New Zealand-made cannabis medicines are not expected to hit the market for several months - will they be affordable? Photo / Supplied
The Government is being urged to consider watering down safety standards or subsidising cannabis medicines to ensure products are accessible and affordable.
The current regulatory rules mean that Kiwi-made medicines are unlikely to be any cheaper than expensive imported ones, the NZ Medical Cannabis Council says.
In the wake of the referendum result against legalising recreational cannabis, Prime Minister Jacinda Ardern has said that medicinal cannabis regulations will be looked at to ensure products aren't too expensive.
Council chairman Manu Caddie, who was at New Zealand's first medicinal cannabis summit this week, welcomed Ardern's comments and said the industry supported safety standards.
But it was about finding a suitable level of quality assurance while not making medicines unaffordable.
The only available medicines so far, such as Sativex, can cost $1000 for a month's supply.
The regulations for medicinal cannabis have only been in place since April, and require products to comply with Good Manufacturing Practice (GMP) in the Medicines Act.
"An alternative is requiring any cannabinoid ingredients to meet GMP rather than the whole manufacturing process," Caddie said.
"Australia uses this approach and it is driving costs down, so that could be worth looking at if the government wants to reduce product costs."
It would mean, for example, that New Zealand companies could use broad acre outdoor cultivation or import cannabis extract, and then use GMP processes to turn it into medicines.
Another option was to have a state subsidy for cannabis medicines, Caddie said, though he acknowledged it would be controversial.
"Places like Germany have the vast majority of cannabis prescriptions fully subsidised by statutory health insurers."
New Zealand has ACC, Winz or Pharmac to subsidise costs, but Pharmac usually only considered registered medicines, which required substantial clinical evidence.
"ACC and Winz have covered only a handful of prescriptions for clients that meet their strict criteria and have been sporadic in eligibility for individual patients. So none of these options seem like a sustainable solution," Caddie said.
"The reality is that without subsidies, prescription cannabis products are going to remain too expensive. Even in Australia, it's cheaper than it is in New Zealand but nowhere near the price most other prescription medicines are here."
Health Minister Andrew Little, who is yet to be briefed on medicinal cannabis, said the council's suggestions would be looked into if medicines turned out to be too expensive.
"The objective of [the new regulations] was to make a different form of pain relief accessible to those for whom it works most effectively, and it would be a pity if it is priced out of reach for far too many people."
If that turned out to be the case, he said: "We would take advice on what options are available. All options would be on the table."
It is expected to be several months before medicines made by New Zealand medicinal cannabis companies are cleared for the market.
Non-GMP products, which tend to cost about half of the GMP ones, are currently available if doctors are willing to prescribe them - but after March next year they must all be GMP and assessed as meeting the new quality standard.
Caddie said all medicines are likely to cost at least $200 to $300 if they require GMP.
Little said the Government did not want patients to have to resort to criminal activity by using black market cannabis.
But most cannabis used for therapeutic purposes are supplied illegally by so-called "green fairies", and will continue to be so if patients can't get affordable medicine.
Little said the new regulations were meant to lead to pharmaceutical-grade medicine, "but it's only meaningful if they are reasonably accessible to people for whom that is the best therapy".