Why isn’t medicinal cannabis on the PBS?

Medicinal cannabis has been hailed as a game changer for patients dealing with chronic pain, epilepsy, cancer-related symptoms, and more. Since its legalisation in 2016, hundreds of thousands of Australians, over half a million, have accessed it, demonstrating its widespread demand and the significant potential for improving lives. Over half of those accessing medicinal cannabis have sought it to relieve their chronic pain. So why isn’t it on the Pharmaceutical Benefits Scheme (PBS)?

The Minister Says: “It’s a Natural Product”

I had with South Australia’s own Federal Minister for Health, affectionately known as “Dimples” (Mark Butler), he explained the key roadblock: medicinal cannabis is a natural product that cannot be patented. And here lies the conundrum. The PBS system is built to support patented medicines, typically developed by pharmaceutical companies with the financial incentive of exclusivity. But when a product like cannabis doesn’t fit neatly into this model, it’s effectively excluded—regardless of how well it works or the demand for it.

Why Should a Patent Be the Gatekeeper?

This raises an important question: why does a product need to be patented to qualify for PBS listing? If medicinal cannabis is already proving its worth for countless Australians, shouldn’t that be enough? One could ask why can’t there be an exemption to allow natural products onto the PBS?

Without this exemption, Australians are left to navigate an expensive and inconsistent landscape. Patients rely on the goodwill of companies, clinics, and pharmacies to provide discounts on a case-by-case basis. This isn’t sustainable or fair.

A Tale of Inequality: Other Products on the PBS

Here’s where things get frustrating. Many products with significantly fewer recipients than medicinal cannabis have been added to the PBS. For example:

• Eculizumab (Soliris), a drug for a rare blood disorder, costs hundreds of thousands per patient annually, yet is PBS-listed for a condition that affects only a few hundred people in Australia.
• Ivacaftor (Kalydeco), a treatment for a rare form of cystic fibrosis, is PBS-listed despite its limited application.

These are undeniably important medicines, however, if such drugs can qualify for subsidisation with far fewer recipients, why can’t medicinal cannabis, which has helped hundreds of thousands, and is improving the quality of life of recipients?

The Cost Barrier for Patients

Medicinal cannabis isn’t cheap! Depending on the condition and dosage, patients can pay hundreds or even thousands of dollars per month. For many, this cost is simply untenable, forcing them to forego treatment or seek alternatives on the black market. The result? Patients are left in a financial and medical limbo while policymakers point to patent regulations.

The Case for Fair Access

There’s a strong argument for allowing medicinal cannabis onto the PBS, patent or not. If the system is truly about ensuring Australians have access to life-improving treatments, the current model fails when it comes to cannabis. The cost burden falls disproportionately on patients, creating inequity and limiting access to a treatment that improves quality of life.

What Needs to Change?

• Exemption for Natural Products: The PBS should accommodate natural products like medicinal cannabis, acknowledging their proven medical benefits – it’s no longer just anecdotal.
• Fair Subsidisation: Australians should not have to rely on corporate generosity for affordable treatment. Subsidies should be applied consistently and fairly, reflecting the demand and benefit of medicinal cannabis.

A Missed Opportunity

Medicinal cannabis represents an opportunity to innovate healthcare and offer meaningful relief to patients across Australia. Yet, the system’s rigidity leaves thousands in pain and uncertainty.

The bottom line? Medicinal cannabis works, and Australians deserve fair access to it without being penalised by outdated policies. It’s time to rethink the PBS model and ensure it serves the people it was designed to help. After all, isn’t that what healthcare policy is all about?