Minnesota has a highly successful medical cannabis program that is helping thousands of seriously ill patients. We have a program that is effective for the majority of participating Minnesota patients, according to patient data published by the Minnesota Department of Health.
Despite these very encouraging results, affordability remains the major challenge facing Minnesota’s three-year old program. While we’re celebrating our clinical success, we can’t turn a blind eye to the affordability problem.
Our company is doing all we can to keep medicines affordable for as many Minnesotans as possible. We offer substantial discounts to low-income patients and veterans, even though our company continues to lose money. Three years of operational experience have helped our operations to be more efficient. Consequently, we have reduced prices for all of our patients during this time.
This has not been enough. Medical cannabis in Minnesota remains unaffordable for many patients. Insurance will not cover these medicines. The fact is, most pharmaceuticals would be prohibitively expensive for many patients if they weren’t covered by insurance companies. For a $6 co-pay, a patient with a diagnosis of chronic pain can go to a pharmacy and fill a prescription for enough opioid pain medicines to kill more than one person. This same patient may pay 30 times that amount for a month’s supply of cannabis-based medication, a much safer and less addictive alternative.
Policymakers who are rightly concerned about affordability of cannabis-based medicines face a dilemma. On the one hand, precisely formulated and dosed cannabis forms such as capsules and oils that are required in Minnesota “medicalize” cannabis in an objective, measurable way. To the benefit of all, this leads to the increased acceptance by mainstream medicine. It is likely that the quality-controlled forms of medical cannabis in Minnesota are safer, permit better dose control, and are better regulated than the raw plant material (“bud”) allowed in other states. This is a very responsible aspect of Minnesota’s law that I have always strongly supported as a physician. Standardized, precision formulations that are pharmacist-dosed for every patient and condition help limit side effects and maximize effectiveness, but they do increase cost. Patients, on average, spend more than twice as much in Minnesota per month for their medical cannabis versus patients in states that allow cannabis flower.
For Minnesota patients who cannot afford these medicines and who are getting no cannabis-mediated relief whatsoever, safety-tested cannabis flower would be more compassionate and humane than no effective medicines at all. For these patients an adage comes to mind: “Don’t let perfect be the enemy of good.”
Several approaches can minimize perceived risk with the utilization of cannabis flower by patients. Encouraging vaporization (versus combustion/smoking) is an approach that has been used in other states to minimize potential risks. Strict quality standards can be placed around the production and storage of plant material to be utilized by patients. Cannabis flower can also be subjected to a wide battery of testing for contaminants such as bacteria, pesticides and other potentially harmful environmental hazards that can be found in unregulated marijuana products.
I believe there is one realistic policy path toward making cannabis-based medicines more affordable for all Minnesotans. Minnesota patients should have the option of utilizing regulated and safety-tested cannabis flower in addition to the current options. Minnesota is now the only state among the 30 with viable medical cannabis laws that does not allow plant material of some type to be utilized directly by patients.
Policymakers clearly receive conflicting information on opposing sides of this debate. As a physician who has witnessed firsthand the positive difference we are making in patients’ lives, my vision is not blurred by any misinformed political agenda. I am grateful Minnesota law has helped so many suffering patients, but there are so many more. Policymakers cannot let these patients continue to suffer from inadequate or ineffective treatment because they can’t afford medicines which offer hope of relief. They can allow eligible patients access to regulated and tested raw cannabis flower, as do 29 other states with medical marijuana programs.
This single policy change will bring an affordable treatment option to the hundreds of thousands of patients with chronic pain and other qualifying conditions across Minnesota who currently see chronically prescribed opioids or black-market marijuana as the viable alternatives.
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