In most countries with a mature medical cannabis market, pharmacists are at the center of an industry going mainstream.
Are pharmacists the key to the adoption of pharmaceutical cannabis?
As more countries legalize medical cannabis, the market is transforming into a mainstream sector of the global healthcare industry. In North America alone, spending in legal cannabis markets could reach as much as US$47.3 billion by 2027, according to Arcview Market Research and BDS Analytics. As one of the first countries to legalize cannabis use for medical purposes, Canada’s medical cannabis industry is rapidly maturing thanks in part to recent legislative changes. The medicinal value of the cannabis plant has officially been codified into the Cannabis Act, which is recognized by Health Canada and the Canadian Pharmacists Association.
Canadians are increasingly turning to healthcare professionals, including their local pharmacists, to learn more about the medicinal effects of cannabinoids. This has created an opportunity for companies like Avricore Health (TSXV:AVCR), which has begun to offer its point-of-care data platform HealthTab™ in pharmacies in British Columbia, Alberta and Ontario. By providing patients with data they wouldn’t otherwise receive at a clinic, Avricore is empowering patients to make informed decisions in the era of medical cannabis.
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Pharmaceutical cannabis going mainstream
The cannabis plant comes in a wide variety of strains (or cultivars, to be more precise), each with their own chemical composition. This variance in composition comes from each cultivar’s unique blend of cannabinoids, terpenes and flavonoids, the active pharmaceutical ingredients in the cannabis plant. Now that the shackles of prohibition are off and clinical researchers are free to study the plant’s effects on the human body, the medical cannabis market is entering a new stage of maturity.
“The stigma around cannabis has changed, and people are beginning to see that there is a credible reason for looking at medical cannabis seriously,” said Dr. Mark Ware, chief medical officer for Canopy Growth (TSX:WEED,NYSE:CGC).
Clinical trials examining the efficacy of cannabinoids in treating a variety of ailments have had positive results. The existing research tells us that both THC and CBD have the ability to work with the body’s endocannabinoid system, representing the potential for a broad spectrum of therapeutics. Cannabinoids have a very good safety profile for medical use without the side effects and risks of dependency associated with opioid medications.
As more positive clinical data emerges, healthcare providers are increasingly gaining the confidence and knowledge necessary to prescribe medicinal cannabis products to their patients. Likewise, consumers are increasingly becoming interested in learning more about the therapeutic properties of cannabis and its potential as an alternative to opioids and NSAIDs.
The wide variety of medical cannabis products and consumption methods on offer can leave consumers confused as to which products are best suited to a particular need, which delivery system works best and which dosage to take. Retail pharmacies are well positioned to provide consumers with this critical information given their education, accessibility and trusted relationship within their local communities.
Health Canada green lights online pharmacy cannabis sales for licensed sellers
Under Health Canada’s cannabis regulations, medical cannabis patients can only purchase products from licensed producers via mail order. The Common Initiative, a group of cannabis producers, drug companies and pharmacists, began lobbying the government last year to allow medical cannabis to be sold in pharmacies. The group includes Canopy Growth, HEXO (TSX:HEXO,NYSEAMERICAN:HEXO), Loblaw (TSX:L,OTC Pink:LBLCF) and its wholly owned drugstore chain Shoppers Drug Mart, Sobeys, Pharmasave Drugs, Apotex and several provincial pharmacist associations.
In December 2018, Health Canada granted Shoppers Drug Mart licensed producer status, allowing the pharmacy chain to sell dried and fresh cannabis, plants, seeds and oils to medical cannabis consumers through an online store. For now, Shoppers is only selling medical cannabis to Ontario residents, but some see the move as a big step toward allowing retail sales of cannabis within brick-and-mortar pharmacies across Canada. The practice is already commonplace in most of the world’s legal cannabis markets, including Australia, Chile, Germany, Israel, the Netherlands and Uruguay.
Canada’s Health Minister Ginette Petitpas, said, “(The federal government) is open to discussing other models of distributing cannabis for medical purposes, including pharmacy distribution.” However, this requires provincial and territorial governing bodies to be on board.
The Canadian Pharmacists Association is supportive of pharmacists dispensing medical cannabis. “We believe that these measures are essential to ensure that patients are not unintentionally diverted into the recreational stream and left to self-medicate without the additional guidance that comes with pharmacist care,” said Shelita Dattani, the association’s director of practice development and knowledge translation.
While Canadians can’t purchase pharmaceutical cannabis products at their local pharmacy as of yet, they can receive medical advice from a pharmacist. Rexall Pharmacy Group, for example, reports that its pharmacists have “gone through training to be able to answer questions from customers/patients about the use of cannabis, including considerations for dosing, titrating and monitoring, as well as key tips for counseling patients with various questions and advising of potential interactions and side effects.”
Ontario, the second largest cannabis market in Canada, recently became the first province in the country to mandate cannabis education for pharmacists. The Ontario College of Pharmacists gave its members until March 27, 2020 to complete an accredited course in medical cannabis. Last year, the college released “A Cannabis Strategy for Pharmacy” detailing the priorities such as preventing harm, developing and maintaining competency in cannabis, developing and tracking medical cannabis data and providing patients with care, health information and advice related to cannabis.
The proactive approach on behalf of pharmacists is largely in response to rising demand for cannabis-related information from today’s consumers, who are increasingly turning to their local pharmacist for healthcare advice and counseling.
“Opinion research conducted last year by the Canadian Pharmacists Association showed that nearly 80 percent of Canadians look to their pharmacist and trust their opinion when it comes to making drug recommendations,” Avricore Health CEO Bob Rai told Investing News Network. “However, with medicinal cannabis now available pharmacists are struggling to understand the risks, benefits and effectiveness of this complex product range within their preferred level of scientific accuracy.”
Avricore will soon launch an elearning and ecommerce platform that offers access to cannabis information for pharmacists as well as a channel for pharmacists to directly order products from a licensed producer, including pharmaceutical cannabis. The company has also partnered with Emerald Health Therapeutics (TSXV:EMH) to distribute a product line of endocannabinoid nutraceuticals.
Through its partnership with Molecular You, Avricore Health is integrating pharmacogenomic tests into its HealthTab platform, which supports a variety of testing and genetic data options. The platform will allow pharmacists to analyze a patient’s genes for sensitivities to THC and CBD. The results can help patients and healthcare practitioners make decisions for the safe and effective use of medical cannabis.
“We are all unique in how we process medications, affecting their safety and effectiveness. While cannabis is an extremely safe substance, some people can be sensitive to normal doses and experience unwanted side effects that can be avoided through our genetic analysis. People also need to be aware of the potential dangers of taking cannabis products with other prescription medications,” said Rob Fraser, CEO of Molecular You.
Data to further drive growth in the medical cannabis market
As medical cannabis legalization spreads globally, we can expect to see a slew of value-added biotechnologies come on the market, from novel cannabis delivery systems that allow for higher bioavailability to cannabis-based pharmaceuticals targeting life-threatening diseases like diastolic heart failure.
Of course, data is going to be critical in the development of such products. Without a large enough pool of studies to build a robust database, standardization and regulatory approval of pharmaceutical cannabis products could be an arduous feat. Recognizing the importance of hard data in pushing cannabis into the next stage of market maturity, technology companies are developing data-driven products that can be used by patients, healthcare providers and medical cannabis companies.
Avricore Health is exploring cannabis data collection applications for the HealthTab platform at the pharmacy level and looking to partner with a licensed producer to run a pilot program. Similar technology companies like Cannvas MedTech (CSE:MTEC) are working to leverage data in the medical sector. The company has launched an online platform that will allow it to generate data in order to provide insights on consumer tastes, needs and habits. By partnering with clinics, CB2 Insights (CSE:CBII) is working to mainstream medical cannabis into traditional healthcare providers. Meanwhile, CBDS Health Sciences has integrated blockchain technology and IoT sensor technology into its existing virtual clinical trials platform to capture vital patient data around the clock.
If medical cannabis is to gain global legitimacy as a therapeutic drug, access to education and critical data will be of the utmost importance. Advanced clinical trials can go a long way toward reaching this objective. However, pharmacies offer another avenue for delivering essential information to consumers and healthcare practitioners. Technology companies with educational data collecting platforms could be well positioned to take advantage of this new subsector evolving in the Canadian medical cannabis industry.
Editor’s note: a previous version of this article incorrectly stated that the Canadian Medical Association (CMA) has recognized the medical benefits of cannabis. The reference to the CMA’s stance on medical cannabis has been removed.
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