Cannabis could become a battleground between Canadian pharmacies and licensed medical marijuana growers. On Apr. 7, the Canadian Pharmacists Association (CPhA) - a group representing individual pharmacists across the country - called on the federal government to let pharmacists take the lead on managing and dispensing medical marijuana to Canada's 50,000+ eligible patients.
"Pharmacists are medication experts and play a critical role in the management and monitoring of medication to ensure safe and optimal use," Phil Emberley - Director of Professional Affairs for CPhA - said in a press release. "And it is patient safety that is ultimately at the heart of CPhA's decision to update its position on the role of pharmacists in the management and dispensing of medical marijuana."
Pharmacies have a change of heart
The announcement is a major change in position for the group. Health Canada discussed the possibility of dispensing cannabis through pharmacies when the Harper government was developing revised medical marijuana laws - the Marihuana for Medical Purposes Regulations (MMPR), which took effect in 2013. But the CPhA didn't want to get involved because of concerns about the lack of research regarding the safety and effectiveness of marijuana, potential resistance from provincial and territorial governments, and the possibility that stocking cannabis would make pharmacies more prone to robbery.
Instead, Health Canada developed a system for patients to order their medicine from licensed growers through the mail. And illegal storefront dispensaries for medical marijuana sprouted up across the country. But now that Health Canada has to revise its medical marijuana laws to allow home growing, the CPhA wants to be included in the market.
The CPhA's announcement puts the whole group onside with Shoppers Drug Mart - a national chain of pharmacies with over 1,300 outlets nationwide - which announced last February that it was exploring the possibility of dispensing marijuana grown by licensed producers.
But the announcement could put them offside with other stakeholders in the legal and gray market medical marijuana.
Stakeholders are willing to share the market
Other stakeholders are willing to share the medical marijuana market with pharmacies, but they don't want pharmacists taking over the industry.
"Pharmacy may be a valuable additional option for patients in the future, but as a complement, not as a replacement to the existing, successful direct access system," said Neil Closner - Chair of the Canadian Medical Cannabis Industry Association - a group that represents licensed producers such as Tweed and OrganiGram.
"Distribution only via pharmacies would reduce access and product choice, and raise costs to patients, and could also increase the risk of diversion [i.e. marijuana being resold on the black market]," added Closner in a press release.
Jonathan Zaid - founder of the advocacy group Canadians for Fair Access to Medical Marijuana (CFAMM) - is also willing to work with pharmacies as an additional but not the sole source in the supply chain for medical marijuana.
"Every patient has unique needs when it comes to product choice and access to their medicine," Zaid said via press release. "While we would welcome pharmacies as part of a legal, regulated medical cannabis supply chain, their inclusion cannot trump other sources of access, including the current, proven mail order system and patient self-production [i.e. home growing]."
Licensed producer says pharmacies don't recognize existing suppliers
Denis Arsenault - CEO of OrganiGram - took exception to the CPHaC's statement because it didn't recognize that Canada's medical marijuana patients are already being served by licensed producers. "Their statement is a bit of a disservice to the reality that the LPs are currently servicing 50,000 customers across the country who are extremely happy with the service they are getting from our staff," he told Civilized.
"It's ironic because they wanted no part in being a stakeholder in the MMPR [the 2013 regulations]," he said. "The licensed producers have made investments with people and training, and now the pharmacy is saying they're the only ones who can handle this. We've lived it on the front lines for three years. We've put the protocols in place. We've put the training in place. With the various strains and symptoms, there is a tremendous learning curve to be able to be trained to serve a patient properly."
Arsenault is still open to working with, or alongside pharmacies so long as the government's new rules serve the patient's interests first.
"Put in place a system that's best for the patient - not best for the LP's or the pharmacies," he said. "Make it patient-centric. Get the patients what they need. At the end of the day, there will be pennies for everybody."