On 26th June 2019, I signed legislation which will allow for the operation of the Medical Cannabis Access Programme (MCAP) on a pilot basis for five years.
Once suitable medical cannabis products are made available by suppliers, the Access Programme will make it possible for a medical consultant to prescribe, in line with the published clinical guidance, a listed cannabis-based product for a patient under his or her care for the following medical conditions, where the patient has failed to respond to standard treatments:
- spasticity associated with multiple sclerosis;
- intractable nausea and vomiting associated with chemotherapy;
- severe, refractory (treatment-resistant) epilepsy.
It should be noted that currently no medical cannabis products are available for use under the MCAP as it is expected that it will take some time for suppliers to arrange to have their products made available on the Irish market. However I am pleased to say that there are a number of suppliers who have already expressed interest.
Pending full operation of the MCAP, and for medical indications not included in the MCAP, doctors may continue to utilise the Ministerial licencing route to prescribe medical cannabis for their patients, should they wish to do so.
In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time
Clinicians may submit an application on behalf of their patients to the HSE for reimbursement approval if the patient has a valid medical prescription for medical cannabis for one of the above medical conditions and have sourced a cannabis-based product which has been prescribed under a Ministerial license.
The HSE has advised that in the previous situations where it considered reimbursement support appropriate, the following steps were completed.
- The patient’s consultant is satisfied that all therapeutic options have been exhausted and is prepared to accept the responsibility for monitoring the patient’s response to the cannabis product.
- A prescriber applies to the Minister for a Ministerial license and this is granted.
- The consultant completes an Individual Reimbursement Form, setting out the therapeutic benefit for the patient. It is important that this is completed in sufficient detail for therapeutic benefit to be demonstrated.
- The Individual Reimbursement Form is considered by the Medicines Management Programme (MMP).
- On review of the documentation, the MMP makes a recommendation for or against reimbursement support for the patient to the HSE, under the patient's eligibility, and informs the Primary Care Reimbursement Service (PCRS) of that recommendation.
If approval is given, the PCRS, when authorised to proceed, will make the necessary arrangements to cover the costs involved for the patient.