Issue link: https://www.e-digitaleditions.com/i/1362577
11 cannapatientcare.com march/april 2021 | cannabis patient care Patient Access The results point to a greater need than ever for patient access and physician support for cannabis as an opioid exit therapy, explained Max Monahan-Ellison, a medical cannabis consultant and board member with Medical Cannabis Canada. "Survey research indicates a good portion of patients are treating for chronic pain, and observational studies have highlighted that cannabis can be an effective option to help reduce opioid dependency," said Monahan-Ellison. "The chal- lenge is that cannabis is still primarily seen as a second or third-line treatment option by prescribers." He added that for insurance providers, most of whom don't recognize medical cannabis, this treatment option is some- thing of a regulatory oddity. In Canada, medications approved for specific indications are issued a drug identification num- ber (DIN). Excluding pharmacological cannabinoid drugs such as Sativex and Nabilone, cannabis in any format has not re- ceived a DIN from the regulator. Without a DIN—and despite necessary medical authoriza- tion—cannabis generally isn't considered or regulated as a traditional pharmaceutical medicine, nor is it covered by any public health drug plans. Yet, many carriers including Sun Life, Canada Life, Green Shield, and Medavie Blue Cross cover med- ical cannabis as an insured drug, with limitations. "The key point here is that despite the fact that carriers have created coverage options, there has been low uptake from employers and other payors to include cannabis on their formularies because cannabis has to be added as a paid ben- efit," said Blecher. Often, standard extended benefits will cover the drug when prescribed to treat specific conditions, such as epilepsy and multiple sclerosis, that have a greater body of clinical evidence for cannabis efficacy. However, those policies tend to exclude the majority of the patient population and businesses typically have to buy into them as part of their benefits packages. Many of the plans seen today resulted from external pres- sure and demand from plan sponsors (employers, union groups, and so forth) looking for medical cannabis options, Monahan-Ellison explained, adding he has heard from the in- surance sector that uptake of these programs is low. "Insurers develop benefits offerings based on the needs of customers, the employers who purchase group plans for their staff—and they emphasize that if the demand isn't there, the benefits won't be there either," he said. "At the same time, as plans expand their coverage to oth- er indications, they will be relevant to a broader group of em- ployees. Continued research is essential for building the case for private insurers to expand covered indications and pub- lic payors to consider reimbursing the treatment option. It will take a coordinated effort of government, industry, and advo- cacy groups to push forward change in this category and ex- pand access," said Monahan-Ellison. WeedMD includes cannabis coverage as a drug benefit in its employee insurance plan, should an employee use cannabis for medical purposes. The company built its Starseed medi- cal platform to bridge the gap between patients and insurers through a "virtual pharmacy" model. Today, the company is Canada's leading licensed produc- er in the paid benefits arena. In addition to its work with four of Canada's major insurers, its offering has been embraced by union groups, who offer reimbursement for Starseed Medic- inal cannabis products to qualifying members. The company doctor focus An employee tends to pre- vegetative plants in WeedMD's indoor Strathroy, Ontario facility.