Why medical marijuana patients can’t access their prescriptions at pharmacies

When marijuana became legal across Canada last October, it became a little easier for recreational users to access cannabis.

First, you could buy it online and as of April 1^st, you could purchase it legally at a handful of brick and mortar stores.

But for years, the 330,000 Canadians with medicinal cannabis prescriptions have been tied to their mailboxes, ordering online and waiting for the delivery.

They can’t get their prescriptions filled at a pharmacy, and instead have to rely on non-medical professionals to help them ascertain if there are potential adverse reactions to other medications they’re taking.

But that isn’t stopping companies like Sandoz — a major pharmaceutical company — from entering the space. Last year Sandoz, a division of Novartis, and one of the fastest growing pharmaceutical companies in the Canadian market, announced a partnership with B.C. cannabis company Tilray to develop and distribute medical marijuana products.

It’s the first deal between a major pharmaceutical company and a Canadian cannabis producer.

“There are actually currently eight products in market. Three which are gel caps and hard caps and the other five which are oils. We’re not in the smoke-able business, only non-smoke-able. And those products contain both of our brands,” explains Sandoz Canada’s  Executive Director of Innovation and Strategic Projects, Vincenzo Ciampi.

“We’re also working on additional products in the future which will be other form factors, which will make it easier for the patient to use the product in a safe way.”

Ciampi says many of the Sandoz/Tilray products have been successful at helping individuals cope with different symptoms or conditions including psychological trauma, PTSD, and neuropathic pain.

“Also things to do with epilepsy, for example. There’s been a lot of indications that they can help to reduce some of the symptoms of epilepsy,” he says.

But their products are only available online through licenced distributors. According to the Health Canada website there are fewer than 100 distributors able to sell directly to patients. Federal and provincial regulations prohibit pharmacists from dispensing any form of medicinal cannabis.

”We’re looking at almost two-fold types of problem,” explains the Ontario Pharmacists’ Association’s (OPA) Allan Malek. ”We’ve got a challenge certainly at the provincial level, and certainly we would love to see the Smoke-Free Ontario Act amended to allow pharmacies to be able to dispense, and now we’re talking about non-combustible forms of cannabis products for medicinal use. But that’s only part of the problem. We have a problem with the federal law, and making, and allowing pharmacists to be in a position to sell and dispense medicinal cannabis.”

The OPA is one of several groups lobbying the provincial government to change the rules, not only so pharmacists can enter into the growing field, but also to better protect patients.

Malek says there are 600 drugs that could have negative interactions with cannabis, with more than 120 of them classified as “severe” or “significant.”

“There’s no opportunity for pharmacists to actually look at a prescription for medicinal cannabis, measure that to make sure it works in conjunction with all the patients other medication therapies that are going on, looking for interactions. Right now there’s really no oversight on this, is what’s really frustrating and quite frankly we see it as a real safety issue.”

Last week, CityNews asked Canada’s Health Minister, Ginette Petitpas Taylor, if the federal government would consider allowing pharmacies to dispense non-combustible, prescription marijuana. “There’s been very little research when it comes to the medicinal use of cannabis and we certainly recognize that more research is being done in that field and I look forward to seeing the results of that research,” she said.

But Petitpas Taylor wouldn’t answer if the government would consider allowing pharmacies to dispense prescribed cannabis products.

Ciampi points to several studies that have shown positive results for patients using cannabis. “We’ve seen many clinical trials, we’ve also seen various studies with data that show that there is definitely a link between the cannabis product and a symptom being alleviated for a patient,” Ciampi says, noting that Sandoz is working with several universities and the Hospital for Sick Children on even more studies in the area. “But today there is enough proof out there, through studies and clinical trials, that there are definitely benefits from medical cannabis.”

In a statement, Health Canada spokesperson Tammy Jarbeau writes: “Enabling cannabis for medical purposes to be sold in pharmacies would require support from the provinces and territories, their regulatory authorities responsible for pharmacists, and pharmacists themselves. Health Canada has previously indicated that it is open to discussing other models of distributing cannabis for medical purposes, including pharmacy distribution, if support exists.”

And support apparently does exist — at least in Ontario. The OPA has been actively lobbying the government for these changes, as have some pharmacies like Shoppers Drug Mart,  which is currently dispensing cannabis-related products online only.

In fact, since legalization 219 different lobbyists have registered to try to persuade the Ontario government on cannabis-related issues — including retail space, regulations about locations, and its availability through pharmacies. It’s one of the biggest single-issue campaigns at the legislature.

Yet Ontario’s Health Minister has declined to comment on the issue, instead pushing us to the Attorney General. In a statement, a spokesperson for the Attorney General writes: “The medical sale of cannabis will continue to be regulated by the federal government,” suggesting the provincial government isn’t interested in re-examining ways pharmacists can play a role in the field.

CityNews asked for clarification, but did not get a response.

“We had conversations with both the federal and provincial government and what we’re being told is that it’s the responsibility of the other party. So we believe there’s some confusion there that we could help to alleviate and actually bring about some change there,” Ciampi says.

“The way we look at it, there are 350,000 patients today that use medicinal cannabis, and we believe we should … make it more easy for them to have access. I think the focus of the government up until now has been on the recreational side. There is a medicinal product and a project in terms of online, but in terms of actual pharmacy access, this is an area we think we can improve. We want to work with the government to enable that.”