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NICE recommends first two cannabis-based medicines for NHS use


By Eleanor Philpotts, Costanza Pearce
Reporters

12 Nov 2019

The first two cannabis-based medications have been approved for NHS use by the National Institute of Health and Care Excellence (NICE).

Draft guidance, published yesterday (11 November), recommended the licensed product cannabidiol Epidyolex for the adjuvant treatment of seizures associated with two rare types of epilepsy – Dravet syndrome and Lennox-Gastaut syndrome.

Both types of epilepsy are rare, but most common in young children, with Lennox-Gastaut syndrome largely considered the most difficult to treat. Epidyolex has been reported as reducing seizures associated with it by up to 40% in some cases.

A second drug – Sativex, which is a THC:CBD spray – was also recommended to treat moderate to severe spasticity in adult multiple sclerosis patients.

The appraisal process for the new guidelines opened yesterday and will end on 27th November. The outcome will be published next month.

 

‘Pharmacists on the frontline’

 

Royal Pharmaceutical Society (RPS) chief scientist Gino Martini said it was ‘excellent news for patients’ that the two medicines have been approved for NHS use.

He said: ‘Pharmacists will be on the frontline of supplying cannabis-based medicinal products and can give advice to patients on them as part of their treatment plan. 

‘It’s essential that there is robust governance around prescribing and dispensing, and pharmacists have a key role to play in ensuring this is in place across health systems.’

Mr Martini welcomed the draft guidance’s recommendation that prescribing is based on clinical evidence and the detail around shared care that ‘balances patient access with specialist expertise’.

He said: ‘The guideline recognises the need for clear lines of responsibility and that some non-specialist clinicians might not be comfortable prescribing.’

In August, draft guidance from NICE outlined how GPs and other healthcare professionals could prescribe medicinal cannabis under shared care arrangements – if initially prescribed by a specialist doctor.

 

‘Not a magic bullet’

 

Professor Ley Sander, medical director at Epilepsy Society and professor of neurology at University College London, said that the news ‘will bring hope to many families’ affected by the two severe forms of epilepsy.

However, he added that the CBD products are ‘not a magic bullet’ and are likely to have varying results for different people.

Professor Sander added: ‘The need for new treatment options is unquestionable and it is reassuring that the new medication has been through clinical trials and regulatory processes.

‘But the timeframe for these means we still cannot be certain of the long-term efficacy of this CBD product or what its effect might be on the developing brain.’

Medical cannabis became legal to prescribe on the NHS in November last year.

In March, a report by The Pharmacist’s parent company Cogora revealed that GPs had seen a significant increase in the number of patients requesting medicinal cannabis in the year preceding the new legislation.


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