Welsh health minister Mark Drakeford has announced that Wales has become the first UK country to authorize a cannabis-based medicine under its National Health Service. Sativex, a proprietary oral spray cannabinoid medicine that has been licensed in the UK to treat muscle spasms and stiffness in people with Multiple Sclerosis (MS) since 2010, has been approved by the All Wales Medicines Strategy Group (AWMSG), and will be available on prescription to treat MS patients who fail to show any response to other medicines. The active chemical agents of Sativex — Delta-9-tetrahydrocannabinol/cannabidiol — are derived from the cannabis plant.
The All Wales Medicines Strategy Group (AWMSG) is a statutory advisory Welsh Assembly-sponsored public body established under the 1977 National Health Service (NHS) Act, to provide advice on medicines management and prescribing to the Welsh Government’s Minister for Health and Social Services in an effective, efficient, and transparent manner, bringing together NHS clinicians, pharmacists, healthcare professionals, academics, health economists, industry representatives, and patient advocates. AWMSG, acting in a strategic and advisory capacity, is an authoritative and expert channel through which consensus can be reached on the use of medicines within both primary and secondary care.
Now that the AWMSG’s recommendation to approve access to the treatment has been ratified at ministerial level, Wales will become the only place in the UK where people with MS can routinely access the medicine. Mr. Drakeford is cited saying, “I hope this decision will help ease the suffering of some of those who have to live with the reality of MS every day.”
According to the U.K. MS Society there is “a very clear need for new treatments for MS symptoms.” The Society notes that “There are few effective treatments for the symptoms of MS. Most of the current drugs only benefit a minority of people and frequently have adverse side effects… this is especially true of pain control, where few treatments are effective… Available treatments for spasticity… afford partial relief and have unpleasant side effects.”
Sativex is also in development and clinical trials as a treatment for cancer pain and neuropathic pain of various origins, and has been has launched in 11 countries and approved in a further 13.
Earlier this year NICE – the body that decides what treatments should be available on the NHS in England and Wales – rejected the drug in their draft clinical guidelines for MS because it was not deemed ‘cost effective,’ but AWMSG decision overrules the NICE guideline in Wales. However, the MS Society, which contends that the NICE ruling was based on a flawed assessment of Sativex’s cost effectiveness, notes that unless local NHS bodies agree otherwise, persons living in England, Scotland, and Northern Ireland for whom Sativex is indicated an appropriate therapy and will continue to go without, or will need to fund the treatment privately. Health departments in England, Scotland, and Northern Ireland follow a different drug approval system than Wales, and the medicine is still not confirmed for use.
That may be subject to change. According to a report by The Guardian’s Nicholas Watt, U.K. drug minister Norman Baker is advocating liberalized drug laws be introduced to legalize already widespread use of cannabis to relieve symptoms of certain medical conditions, including the side effects of chemotherapy, voicing concerns that “credible people” are being obliged to break the law in order to secure the only substance that can help relieve their condition, Mr. Baker is writing to U.K. health secretary, Jeremy Hunt, to call for a review of the medicinal properties of cannabis.
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