Just over a month ago I started my role as CCO with Grow Biotech/Logist Pharma. We are at the centre of what has been deemed the medicinal cannabis boom. Technically we are still a startup but within the medicinal cannabis world it feels that we are one of the oldies already. Below I have captured a few initial observations about this exciting new industry.
Two key thoughts spring to mind immediately. Firstly, I believe that this industry needs to grow up quickly and become more ‘pharmaceutical’ in it’s behaviour. We’re talking to doctors and dealing with patients hence behaving like a pharma company and using terminologies that are familiar and make sense. That’s why in Logist Pharma we have MSLs (medical science liaisons) in our field team and a medical affairs team. We are adopting approval processes for materials that are well documented and trusted in pharma. It’s also why we need to get away from cheap and silly comments like ‘a potted history of medicinal cannabis’ or ‘our high flying industry’. Bar two small bandwidth exceptions this is still unlicensed medicinal cannabis we are dealing with, so we need to tread carefully and be very serious about it. It also means that producers cannot talk directly to clinicians and we cannot promote products.
Secondly, and maybe simply because it is still so much in its infancy; I believe the industry would benefit from more direction and a clearer strategy. Currently there are too many people with opinions and views, too many organisations that want to have a say and role in driving this industry forwards. Some of that may also be driven by the very slow progress in the U.K. versus so many other countries. Patients, companies and other organisations are getting impatient and organise meeting after meeting to discuss, most of the time trying to change the system by force. I’m afraid that is simply not going to work.
In my 30 years in pharma I’ve seen it all. We wanted diabetes guidelines to change and to be reviewed faster; we wanted eligibility thresholds for anti TNFs in RA or Crohn’s disease to be lowered faster. All of that because we knew there were thousands of patients who would benefit from it. It just doesn’t work that way unfortunately. I have a slightly more holistic view on the discussions that are going on about pushing NICE to approve medicinal cannabis for the NHS and what would work…
NICE will only make decisions based on RCT evidence and it will also take a long time to review these if they were available. The fact that 1.4 million people are already using medicinal cannabis is an argument in itself, but not to get it through the NHS. It’s an argument to find a way to regulate the use, pull it out of the black market, make it accessible for patients in a controlled way at cost comparable to their current black market expense. That would be a smart objective. At the same time this could be setup in a way so that we could monitor and register what happens to these patients, thereby creating a real world evidence (RWE) base that might well support a future NICE submission. We could compare the use of medicinal cannabis to that of opioids or other strong painkillers and see if there is a benefit. After all, there are plenty of super strong pain medications that should stop patients from driving, but we still allow this. I can see where CBMPs could play a role here for example.
These are my two observations after a month. Our ambition is to be a key player, a thought leader and a reliable partner to everybody involved in increasing access for patients who would benefit from using medicinal cannabis without throwing a list of 52 possible indications at everybody and demanding approval at gunpoint. RWE and evolving evidence in a controlled setup are the key principles whilst also removing some of the blockages around imports as well.
Pierre van Weperen
Grow Biotech/Logist Pharma