Pubdate: Tue, 27 May 2014
Source: Los Angeles Times (CA)
Copyright: 2014 Associated Press
Contact:  http://www.latimes.com/
Details: http://www.mapinc.org/media/248

INSURERS JUST SAY NO TO MARIJUANA

They Don't Cover the Treatment, Which Costs As Much As $1,000 a Month.

Patients who use medical marijuana for pain and other chronic 
symptoms can take an unwanted hit: Insurers don't cover the 
treatment, which costs as much as $1,000 a month.

Marijuana in recent years has gained increased mainstream acceptance 
for its ability to boost appetite, dull pain and reduce seizures in 
people with a wide range of disorders and diseases, including 
epilepsy and cancer.

Still, insurers are reluctant to cover it, in part because of 
conflicting laws. Although 21 U.S. states have approved it for 
medical use, the drug still is outlawed by the federal government and 
most states.

But perhaps the biggest hurdle for insurers is its lack of approval 
by the Food and Drug Administration. Major insurers generally don't 
cover treatments that are not approved by the FDA, and that approval 
depends on big clinical studies that measure safety, effectiveness 
and side effects.

That research can take years and millions of dollars. And although 
the FDA has approved treatments like Marinol that contain a synthetic 
version of an ingredient in marijuana, so far no one has gained 
approval for a treatment that uses the whole plant.

As a result of the obstacles, advocates for medicinal marijuana say 
insurers probably won't cover the drug in the next few years. In the 
meantime, medical marijuana users - advocates estimate that there are 
more than 1 million nationwide - have to find other ways to pay for 
their treatment.

Bill Britt, for instance, gets his supply free from a friend whom he 
helps to grow the plants. Britt lives mostly on Social Security 
income and uses marijuana every day for epileptic seizures and leg 
pain from a childhood case of polio.

"I'm just lucky I have somebody who is helping me out, but that could 
go away at any time," said Britt, 55, who lives in Long Beach. "I am 
always worried about that."

Insurers have not seen enough evidence that marijuana is safe and 
more effective than other treatments, said Susan Pisano, a 
spokeswoman for America's Health Insurance Plans, an industry trade group.

Marijuana's Schedule I classification under the federal Controlled 
Substances Act makes it difficult to conduct clinical studies that 
might provide that evidence. The classification means the drug is 
considered to have a high potential for abuse and no accepted medical 
use. And that means extra precautions are required in order to study it.

Researchers have to apply to the FDA to approve their study. Public 
Health Service, another arm of the Department of Health and Human 
Services, also may review it, a process that can take months.

The Drug Enforcement Administration has to issue a permit after 
making sure researchers have a secure place to store the drug. 
Researchers also have to explain the study plan to the National 
Institute on Drug Abuse, or NIDA, another Health and Human Services agency.

And researchers have to use marijuana supplied by NIDA, which 
contracts with the University of Mississippi to grow the only 
federally sanctioned source of the drug. That can limit the options 
for strains of marijuana researchers can study.

Researchers also must find a location where the marijuana can be 
smoked or vaporized and scientists can monitor the patients 
afterward. That's no easy task, especially when dealing with public 
universities.

The American Medical Assn. has called for a change in marijuana's 
classification to one that makes it easier for research to be 
conducted. The current classification prevents physicians from even 
prescribing it in states where medical use is permitted. Instead, 
they can only recommend it to patients.

There is no easy and cheap way to get the drug legally. Patients in 
states where medical marijuana is legal can either grow it or buy it 
from government-approved dispensaries.

At dispensaries, an eighth of an ounce, which produces three to seven 
joints, costs $25 to $60, said Mike Liszewski, policy director for 
Americans for Safe Access, which advocates for safe and legal access 
to therapeutic cannabis. He noted that such an amount may not last 
long for patients who use the drug regularly to control pain or to 
help their appetites. Those patients might spend $1,000 a month or 
more. Patients may get a price break from their dispensary if they 
have a low income, but that depends on the dispensary.

Growing marijuana costs less but takes three or four months. And 
success depends on a number of factors, including the grower's skill. 
And there are other problems: Britt, from Long Beach, tried growing 
it in his backyard only to have thieves steal it.

Even if the FDA approves medicinal marijuana, there's no guarantee 
that insurance coverage will become widespread. Big companies that 
pay medical bills for their workers and dependents decide what items 
their insurance plans cover.

Meanwhile, patients such as Kari Boiter, 33, of Tacoma, Wash., 
continue to get medical marijuana any way they can. Boiter has a 
genetic disorder that causes pain, nausea and vomiting, and she uses 
marijuana she helps grow in a cooperative garden to control the symptoms.

Boiter, who is unemployed, said she'd have to go back to largely 
ineffective prescriptions, or do without treatment if the cooperative 
went away. "It would be really hard for me," she said.
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MAP posted-by: Jay Bergstrom