Bern, 26.06.2019 – The Federal Council wants to facilitate access to medical cannabis treatments. At its meeting on June 26, 2019, it put into consultation a draft amendment to the Narcotics Act (LStup). The latter provides that patients can be prescribed cannabis treatments directly by the doctor, without having to ask for an exceptional authorization from the Federal Office of Public Health (FOPH). On the other hand, nothing changes for non-medical cannabis, which continues to be banned.
The use of medical cannabis has risen sharply in recent years. Thousands of patients use it for example in case of cancer or multiple sclerosis. At present, patients who wish to receive a cannabis treatment containing more than 1% THC must in most cases apply for an exceptional authorization from the FOPH. This procedure complicates access to treatment, delays the start of therapy and is no longer adequate given the growing number of requests. In 2018, the FOPH has issued nearly 3,000 authorizations.
Prescription directly by the doctor
The project allows the doctor to prescribe cannabis treatments directly. To do this, it is planned to lift the ban on the circulation of medical cannabis in the law on narcotics. The cultivation, processing and trade of medical cannabis will therefore be possible within the framework of the control system provided by Swissmedic. In contrast, non-medical cannabis continues to be banned.
The cannabis-based treatments that can be prescribed in Switzerland are either medicines authorized by Swissmedic, or master preparations developed in pharmacy, and are usually taken orally.
Medical cannabis is used in several indications. It helps, for example, to relieve chronic pain and stimulate the appetite of patients suffering from cancer. It is also used to reduce spasticity in multiple sclerosis.
Mandatory refund review
The question of reimbursement of cannabis treatments through compulsory health insurance will be analyzed separately and is not part of the project put in consultation.
At present, the treatments can only be reimbursed on a case by case basis, after an examination carried out by the patient’s health insurance according to specific criteria. One of the conditions for reimbursement is that other treatment options have failed.
The main obstacle to automatic reimbursement lies in the fact that the scientific evidence on the efficacy of medical cannabis is still insufficient and the conclusions of existing studies partly contradictory. This proof of efficiency is one of the essential conditions laid down by the law on health insurance. At present, doctors are certainly seeing positive signs in clinical practice, but large-scale studies are still lacking.
To clarify the situation, the FOPH will launch an evaluation project (Health Technology Assessment). It will have to show whether the effectiveness of cannabis treatments can be sufficiently proven to allow a mandatory reimbursement and if so for what indications.
Source – The Federal Council
Image – Hans (p)