Despite becoming a legal medication available on prescription in 2018, patients continue to face challenges gaining access to medical cannabis. In 2019, Drug Science’s Project Twenty21 launched with the aim of providing patients with access to affordable legal cannabis. However, a recent announcement of a 40% price increase creates concerns for patients as participants in the project voice they won’t be able to remain a part of the study due to increased costs. Patients risk having to return to using illegal markets in order to gain access to the medication, increasing the potential harms from product quality and legal repercussions.
Cannabis-based medications such as cannabis flower and cannabis oil have been legally available on prescription in the UK since 2018. Although not currently available through a public prescription on the NHS, patients requiring cannabis-based treatments for a variety of medical conditions can gain access to the medication through private clinics. Eligible patients wanting to receive treatment must pay for a consultation, a private prescription and regular follow up appointments. This price varies across clinics.
Due to cannabis being prescribed for serious and debilitating health conditions, a high percentage of patients needing treatment may already struggle to pay for a private prescription because of their reduced ability to work. This means not every patient can afford to gain legal access to the medicine they need, particularly as the price of medicine can balloon into several hundreds of pounds per month.
In a bid to help more patients gain access to affordable legal cannabis, Project Twenty21 was launched by DrugScience. The project collects data to demonstrate the effectiveness of cannabis as a medicine in the UK, with the aim of collecting enough evidence to demonstrate the benefits of making it routinely available for public prescription through the NHS. The project originally set prices of cannabis flower and oil to £5 a gram with a £150 price cap, making it cheaper than other private clinics.
However, Project Twenty21’s 40% price increase for patients has removed the price cap model and increased the price of cannabis flower and oils to £7 per gram and millilitre. It appears that in comparison with other private clinics, Project Twenty21 is no longer the cheapest option available for patients. The announcement has caused great distress in the patient community, with many Project Twenty21 participants voicing their opinions online. The price increase impacts everyone involved in the study but particularly those who are receiving prescriptions for concentrated cannabis oil, as the removal of the original price cap causes the new price per bottle of oil to soar.
The price change was originally set to happen on the 1st Feb 2022. Drug Science explained the change in price was due to the project needing to be extended to gather more data after not reaching their original target. The team are quoted saying:
“The decision has only been taken to ensure that Project Twenty21 can continue, remain competitive, and that our producers can keep supplying the highest quality medicines to enrolled patients… By continuing for at least another year, Project Twenty21 will move us closer to our long-term goal, providing enough high-quality UK-based evidence around the benefits of medical cannabis to open up NHS funding for these medicines”.
After a number of patients shared their concerns and asked for the new price model to be changed, Project Twenty21 announced that the price changes would be delayed until the 1st March 2022. Patients are still concerned about how this will affect them. With patients already struggling to afford legal access to cannabis, this news foreshadows how access will be compromised even further. Not only will this influence the projects data as patients are forced to withdraw from the study but it will also force patients towards illegal markets in order to still gain access to the medicine they need.
The news of the price rise came shortly after the Government’s release of their 10-Year Drug Strategy. The strategy completely fails to mention medical cannabis at all, failing to highlight the lack of funding for medical cannabis prescriptions despite promising to increase funding in other drug treatment areas. This comes as no surprise as MPs and law enforcements attitudes towards legal access continues to remain negative, lacking evidence to support their claims. It has also been highlighted there is a lack of political support surrounding the Medical Cannabis Bill as MP Jeff Smith sponsoring the Bill acknowledges that it’s set to fail.
Those who cannot continue to remain within Project Twenty21’s study or afford private healthcare will be forced to withdraw from the study and seek out cannabis through illegal markets, changing their status as a patient to a recreational drug user. The strategy explains: “We will improve our methods for identifying ‘recreational’ drug users and roll-out a system of tougher penalties aimed at this”, emphasising both that cannabis is the most wildly used recreational drug in the UK and that people who use drugs ‘recreationally’ must be penalised. As a result, patients could fall victim to the Government’s tough approach towards recreational drug use, potentially facing arrest for possessing or procuring their medicine.
Project Twenty21’s struggle to maintain its prices low are an indication of a wider struggle within the UK’s medical cannabis market. More recognition of medical cannabis by the Government and Home Office is needed to ensure that patients are treated like patients rather than criminals and are protected from criminal sanctions and other forms of punishment or coercion. This is a crucial step in improving access to harm reduction and the quality of life for those living with chronic health conditions.
The lack of recognition of cannabis as a medicine is keeping prices high for patients, restricting access for all that could benefit from the medicine. They must bear the financial load of proving to the health system that their medicine is working for them. Until medical cannabis is completely acknowledged as a legitimate form of medicine that is adequately reimbursed for greater access, patients will continue to be forced to access illegal markets to acquire their medicine, and be criminalised by a Government that fails to recognise their unmet medical need.
