Will I have to pay?
At present, there is no medicinal cannabis product listed on the Pharmaceutical Benefits Scheme (BPS). This means there is no Commonwealth Government subsidy and the patient bears the full cost of the medication.
For many Australians, the cost of medicinal cannabis is out of their reach or significant measures, such as accessing their superannuation or selling their house, need to be taken to finance the ongoing cost of the treatment.
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.
Why is it so costly?
Prices are set by the manufacturer and are driven by market demands. They vary depending upon the condition being treated, the product and dosage prescribed.
In addition to this, there may be importation costs (including shipping and customs fees), as well as general importer and pharmacist mark-up.
Are costs likely to ever come down?
With an increase in Therapeutic Goods Administration approvals, the cost of importing products will decrease and new medications coming to market will provide much needed competition.
An Australian based cannabis access company compared the prices of 11 suppliers and found that the prices charged by suppliers had fallen in the previous 12 months.
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.
Why can’t I find suppliers advertising medicinal cannabis?
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:
I therefore agree:
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