In the frame of the Cannabis Report 2020 from BKK Mobil Oil, Professor Gerd Glaeske’s working group at SOCIUM Research Center on Inequality and Social Policy at the University of Bremen analyzed the pharmaceutical account statements for cannabis prescriptions from 2017 to October 2019.
The result: Only a fifth of the applicants received cannabis-based pharmaceutical products within the frame of assessed and approved fields of use. These especially include the specialized, outpatient, palliative care of cancer patients, as well as applications from insured persons with neurological problems or anorexia.
Not a Relevant Therapy Option for Many Indications
However, the majority of the patients received cannabinoids for indications outside of those assessed in clinical studies – for example, due to chronic pain syndrome (27 percent), sustained back pain (7 percent), spasticity (6 percent), or polyneuropathy (5 percent).
Four Years of Cannabis-Based Pharmaceuticals
Since March 10, 2017, doctors have been allowed to prescribe cannabis-based pharmaceuticals as a narcotics prescription. There is a broad range of products. Alongside finished products that contain nabilone or nabiximols, the majority of the prescriptions are for dronabinol, as well as cannabis flowers and extracts of a pharmaceutical quality.
Since the beginning of 2017, the expenditure of the state health insurance companies has increased by more than 500 percent, “without approval of most of the cannabis products, such as flowers and extracts, without assessment of the additional usage with regard to tried and tested pharmaceuticals, and thus without clear evidence for use,” criticizes Professor Glaeske. The study leader calls this “seemingly archaic therapy in times of availability of cannabis products that are manufactured in a standardized manner and are available on the market, and especially well assessed, effective, and repeatedly tested pain medicine.”
Doubt Regarding Therapeutic Use
It is notable to the study authors that over 50 percent of the service expenditure on cannabis-based medical products can be matched to only around 8 percent of the patients. Several of them received a dose of 3 to 20 grams of cannabis flowers per day, thus far more than is included in the Netherlands’ state program, where a doctor can prescribe 0.62 to 0.82 grams per day. According to the study, such high dosages indicate that there may be abuse of the product or that the prescribed quantities are being sold on.
Demand for Legal Framework
Based on this, the study demands there be better legal frameworks in the form of further specification of the dosage forms and dosages, as well as a benefit assessment of the entire range of cannabis applications. “After all, cannabis is not a miracle cure,” summarizes Professor Glaeske. “Evidence, therapy safety, and patient benefit should stand at the forefront when deciding on the implementation of cannabis products. Thus, as is the case for all new pharmaceutical therapies, an AMNOG assessment should be completed by the Federal Joint Committee.” However, even after four years of cannabis prescriptions, we are still far away from attaining this.
SOCIUM Research Center on Inequality and Social Policy
University of Bremen
Phone: +49 421 218-58530
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