UK: report opposes NHS funding of medical cannabis

In the United Kingdom, the medical cannabis was legalized last year,after the parents of Alfie Dingley and Billy Caldwell, both suffering from treatment-resistant epilepsy, publicly defied the authorities by illegally importing cannabis oil into the country. Since then, legalization has theoretically been effective, but regulations and the difficulty of accessing medicines mean that patients are unable to obtain their treatment, or at prohibitive cost. The British health authorities had therefore commissioned reports to enable an effective medical cannabis distribution system to be set up. However, while the public health system (NHS) has published a report this week introducing a series of measures to remove barriers to the appropriate prescription of medical cannabis, the National Institute for Health and Care Excellence (NICE), has published a contradictory report.

Doctors and families against the report

The National Institute for Health and Care Excellence is responsible for deciding which healthcare products can be funded by the NHS. Their report found that «the committee was unable to recommend the use of cannabis-based medicines for the treatment of severe treatment-resistant epilepsy, due to a lack of clear evidence of efficacy». On the one hand, this outraged doctors, since even if there is still some way to go research proving the efficacy of medical cannabis and on the other hand, patients' associations, who have seen their quality of life greatly improve since being treated with medical cannabis.

Dani Gordon, a Canadian physician who now specializes in cannabis in the UK, said the report is «very disappointing, as it doesn't reflect what we see for the medical treatment of chronic pain patients. Nor does it recognize that this is a treatment that improves the quality of life for people with severe and incurable chronic illnesses.» Hannah Deacon, whose son Alfie Dingley is one of the few patients to have received an NHS prescription, said she was also extremely disappointed by NICE's decision. «Hundreds of thousands of people use cannabis-based medicines around the world and it has an extremely positive impact on their health,» she said. «Many countries have legalized the medical cannabis industries - America, Canada and the other G7 countries - and are finding that the evidence is sufficient. The UK insists on reinventing the wheel for no reason and the people suffering are patients.».

This anger is also shared by patients suffering from multiple sclerosis, since NICE has rejected the Sativex, a cannabis-based medicine, on the grounds that the price was too high. The report stated that the drug was not cost-effective for the NHS and that alternatives should be used instead. The National Multiple Sclerosis Society said it was bitterly disappointed. «NICE's refusal to recommend cannabis for muscle pain and muscle spasm, or to fund Sativex through the NHS, means that thousands of MS sufferers will continue to be denied effective treatment,» said Genevieve Edwards, the society's director of external affairs.

Medical cannabis is very expensive indeed. The parents of Murray Gray, who at the end of July 2019 became the Scotland's first patient to obtain a prescription for medical cannabis, They are currently paying £1500 a month for their son's treatment. For the time being, they are able to raise this money through private donations, but Karen Gray had hoped that the NHS would be able to pay for her child's medication. The NICE report, however, sounds the death knell for this hope.

The National Institute for Health and Care Excellence recommends two clinical trials. Dr Keith Ridge said, «We have heard loud and clear the concerns and frustration of the children's families, but these recommendations are intended to help us develop the evidence base for understanding the safety of these products, and to ensure specialist education and advice to help clinicians in the UK.».