Les médicaments à base de cannabis bloqués pour une utilisation de routine dans le NHS, car les chiens de garde exigent des preuves de leur innocuité

Les médicaments à base de cannabis bloqués pour une utilisation de routine dans le NHS, car les chiens de garde exigent des preuves de leur innocuité

août 11, 2019 0 Par admin

Translating…

Cannabis-based medicinal products were abruptly decriminalised in November 2018
Cannabis-based medicinal products were abruptly decriminalised in November 2018 Credit: PA

Cannabis-based drugs controversially legalised by the government have been blocked by NHS watchdogs because there is insufficient evidence they are safe.

The National Institute for Health and Care Excellence (Nice) yesterday called for fast-tracked clinical trials after concluding it could not recommend cannabis-based medicinal products (CBMP) for routine use.

The drugs were decriminalised by Sajid Javid last November following the high-profile campaign in support of Alfie Dingley, a severely epileptic child whose mother was being forced to seek treatment abroad.

However, without Nice approval only a tiny handful of doctors are qualified and willing to prescribe CBMPs, meaning they are virtually impossible to obtain in practice.

Last night patient charities were left devastated by the Nice decision, saying it denies effective treatment to thousands of people.

Any accompanying report by NHS England blamed last year’s “rapid-rescheduling” of CBPMs for leading to a “very high expectation from patients and their families that they would be able to access these medicines on the NHS”.

The criticism echoes findings published last month by the Health Select Committee.

As well as blocking the routine use of cannabis-based epilepsy treatments on the NHS, the Nice draft guidance also refused to recommend Sativex, a cannabis-based epilepsy medicine, on the grounds it is not cost-effective.

However, the body did approve Nabilone, a synthetic cannabis-based medicine for cancer patients struggling with side-effects of chemotherapy.

Hannah Deacon, whose son Alfie Dingley is one of just two patients with an NHS prescription, said: “There are hundreds of thousands of people using cannabis-based medicines across the world and it’s having an enormously positive impact on their health.”

She pointed out that America, Canada and other G7 countries had legalised medicinal cannabis, adding: “The UK is insisting on reinventing the wheel for no reason and the people who are suffering are patients.”

Last year’s redesignation of CBPMs from Schedule 1 to Schedule 2 of the Misuse of Drugs Regulations means specialist doctors are permitted to prescribe them.

In the absence of Nice guidelines, however, they may be personally liable if something goes wrong.

Dr Keith Ridge, chief pharmaceutical officer at NHS, 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 that clinicians are very reluctant to prescribe.”

Nice is considered arguably the most rigorous agency of its kind in the world because it demands copious evidence from clinical trials before signing off drugs as safe, effective, and good value for money.

Because use of cannabis-based drugs was banned under all circumstances until so recently, so such evidence exists.

NHS England yesterday pledged to begin “one or more” randomised control trials looking at CBMPs for severe treatment-resistant epileptic children. 

It will also offer full genome sequencing to all children under consideration for treatment with medical cannabis.

The Medicinal Cannabis Clinicians Society said it was wrong to apply the same standard of evidence to CBMPs to other drugs and accused the Nice committee as being biased against cannabis.

Genevieve Edwards, from the MS Society, said: “MS is relentless, painful and disabling and yet not a single person with MS has benefited from medicinal cannabis being legalised nine months ago.” 

“The government and the companies behind Sativex need to make people with MS a priority.”

Nabilone, the first cannabis-drug to be approved for routine use in the NHS, is a synthetic product that mimics the effects of tetrahydrocannabinol (THC), the component that makes recreational cannabis users “high”.

Already licensed, It will become available to patients suffering with chemotherapy-induced nausea and vomiting which has not responded to conventional medicine.


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