Medicinal Cannabis: Economic Contribution

Debate between Will Quince and Graham Stringer

Thursday 20th April 2023 Westminster Hall

[Sir Jeremy Wright]

The Minister is probably right, but I am sure that when he looks at this again he will also want to look at the NICE guidelines that apply, which are extremely restrictive. The risk to an individual doctor from making a decision to prescribe will be perceived to be much higher if the NICE guidelines appear to deter such a prescription. The Minister is right that there are many elements to this, but one of them is how much we encourage doctors to believe that this is the right thing to do. I go back to the point that I was making: there is some logical dissonance here. We have said already that it is right to reschedule these products as far as the Home Office is concerned. We are starting to see prescriptions in the NHS, but not in the numbers that will benefit the maximum number of patients.

[Graham Stringer (in the Chair)]

Order. We have not been short of time this afternoon, and every hon. Member has had the opportunity to speak. Interventions should be brief and to the point.

[Will Quince]

Thank you, Mr Stringer. My right hon. and learned Friend makes a good point. When we meet the members of the APPG, it is very hard not to be moved and to want to do all in our power to bring about the change that people want to see. I have considered the calls to change NICE guidelines, which have recently reviewed the basis of these products, but I am afraid the guidelines are unlikely to change until the evidence base develops, and that will happen through clinical trials and evidence. That is why I say all roads lead back to building an evidence base and a clinical trials base. That is the crux of this debate.

In January, the National Institute for Health and Care Research issued guidance recommending that the NHS prescribe cannabidiol to patients with a rare, seizure-causing genetic disorder, which is, I think, the fifth condition for which a cannabis-based treatment has been approved by regulators and offered to NHS patients in England. I understand that the treatment is also available and approved in Scotland and Northern Ireland. The NHS now funds thousands of these medicines each year.

I mentioned Jazz Pharmaceuticals earlier. I am not sponsored by it; it just happens to be the manufacturer and provider that I visited. It is a good example of the trailblazers in this space that not only create, but undertake the research, manufacturing and—the key part—licensing of cannabis-based medicines. It has shown what can be done. The key is very much in the research.

My right hon. Friend the Member for Dumfriesshire, Clydesdale and Tweeddale mentioned consistency and coherence in policy, which is why it is key that we treat cannabis-based products as we would any other medicinal product that we wanted to prescribe on our NHS. There is an economic case as well, although that is not what drives the Government. My whole focus in this is what is right for our NHS and patients. I am aware that there is huge hope and patient demand for access to medicinal cannabis, and that it is claimed that it can help with an array of medical conditions from chronic pain to anxiety; I believe there is also research under way at the moment on how cannabis-based products might be able to help with psychosis. I very much hope that those trials are successful. That is the right approach.

To date, much of the evidence suggesting cannabis could be an effective medical treatment is anecdotal or observational. As I mentioned earlier, only for a handful of conditions have enough clinical trials been done to prove scientifically that the drug is safe and effective. However, I am acutely aware that there are thousands of patients who now pay to access those unlicensed products on private prescriptions. Having spoken with campaigners and members of the APPG, I also know that some patients believe that funding cannabis on the NHS will reduce overall healthcare costs by alleviating symptoms and reducing the extent of hospital visits and other treatments. I understand and hear that case, but—I apologise for labouring the point; I have to keep coming back to it—before any new medicine can be proven to be cost effective, it must be proven to be safe and clinically effective. That is why research is so essential.

The Labour Front-Bench spokesperson, the hon. Member for Bristol South, asked what steps we are taking. That is a challenging question, because it is a pioneering area of research. Following collaborative work with clinicians and patient representatives, the NIHR and NHS England have confirmed support for two clinical trials into early onset and genetic generalised epilepsy. If you will permit me, Mr Stringer, I would love to use this debate to highlight a tender opportunity that will be launched by University College London in the next few weeks. UCL is seeking a supplier to assist in a world-first randomised control trial comparing cannabis-based medicines containing CBD and THC in the treatment of drug-resistant epilepsies in adults and children. I hope that that tender process is successful and that UCL finds a commercial partner to supply products for the trials so that they can commence as soon as possible.