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Michel Robidoux is president and general manager of Sandoz Canada Inc.

As the implementation of recreational cannabis is rolling out across Canada, it brings with it some confusion. Patients authorized to use cannabis for medical purposes also find their system under a bit of a haze. However, one thing is perfectly clear – the medical cannabis system must remain a distinct system and be strengthened to retain the medical patients who have been authorized by physicians.

The results of a recent national survey of 1,500 Canadians, conducted by Leger, confirm some of our fears – 61 per cent of Canadians said that the medical system no longer exists, or don’t know if it exists. Another 47 per cent expressed concern that medical cannabis patients will venture into the recreational market for product. These numbers are alarming. In this era of legalized recreational cannabis, where will Canada’s current 330,758 registered patients and new medical cannabis patients turn to access treatment?

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If patients transition to a recreational stream, the survey shows concern that patients will no longer be under the care of a healthcare professional and could self-medicate (63 per cent). Canadians are also concerned that recreational cannabis is not the same product as medical cannabis in terms of dosage or consistency, and as such, more side effects from recreational products could occur when taken with other medicines (54 per cent).

Earlier this year, Sandoz and Tilray, a licensed producer, entered into a strategic alliance in Canada to provide high-quality medical cannabis products and to provide better access to the medical cannabis stream. Here’s how we plan to address the issues and barriers.

Increase Professional Care – Access to a broader network of healthcare professionals will be critical to strengthening the medical cannabis system in Canada. As such, governments should allow pharmacists and pharmacy retail chains to dispense medical cannabis. We are currently supporting the Canadian Pharmacists Association to launch accredited educational training content on medical cannabis so that pharmacists can be trained to dispense and provide patient counselling.

In the Leger survey, 53 per cent of respondents agree that there is currently a lack of professionals involved in prescribing and dispensing medical cannabis and providing care. Just under half (49 per cent) believe that increasing the scope and role of pharmacists can improve access to medical cannabis and mitigate movement to the recreational market. Pharmacists can also identify potential interactions with other medications. If cannabis is used to treat a medical condition, we believe that it should be distributed through an appropriate channel to properly regulate the therapeutic intent of the treatment.

Remove Access Barriers to Medical Cannabis – Canadians state that the two major barriers to entering the medical cannabis market are the lack of information on how to have access to medical cannabis, and the lack of public and private payer drug coverage (58 per cent). Other barriers include the excise tax on medical treatment and the limited clinical evidence to support cannabis for medical purposes. As such, we are currently advocating for the removal of excise taxes on medical cannabis (like any other drug treatment) and an increase in private and public drug plan coverage.

Enhance Innovation and Evidence – Beyond capsules and ingestible oils, further innovation is required to develop other high-quality products while using stringent manufacturing standards. Tilray, in collaboration with Sandoz, will look to develop new non-combustible medical cannabis products in other formats to serve patients. In addition, we are encouraged by the advancement of clinical studies to support physician decision-making. Today, many clinical studies are underway to examine a number of indications, including the use of cannabis extracts in the treatment of pediatric epilepsy, chemotherapy-induced nausea and vomiting, and essential tremors.

We must continue to maintain a focus on the medical cannabis field and ensure that strong and distinct differentiations are sustained between recreational and medical uses. These streams are not interchangeable. Moving forward, we must solve the immediate barriers to medical cannabis access. One solution is clear, pharmacists must be involved in the distribution of medical cannabis to ensure that patients receive ongoing care and do not drift to a recreational stream.

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