Cannabis-Based Medicines Approved for NHS Use 

Peter Russell

November 11, 2019

Cannabis-based medicinal products for people with intractable nausea and vomiting, spasticity or severe treatment-resistant epilepsy have been approved for NHS use in England for the first time.

Draft guidance was issued by the National Institute for Health and Care Excellence (NICE) which had examined several substances to treat the conditions.

The move was welcomed by charities but some campaigners said too many people who would benefit from cannabis-based medicines were being excluded from treatment.

New Guidelines

The guidance meant that health professionals would be able to prescribe:

However, NICE ruled out prescribing nabilone, dronabinol (a synthetic THC preparation), THC alone or the combination of CBD with THC to treat chronic pain.

It stressed that an initial prescription of cannabis-based medicinal products must be made by a specialist medical practitioner.

The appraisal committee recommended a number of key issues for research.

Reaction to the Decision

The MS Society welcomed the decision but called for more to be done to make cannabis-based medicine available to everyone with MS who could benefit.

 

Genevieve Edwards, the charity's director of external affairs, said: "These guidelines are an important first step, but don't go far enough. No cannabis-based treatments have been recommended to treat pain, a common symptom of MS.

"Additionally, because Sativex will be funded by local bodies – who might not have the resource they need to prescribe it – even more people could miss out."

The MS Society called on the next government to accelerate research and remove barriers to treatment with cannabis-based medicines.

Epilepsy Action described the decision to recommend nabilone and cannabidiol as a welcome step. Simon Wigglesworth, the charity's chief executive, said: "For people affected by Lennox-Gastaut syndrome and Dravet syndrome, the reality of living with these conditions is often incredibly challenging. These syndromes are often treatment-resistant and can cause tens or even hundreds of seizures every day. Any one of these seizures could be life-threatening.

"Epidyolex is not a silver bullet. However, there is high-quality clinical evidence that this treatment can reduce the number of seizures caused by these epilepsies."

Mr Wrigglesworth said there was potential for the treatment to be used for other treatment-resistant epilepsies.

Gino Martini, chief scientist at the Royal Pharmaceutical Society, commented: "Pharmacists will be on the frontline of supplying cannabis-based medicinal products and can give advice to patients on them as part of their treatment plan.

"It's essential there is robust governance around prescribing and dispensing, and pharmacists have a key role to play in ensuring this is in place across health systems."

Change in the Law

Legislation in November 2018 allowed specialist doctors to prescribe medicinal-based cannabis. However, many healthcare professionals have been reluctant to do so due to concerns about prescribing guidance.

That led to a number of carers seeking supplies abroad, and some families importing cannabis-based medicinal products into the UK illegally.
 

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