Cannabis-based medicines approved by NHS

Two cannabis-based medicines for patients with severe epilepsy or multiple sclerosis have been approved for use by the National Health Service (or NHS) in England.

The United Kingdom's drugs advisory body, the National Institute for Health and Care Excellence, or NICE, issued new guidelines recommending that the two medicines receive reimbursement by NHS England.

Doctors will now be allowed to prescribe Epidyolex for patients older than two years who suffering from severe forms of treatment-resistant epilepsy.

A second drug – Sativex, which is a tetrahydrocannabinol / cannabidiol spray – was recommended to treat moderate to severe spasticity, or muscle stiffness and spasms, in adult multiple sclerosis patients.

Epidyolex is cannabidiol (also known as CBD) based, making it similar to tetrahydrocannabinol ( also known as THC), but nonpsychoactive, according to the World Health Organization.

CBD is the second-most prevalent ingredient in marijuana but is derived from hemp, a cousin of marijuana. Epidyolex treatment would be for seizures associated with two rare types of epilepsy – Dravet syndrome and Lennox-Gastaut syndrome.

Epidyolex has been reported as reducing seizures associated with Lennox-Gastaut syndrome, considered the most difficult to treat, by up to 40 percent in some cases.

The UK law was changed in November 2018 to allow specialist doctors to prescribe cannabis medicines, but this has happened in only a handful of cases, the BBC reported. Each country within the UK makes its own decision on drug approval, and NICE guidance should also apply in Wales and Northern Ireland, while Scotland could follow suit next year, it added.

Professor Helen Cross, a consultant in paediatric neurology at Great Ormond Street Hospital, who led UK trials of Epidyolex, told the BBC it was "great news".

"Dravet and Lennox Gastaut syndromes are both complex difficult epilepsies with limited effective treatment options and this gives patients another option … that could make a difference to care," she said.

However, some charity campaigners who have been fighting for access to the drugs have said it does not go far enough.

"It is particularly devastating there is no positive recommendation that the NHS should allow prescribing of whole-plant medical cannabis containing both CBD and THC in appropriate cases of intractable childhood epilepsy," Millie Hinton, from the campaign End Our Pain, said.

"A number of the families we represent met senior NICE representatives in person only a few weeks ago.

"They explained first-hand they were paying thousands of pounds every month for private prescriptions of whole-plant extract medical cannabis and their children were showing dramatic reductions in seizure rates and equally dramatic improvements in quality of life," said Hinton.

Sativex has been available in Wales on the NHS since 2014, making it the first cannabis-based drug to be licensed in the UK following clinical trials. Manufactured by GW Pharma, it costs around 2,000 pounds ($2,530) per patient per year.

Regulators in England initially said it was not cost-effective, however, they have since reversed their stance. The approval decision means Sativex can only be prescribed for spasticity, not pain.