In a major step forward for the legalisation of medical cannabis and cannabis-derived medicines in the UK, the NHS has for the first time approved 2 medicines in the latter category for prescription. Last autumn, following a period of intense public pressure, the UK government made a landmark ruling that meant that medical cannabis could be legally prescribed.
However, only if other approved treatments for a condition had already been tried and proven to be ineffective and the prescription has to be made by a specialist consultant rather than any GP. The tight restrictions, and fact that official supply lines have been limited due to the newness of the ruling, mean very few legal medical cannabis prescriptions have actually been made and successfully received.
However, in a further sign of softening attitudes towards the drug, particularly within the context of its medicinal qualities, two cannabis-derived treatments have also now been approved by the National Institute for Health and Care Excellence (Nice). The first is Epidyolex, made from cannabidiol and designed to treat children who suffer from two rare forms of epilepsy. The second is Sativex, a cannabidiol and tetrahydrocannabinol-based spray used to treat multiple sclerosis. It relieves the muscle stiffness that the condition results in.
Cannabidiol is often referred to by the acronym CBD and containing none of the psychoactive qualities associated with cannabis grown for recreational use is most associated with cannabis for medical use. Tetrahydrocannabinol is better known as THC and is the psychoactive constituent of cannabis.
Earlier draft guidance published by Nice in August came to the conclusion that both treatments were too expensive to be recommended for prescription through the NHS. But the regulator has since changed its position and is now recommending them. Both treatments are produced by GW Pharmaceuticals, a British pharmaceuticals company that specialises in cannabis-derived treatments. Despite hailing from the UK, GW is listed on the Nasdaq rather than London Stock Exchange and has been forced to located much of its operations, particularly R&D, on mainland Europe and in the U.S. due to strict rules around cannabis in its home country.
GW COO Chris Tovey was predictably positive on the NHS development, announcing the move by Nice as a: “momentous occasion for UK patients and families who have waited for so many years for rigorously tested, evidenced and regulatory approved cannabis-based medicines to be reimbursed by the NHS”.
There has been a lack of clinical trials on medical cannabis in its pure form, meaning that conclusive evidence of many of its claimed medical qualities and benefits are yet to be definitely proven. That has led to a reluctance from British doctors to prescribe the drug in its plant form. However, medicines derived from cannabis, such as Epidyolex and Sativex have gone through the same clinical trials as any other approved pharmaceutical.
David Nutt, a neuropsychopharmacologist, commented for The Times: “The door is now opening to plant-based cannabis medicines and that is exciting.” However, he thinks that local NHS commissioning groups may still consider the drugs too expensive.
Professor Nutt is behind the Twenty21 project. Its goal is to attract 20,000 people to test cannabis-based medicines on to provide the data to guide future approvals. A survey by YouGov for the Centre for Medicinal Cannabis found that 1.4 million Britons used “street cannabis” for medical reasons.