• Harrison Jordan

Don’t Forget Us: Cost-Coverage and Medical Cannabis Patients in a Legalized Canada

As the Canadian government prepares to legalize non-medical cannabis for summer 2018, medical cannabis patients across the country hope that both the federal government and cannabis companies will continue to support their needs.

The commencement of a lucrative non-medical cannabis system may mean that commercial cannabis producers turn their sights away from the medical market and towards the bourgeoning recreational market.

But there is some reason to have measured optimism. At least one company is developing a dried cannabis product that, if approved, would receive a Drug Identification Number from Health Canada - opening the door for cost-coverage by insurance companies.

Biopharmaceutical firm Tetra-Bio Pharma (TBP) has teamed up with licensed producer Aphria to develop a dried cannabis product called PPP001 that is meant to be smoked by medical cannabis users. The company is now going through an extensive drug review process with Health Canada in an attempt to get the drug approved for patients in Canada.

Jonathan Zaid of Canadians for Fair Access to Medical Marijuana thinks it’s a move in the right direction.

“It’s a positive step towards a pharmaceutical product derived from medical cannabis, which could also help broaden access through traditional pharmaceutical distribution methods and cost-coverage.”

Zaid notes that there are other companies trying to go down this path, “so it’s open for anyone to apply for a medical cannabis product to go through the drug approval process.”

Zaid would like those other companies to succeed at developing such products.

Erin Prosk is the director of Santé Cannabis in Montreal, a medical clinic that is helping run clinical trials for PPP001.

“We’ve been operating as a clinic doing observational research in Quebec for the last 3 years, and we have to move out of our clinical experience and into the regulatory world if we really want to make an impact for patient. While there are individual patients making a lot progress with their own cases against their insurance or worker’s compensation or other public insurers, for a more global impact on cannabis we have to go after the Drug Identification Number, because that’s really getting cannabis into the category where it speaks to the insurance companies and public insurers.”

She says Santé Cannabis formed a partnership with TBP when they were pursuing the development of an inhaled product of cannabis formulation. “Based on our experience at Santé Cannabis and the published literature, we helped them develop the formulation and we were involved in the Phase 1 study looking at safety in individuals.

“In the initial phases we had to work with research staff to understand how someone is properly inhaling. So we had some of our experience from the clinic where we have our educators teaching how to inhale and how to do so in a controlled way so the inhalations are as standardized as possible. We used those techniques and the experience that we developed here to support the Phase 1 study.”

Though vaporization may generally be safer than smoking, Prosk notes that it would be cost prohibitive to provide vaporizers for all the study participants.

“We do plan to bridge over into vaporizers as well, but the justification for [a smoking] pipe is that it’s a cost issue. The only approved medical devices that are vaporizers are very expensive, and if we’re thinking about cost coverage on the other end, we want to make sure there is an affordable option.”

Despite the advancements with the PPP001 product, patients may still have limits within the medical cannabis program. Tax will apply to both medical and non-medical cannabis products, and those who purchase recreational cannabis will have access to products from a variety of producers within a single retail store, while medical cannabis patients will continue to be locked into one licensed producer per medical document that their doctor signs.

I wondered how Zaid felt about this, and he was quick to note some promising new changes that Health Canada has said they are bringing to the medical system.

“It’s a good question. The regulation proposals under C-45 [the Cannabis Act] contemplates patients being able to transfer their medical document between licensed producer themselves, the same way you can switch between pharmacies.

“This will allow more access for patients. But yet, recreational cannabis may actually be easier to access than medical cannabis. So it’s really important that things like cost-coverage and tax differentials are used for the medical system to ensure patients using it for medical purpose have access.”

Zaid has some reason to celebrate; Sun Life, the insurer he had been fighting to cover his medical cannabis, has now broadened its policy so that other patients (under certain conditions) can access medical cannabis cost-coverage through their plan’s Extended Health Benefits.