Pubdate: Fri, 15 Apr 2016
Source: Windsor Star (CN ON)
Copyright: 2016 The Windsor Star
Author: Peter Koven
Page: B8


TORONTO Canada's pharmacists and medical marijuana producers are
engaged in a brewing dispute over how pot should be distributed to
patients. If they can't reach an agreement, it could leave Ottawa with
a tough decision as it crafts new regulations for the sector.

The pharmacists believe they are the only ones who can provide proper
clinical advice and oversight over the growing use of medical pot, and
think they should control distribution. The marijuana producers, on
the other hand, believe the current mail-order system is a resounding
success, though they are open to involvement from pharmacies.

"By any metric, the medical cannabis system in Canada is working
exceedingly well," said Cam Battley, chair of the advocacy committee
at the Canadian Medical Cannabis Industry Association (CMCIA).

Canada's medical marijuana sector got its start in April 2014, when
Ottawa introduced rules forcing patients to buy their product from
licensed producers. Dozens of marijuana companies quickly emerged, and
they now have more than 50,000 patients signed up across the country.

When the federal government was formulating its regulations around pot
in 2012 and 2013, it invited the pharmacies to take part in
distribution. But the Canadian Pharmacists Association (CPhA) declined
to participate. In early 2013, the group sent a letter to Health
Canada saying it was concerned about a "lack of evidence" supporting
the use of medical marijuana.

It now belatedly wants to get on board. Last week, the CPhA announced
that pharmacists should play a "front-line role" in dispensing
marijuana. The CPhA's position was backed by a detailed report from

Phil Emberley, the CPhA's director of professional affairs, said
pharmacists still think more evidence is needed around marijuana's use
as medicine. But as Canadians use the product in increasingly large
numbers, he said pharmacists are needed to ensure patient safety.

"We know that there are side effects with marijuana, and potential
drug interactions as well," he said. "We feel that a lot of patients
are accessing medical marijuana without being protected from some of
those concerns."

The pot companies want to increase patient access to marijuana, so
they are broadly supportive of pharmacies playing a role in
distribution. They recognize that some patients will always prefer to
get their medicine from a pharmacist.

But they oppose the outright takeover of their direct-mail
distribution system by pharmacies.

Battley said pharmacy-only distribution could lead to higher costs for
patients and a much more limited selection of products. He noted a lot
of patients are very ill and it is convenient for them to get the
product at their doorstep.

Additionally, the CMCIA said there are security and product handling
concerns with marijuana that pharmacists would have to address.

Battley said it would make sense for pharmacies to take over
distribution if there were serious problems with the current model -
for example, if there were quality control or product delivery issues,
if there were drug interaction problems, or if there was evidence the
product was getting into the black market. But he claimed those things
are not happening.

The two industry associations plan to meet and discuss the issue. If
they can reach a settlement, they could make a joint recommendation to
Health Canada, which is reviewing its medical marijuana regulations
after a federal court judge struck down the current legislation in
February. Ottawa will ultimately decide whether the current
distribution system should be changed.

Jonathan Zaid, founder of the lobby group Canadians for Fair Access to
Medical Marijuana, said patients need to have a mix of options to
access pot, including pharmacies and direct mail. He noted too many
patients have been getting product through illegal

"There needs to be a regulated legal source that patients can go to in
person, and that just doesn't exist today," he said.
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