By Jessica Kindynis
There has been an incredible groundswell of advocacy for medical cannabis in a grassroots, business development and medical capacity in recent years. However, there is still a great deal of uncertainty and sensationalism surrounding the health benefits or possible harms of medical cannabis. Such attitudes maintain long-established barriers to access for patients and can impact their ability to receive unbiased and holistic advice on products – including on product cost, and the cost of ongoing treatment. For many, the lack of disagreeable side effects and increased efficacy compared to conventional treatments is worthwhile, regardless of cost. However pricing can still present a barrier for some new patients, and sometimes be difficult to manage for existing ones, partly due to the ongoing lack of federal government subsidization via the Pharmaceutical Benefit Scheme.
Putting aside cost, a wide range of Australians believe medical cannabis has a role to play in modern medical treatments. The 2016 Cannabis As Medicine Survey (CAMS) assessed the medical use of cannabis amongst Australians: 81% of people reported their cannabis consumption was primarily for medicinal purposes. Most individuals utilised cannabis for pain (back, neck, gastrointestinal), mental health (anxiety, depression, PTSD) as well as for sleep or neurological complaints.
As this CAMS survey was conducted assessing the medical use by laypersons acquiring illicit cannabis, it did not include indication or cost data on authorised or medically prescribed cannabis. Nonetheless, average costs derived from this provide a useful picture of how much individuals are paying to treat their medical conditions with cannabis, as well as how much they would be willing to pay.
Within the CAMS study, individuals were paying an average of $10-13.50 per day. When queried on how much they would be willing to pay for medical cannabis through legal pathways, the average cost amounted to $11 per day. The large majority (80%) of those involved in the study reported that their symptoms were effectively managed by medical cannabis.
Freshleaf Analytics has been monitoring patient growth and product pricing since the medical cannabis system came into place. In Q3 of 2019 Freshleaf found that patient monthly costs of medicinal cannabis appear to have stabilized. Minimum ($0.10 per mg) and average prices ($0.23 per mg) for oral products have remained unchanged in the past 6 months. While prices vary significantly in the market (highest cost products are 17X lowest price), Australian doctors now at least have more products to select from in the low end of pricing. There are now 76 products available for doctor prescription in the Aussie market – a 40% jump from 54 confirmed by FreshLeaf in Q1 2019.
Freshleaf also found that the most common spend range was $5–10 per day accounting for around one-third of all patients, with around 55% of patients spending $11 or less. So based on the $11 per day that the CAMS study determined as ‘affordable’, that suggests most patients would find treatment costs acceptable.
In light of the fact the PBS doesn’t cover medicines unauthorised by the TGA (there is currently no subsidised price for prescribed medical cannabis) this may still make cannabis medicines out of reach for potential patients. Medicines subsidized in Australia by the PBS are cost-capped in 2019 at approximately $40.10 per prescription ($6.50 per month for concession card holders). By comparison, any price points above these amounts will likely make unsubsidized medicine such as cannabis seem ‘expensive’ to patients. And considering many of those requiring medical cannabis suffer from complex and debilitating conditions that impact their ability to earn, such prices can be unmanageable.
While it’s unscientific, it’s nonetheless worth comparing weekly medical cannabis costs to other consumables prevalent in Australian society, such as coffee and cigarettes. We can quickly see discrepancies in what individuals are willing to pay for products, whether helpful or harmful to their health and wellbeing. The average cigarette smoker spends $100 per week on tobacco products, while at the opposite end of the health scale, the average person spends $60 per week on medical and hospital services. The standard coffee drinker (especially in Victoria) can spend as much as $4-12 on coffee per day, or on average $55 a week. These are certainly simplistic comparisons, yet they offer insight into where our society is willing to place its money!
|CAMS study cannabis||2019 Q3 medical cannabis||Medical services||Coffee||Cigarettes|
|Approx average weekly spend||$69||$77 (avg $11.83/day)||$60||$55||$100|
While some reports on exorbitant medical cannabis costs are certainly sensationalist, there is local Australian research confirming people are likely to forgo healthcare due to the cost, or may “self-medicate”. And if medical cannabis treatment costs aren’t within the range of the average PBS-covered pharmaceutical drug, in addition to the associated stigma, some patients may not investigate cannabinoid medicines even if many of them would otherwise receive huge benefit from it.
So what can we expect to see in the future? As the market grows, product options expand and the TGA begins to approve certain medical cannabis and CBD oil products, prices are likely to slowly decrease. The future will also depend on the direction the Australian cannabis manufacturing and production market takes, and only time will tell.