In Depth

The cannabis-based medicines approved for use on NHS

Charities welcome new epilepsy and MS drugs but criticise watchdog over ‘massive missed opportunity’ to treat other conditions

Medicines derived from the cannabis plant are to be made available to patients on the NHS for the first time.

The move comes after the National Institute for Health and Care Excellence (Nice) approved two new products containing cannabis extracts.

Which drugs have been approved?

Epidyolex, a medicine made with cannabis oil, or cannabidiol (CBD), has been approved for the treatment of two rare types of severe epilepsy.

According to the BBC, doctors will now be able to prescribe Epidyolex for children over the age of two who suffer from either Lennox Gastaut syndrome and Dravet syndrome, which can cause “multiple seizures a day”. An estimated 3,000 people in England have Dravet, while 5,000 have Lennox Gastaut syndrome.

The broadcaster reports that clinical trials have shown the oral solution “could reduce the number of seizures by up to 40% in some children”. Epidyolex was approved for use in Europe in September, but Nice initially ruled that it not sufficient value for money.

The drug costs between £5,000 and £10,000 per patient each year, but its manufacturer, GW Pharmaceuticals, has agreed a lower discounted price with the NHS.

The other newly approved drug is Sativex, a mouth spray containing both CBD and tetrahydrocannabinol (THC), the main psychoactive ingredient in cannabis.

The spray has been approved by Nice for the treatment of symptoms relating to multiple sclerosis (MS), including muscle stiffness and spasms, but “doctors will not be allowed to prescribe it to treat pain”, says the BBC.

Both medicines were developed in the UK, where they are also grown.

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What about patients with other conditions?

Some campaigners have criticised the scope of the new Nice guidelines, which state that both medicines will be ineligible for prescription to treat other medical conditions. And only a limited number of doctors in the UK will be able to prescribe Epidyolex or Sativex to patients.

The Guardian reports that charities say “thousands of other people who could benefit from cannabis-based medicines” have been left “in limbo”.

Experts and activists fighting for the legalisation of cannabis have voiced disappointment after Nice claimed there was not enough evidence to support about the use of THC to manage chronic pain. 

The drug watchdog also said more research was needed into the use of cannabis-based medicines to treat forms of epilepsy other than Lennox-Gastaut and Dravet.

Charities had “hoped that the drug would become widely available after it was decriminalised for medical use by Sajid Javid last November”, The Telegraph reports. Up to 1.4 million people in the UK are thought to use cannabis to treat health conditions and chronic pain, adds the Daily Mirror.

Millie Hinton, from campaign group End Our Pain, has criticised the new guideline as a “massive missed opportunity” by Nice.

“It is particularly devastating that there is no positive recommendation that the NHS should allow prescribing of whole plant medical cannabis containing both CBD and THC in appropriate cases of intractable childhood epilepsy,” she said. 

“It is this kind of whole plant extract that has been shown to be life-transforming for a significant number of children, including those involved in the high-profile cases of last year which led to medical cannabis being legalised.”

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