Pharmacists, pot producers in brewing dispute over distribution as Ottawa holds the final decision
TORONTO — Canada’s pharmacists and medical marijuana producers are engaged in a brewing dispute over how pot should be distributed to patients. If they can’t reach an agreement, it could leave Ottawa with a tough decision as it crafts new regulations for the sector.
The pharmacists believe they are the only ones who can provide proper clinical advice and oversight over the growing use of medical pot, and think they should control distribution. The marijuana producers, on the other hand, believe the current mail-order system is a resounding success, though they are open to involvement from pharmacies.
“By any metric, the medical cannabis system in Canada is working exceedingly well,” said Cam Battley, chair of the advocacy committee at the Canadian Medical Cannabis Industry Association (CMCIA).
Canada’s medical marijuana sector got its start in April 2014, when Ottawa introduced rules forcing patients to buy their product from licensed producers. Dozens of marijuana companies quickly emerged, and they now have more than 50,000 patients signed up across the country.
When the federal government was formulating its regulations around pot in 2012 and 2013, it invited the pharmacies to take part in distribution. But the Canadian Pharmacists Association (CPhA) declined to participate. In early 2013, the group sent a letter to Health Canada saying it was concerned about a “lack of evidence” supporting the use of medical marijuana.
It now belatedly wants to get on board. Last week, the CPhA announced that pharmacists should play a “front-line role” in dispensing marijuana. The CPhA’s position was backed by a detailed report from KPMG LLP.
Phil Emberley, the CPhA’s director of professional affairs, said pharmacists still think more evidence is needed around marijuana’s use as medicine. But as Canadians use the product in increasingly large numbers, he said pharmacists are needed to ensure patient safety.
“We know that there are side effects with marijuana, and potential drug interactions as well,” he said. “We feel that a lot of patients are accessing medical marijuana without being protected from some of those concerns.”
The pot companies want to increase patient access to marijuana, so they are broadly supportive of pharmacies playing a role in distribution. They recognize that some patients will always prefer to get their medicine from a pharmacist.
But they oppose the outright takeover of their direct-mail distribution system by pharmacies.
Battley said pharmacy-only distribution could lead to higher costs for patients and a much more limited selection of products. He noted a lot of patients are very ill and it is convenient for them to get the product at their doorstep.
“There needs to be a regulated legal source that patients can go to in person.”
Additionally, the CMCIA said there are security and product handling concerns with marijuana that pharmacists would have to address.
Battley said it would make sense for pharmacies to take over distribution if there were serious problems with the current model — for example, if there were quality control or product delivery issues, if there were drug interaction problems, or if there was evidence the product was getting into the black market. But he claimed those things are not happening.
The two industry associations plan to meet and discuss the issue. If they can reach a settlement, they could make a joint recommendation to Health Canada, which is reviewing its medical marijuana regulations after a federal court judge struck down the current legislation in February. Ottawa will ultimately decide whether the current distribution system should be changed.
Jonathan Zaid, founder of the lobby group Canadians for Fair Access to Medical Marijuana, said patients need to have a mix of options to access pot, including pharmacies and direct mail. He noted many patients have been getting product through illegal dispensaries.
“There needs to be a regulated legal source that patients can go to in person, and that just doesn’t exist today,” he said.