Epidyolex and Sativex: NHS England can now prescribe cannabis-based medicines to treat epilepsy and multiple sclerosis
Two cannabis-based medicines have been approved for use by the NHS in England to treat epilepsy and multiple sclerosis.
Advisory body NICE looked at cannabis products and their effectiveness in treating a number of conditions and advised their use in treating these illnesses.
While charities have welcomed the move, a number of campaigners who have been demanding the drugs for some time say that the change does not go far enough. Doctors will now be able to prescribe the drugs, which have both been produced in the UK using cannabis also grown in the country.
What can the drugs be used to treat?
One of these drugs is Epidyolex, prescribed to children with two types of severe epilepsy (Lennox Gastaut syndrome and Dravet syndrome) which can both cause multiple seizures a day.
There are an estimated 3,000 people in the UK with Dravet and and around 5,000 with Lennox Gastaut syndrome.
The oral solution, which contains cannabidiol (CBD), could reduce the number of seizures by up to 40 per cent in some children, according to evidence from medical trials. It does not contain THC, which is the psychoactive component present in cannabis.
Epidyolex was previously refused by NICE on the grounds that it is not good value for money, in spite of the fact that it was approved for use in much of Europe. However the NHS has been given a discounted price by manufacturer GW Pharmaceuticals to make the drug viable for use in England.
The other treatment to be approved is Sativex - a mouth spray that contains THC and CBD which has proved effective in treating muscle stiffness and spasms, also known as spasticity, in multiple sclerosis.
Sativex has been approved for use in Wales since 2014 and was the first cannabis-based treatment to be allowed in the UK.
How much will it cost?
Epidyolex will cost less than the usual £5,000 to £10,000 per year per patient.
Sativex costs around £2,000 per year for each patient. Previously, English officials also ruled this treatment as too expensive. Doctors will not be allowed to prescribe Sativex to treat pain.
Chris Tovey, of GW Pharmaceuticals, said, “This is a momentous occasion for UK patients and families who have waited for so many years for rigorously tested, evidenced and regulatory approved cannabis-based medicines to be reimbursed by the NHS.
“This is proof that cannabis-based medicines can successfully go through extensive randomised placebo-controlled trials and a rigorous Nice evaluation process to reach patients.”
Do the guidelines go far enough?
However, Millie Hinton, from the campaign End Our Pain, said the guidelines do not go far enough and leave thousands of people with conditions that can be treated with cannabis-based medicines still unable to legally and affordably access what they need.
Parents of children with epilepsy are often paying thousands to have drugs that contain CBD and THC imported from Canada and Europe and believe the refusal to approve treatments that contain THC for epilepsy is a missed opportunity.
Ms Hinton said, “It is particularly devastating that there is no positive recommendation that the NHS should allow prescribing of whole-plant medical cannabis containing both CBD (cannabidiol) and THC in appropriate cases of intractable childhood epilepsy.
“It is this kind of whole plant extract that has been shown to be life-transforming for a significant number of children, including those involved in the high-profile cases of last year which led to medical cannabis being legalised.”
Simon Wigglesworth, deputy chief executive at Epilepsy Action, welcomed the decision to recommend Epidyolex. However, he said there were many thousands of people with other complex and treatment-resistant epilepsies who could potentially benefit from cannabis-based medicines.
Commenting on the decision, a spokesperson for charity Young Epilepsy wrote, “Based on the information provided, the recommendations are sound and a suitable basis for guidance to the NHS.
“We strongly recommend that specialist clinicians should still be able to prescribe cannabidiol on a case-by-case basis.”