seen as making unsubstantiated medical claims yet to be tested.

To confidently prescribe any new medicine, doctors require high quality clinical research conducted in humans to decide if their patient would benefit from that medication.

Any doctor prescribing an unapproved therapeutic good, such as medicinal cannabis, takes on the legal liability for that patient’s wellbeing.

Lack of knowledge and experience with medicinal cannabis products and the legal liability when prescribing unapproved therapeutic goods can influence a doctor’s willingness to prescribe medicinal cannabis.

As there is only one cannabis-based medicine currently registered with the Therapeutic Goods Administration (TGA) for treating multiple sclerosis, doctors willing to prescribe unapproved therapeutic goods such as pharmaceutical grade medicinal cannabis, take on the legal liability. If they work within a hospital or within a research study, the organisation takes on that responsibility.

Patients are required to make informed decisions about their treatment in consultation with the treating doctor. Therefore, signing of a medical consent form is required.

The sample below is quoted from the Western Australian Department of Health Cannabis-based Treatment Consent Form:

My doctor has proposed using a cannabis-based product to help improve health profile. I understand:

• that the treatment is not guaranteed to work, as the scientific evidence of its effectiveness is limited
• that I will be starting it as a trial, which we will stop or vary if there is not a significant benefit
• that it may have some side effects, which my doctor and I have discussed
• using cannabis-based products in combination with alcohol is not recommended
• that it may or may not lead to a reduction in some of my other medications
• that the doctor will have to report on my progress to the Health Department

I therefore agree:

• to take the treatment strictly as recommended and only alter the dose in discussion with my doctor
• to report any beneficial effects and any side-effects at the scheduled follow-up visits the doctor has made for me
• to be honest with the doctor about my full medical and psychiatric history, as well as any history of recreational drug use
• never to share the product with another person
• not to drive or operate machinery until the effects on my alertness have been assessed and discussed with the doctor.
• (if female) to inform my doctor if I become or are thinking about becoming pregnant