Martin Browne
Question:41. Deputy Martin Browne asked the Minister for Health the status of the medicinal cannabis access programme; and if he will make a statement on the matter. [28321/21]
View answerTuesday, 13 July 2021
Questions (41)
Oral answers (7 contributions)
I ask the Minister for Health the status of the medicinal cannabis access programme and if he will make a statement on this matter.
I thank Deputy Browne for his question. The provision of the medical cannabis access programme is as a result of recommendations by the Health Products Regulatory Authority, HPRA, in its review, Cannabis for Medical Use - A Scientific Review.
The review stated that if the policy decision is to make cannabis available for medical purposes, the HPRA advised it should recognise patient need but be evidence based. It was advised that treatment with cannabis be only permitted under a controlled access programme for the treatment of patients, with the following medical conditions, who have failed to respond to standard treatments: spasticity associated with multiple sclerosis, intractable nausea and vomiting associated with chemotherapy and severe, refractory, treatment-resistant epilepsy. Subsequently, the former Minister for Health established an expert reference group to advise on the development of a medical cannabis access programme. This group developed detailed clinical guidelines for the MCAP to be followed by clinicians, which contained inter alia guidance on ingredient combinations recommended for each of the three indications included in the programme.
The programme is a five-year pilot programme. The purpose of the programme is to facilitate access to acceptable cannabis-based products for medical use that are of a standardised quality and meet the requirements outlined in the misuse of drugs regulations 2019. It is an important and positive step forward for those individuals who are suffering serious ill health but for whom conventional treatments are not working. There are currently four products assessed by the HPRA for inclusion in schedule 1 of the regulations and more products are being assessed by the HPRA.
Reimbursement of the products, prescribed by approved medical consultants and supplied through community pharmacies for a specified therapeutic indication in line with schedule 2 of the misuse of drugs regulations 2019 will be on an individual named patient basis, aligned to the patient's eligibility under the community drug schemes. It cannot be assumed that reimbursement approval will be forthcoming on submission of applications. A reimbursement decision will be communicated with the prescribing consultant in writing.
The HSE has indicated that the medicinal cannabis access programme is rapidly progressing and I hope to be in a position to update the Deputy shortly.
The Minister will not be surprised to hear I am again highlighting the plight of Ms Vera Twomey and her daughter, Ava, who suffers from Dravet's Syndrome. This family and other families still have to fork out €9,500 every three months to get Bedrocan and they have to wait as long as five to six weeks to get reimbursed. I know the Dutch authorities will not allow the commercial export of the oil-based cannabis products to pharmacies or wholesalers. That is its decision, but being unable to apply to the Health Products Regulatory Authority, HPRA, to have it included in the medicinal cannabis access programme, like other products, is something the Minister is in a position to influence.
As the Minister said, he is due to announce funding for the MCAP and he has asked his official to find a way to ensure patients will no longer need to pay upfront for Bedrocan. Yet Ms Twomey and other families are constantly told the Department is working on it and they have to patient. How patient must these families be? Ms Twomey told me this week she is exhausted from the pressure she is under. Can the Minister tell Ms Twomey, Ava and the other families throughout the country Bedrocan will be funded at source and when that funding will be announced?
I am, of course, aware of the case of Ms Twomey and Ava and many other families around the country. Can I just make a few points on Deputy Browne's reasonable question? I have funded the medicinal cannabis access programme, MCAP, for the first time. While the programme existed previously, there was never any money allocated to it. We have now allocated money to it. It will be fully funded. It will cost a significant amount of money. We will be able to make an announcement and I look forward to being able to share that with Deputy Browne shortly. An awful lot of work has gone on this year to bring it to this point.
The Deputy will appreciate I cannot talk about any specific families for data protection reasons, obviously. For many families in this situation, what is currently happening is the products are being delivered to their front doors from Holland. That is something the Government and the State is doing. The Deputy will be-----
The Minister will get a chance to come back in.
I appreciate the Minister has made the moneys available. It is there now. I am talking about the Twomey family because I know Ms Twomey well. I have been in her house and have seen the way Ava has responded to medicinal cannabis and Bedrocan. Families such as the Twomeys and others have a worry every three months in terms of coming up with the €9,500. All they are asking for is a level playing field and for the Minister to give them an assurance the €9,500 has stopped and there is no more of that kind of pressure. It is enough having a child sick, like Ava was. We all know the case. I walked to Dublin with Vera. I saw the pressure she was under and saw her raising the issues.
It is about going from 30, 40 or 50 attacks per day down to one or two per week and seeing that child being able to go to mainstream school. I know the Minister is new to it, but the previous Government and Ministers have dragged their heels on it. I am asking the Minister to give assurance to those families that, from now on, there is no more having to worry about €9,500 being there every three months to access Bedrocan.
To the first question, Ms Twomey and others were having to go to Holland to secure things. The first thing I wanted to make sure was that stopped. I have given a commitment directly to Ms Twomey and I am happy to repeat it here on the floor, that would not happen again. We have a system in place whereby the pharmaceuticals are being hand-delivered to the door. That is the first thing and it is important. As the Deputy said, these things are not cheap. Using the Deputy's figures, if it were €9,000, for example, every quarter for any family, it would be nearly €40,000 for the year.
That cost gets covered by the State. Second, there should not have to be a prepayment for it. I can assure the Deputy, and Ms Twomey has been assured, that significant work has been going on in this regard. It is my intention that Ms Twomey and other families will not have to pay up front. We needed to establish why it was happening in the first place. There were technical reasons, which I can share later with the Deputy. However, I can give a commitment that we are moving as quickly as possible to stop the prepayment requirement because I do not believe it is acceptable. It is my intention to solve it.