UK drug watchdog issues report on cannabis-based medicine

A UK drug watchdog has issued draft guidance that no cannabis-based medicinal products should be used for treating chronic pain.

The National Institute for Health and Care Excellence (NICE) has published its draft recommendations on the use of cannabis-based medicinal products following an evaluation of their clinical and cost-effectiveness.

NICE said the benefits cannabis-based
medicinal products offer are very small compared with their high costs and so
they can’t be considered a cost-effective use of NHS resources.

The draft guidance, which is open for public consultation until September 5 2019, considers the use of these products for people with intractable nausea and vomiting as a result of chemotherapy, chronic pain, spasticity, and severe treatment-resistant epilepsy.

NHS England has also today published a review aimed at assessing the barriers to prescribing cannabis-based medicinal products where it is safe and clinically appropriate.

The review highlights that the
lack of evidence about the long-term safety and effectiveness of medicinal
cannabis has weighed heavily on prescribing decisions and recommends two
clinical trials be set up.

“We recognise that some people will be disappointed”

Paul Chrisp

Paul Chrisp, director of the Centre for Guidelines at NICE, said: “We recognise that some people will be disappointed that we have not been able to recommend the wider use of cannabis-based medicinal products.

“However, we were concerned
when we began developing this guidance that a robust evidence base for these
mostly unlicensed products was probably lacking.

“Having now considered all the
available evidence it’s therefore not surprising that the committee has not
been able to make many positive recommendations about their use.

“In most cases, the draft
guidance recommends that more research is carried out, echoing the recent call
by the National Institute of Health Research for research proposals for
these products.

“To that end NICE welcomes
the recent suggestion from the House of Commons Health and Social Care
Committee that companies should be encouraged to undertake or enable
research into their medicinal cannabis products.”

The NHS England review,
developed by listening to families and the specialist clinicians responsible
for care, makes clear that consistency is key and to ensure this, clinicians
need the best information and support available to make decisions to prescribe
medicinal cannabis for children with severe epilepsy which does not respond to
regular treatment.

New research and a network of
clinical experts who can provide doctors with advice are among the
recommendations made.

Dr Keith Ridge, chief
pharmaceutical officer at NHS England said: “Without sufficient evidence to
help them balance potential benefits against potential harms when they are
deciding whether to prescribe medicinal cannabis to children with very severe
epilepsy, it is clear clinicians are very reluctant to prescribe.

“We heard loud and clear the
concerns and frustration the children’s families are feeling, but these
recommendations aim to help us develop the evidence base to understand how safe
these products are, and ensure education and expert advice is available to
support clinicians across the UK.”

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