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Randomised controlled trials

Medical cannabis industry should be told to provide evidence if it wants products prescribed, MPs hear

Keith Ridge told the House of Commons Health and Social Care Select Committee hearing on medical cannabis policy that he saw the primary purpose of rescheduling medical cannabis as supporting development of good evidence.

Evidence for the prescribing of medical cannabis is lacking, Keith Ridge, chief pharmaceutical officer for England, has told MPs.

Speaking at the second of two House of Commons Health and Social Care Select Committee hearings on medical cannabis policy on 26 March 2019, Ridge said that he saw the primary purpose of rescheduling medical cannabis as to support “development of good evidence of both benefit and risk”.

He told MPs that it was important to “consider the needs of seriously ill patients” and to ensure that “when a patient needs a medicine urgently, there are systems in place” to allow that to happen. But he emphasised that commissioning systems are “based on evidence … at the moment we find ourselves in a situation where evidence is lacking”.

Robust, randomised controlled trials (RCTs) are “top of the list”, he added.

Baroness Blackwood, under secretary of state for health and social care, told the committee that “pressure should be put on the industry” to fund RCTs, echoing sentiments previously expressed by Dame Sally Davies, chief medical officer for England.

“These are multibillion dollar companies; [medical cannabis] is a billion pound market, and there is no reason that I can see that they should not be funding clinical trials like any other drug company,” she said.

Committee chair Sarah Wollaston asked Blackwood what could be done if manufacturers refused to supply a medical cannabis product for trials. She said the British Paediatric Neurology Association had told the committee that they “haven’t been able to secure an agreement from [medical cannabis producer] Tilray to provide the product for a trial that they are proposing to conduct”.

Blackwood replied that such a response was “completely unacceptable” from a cannabis company.

“We obviously need to develop the clinical evidence. I can’t understand for the life of me why a cannabis company wouldn’t want to develop the evidence base in order for their drug to be more prescribed and for there to be more confidence in it,” she said.

“I will take that away and I will talk to the Department and see what action could be taken”.

Chris Whitty, chief scientific advisor at the Department of Health and Social Care, said: “If this committee can make clear to the industry that in the UK we take evidence very seriously, and if you will not provide the evidence you’ve very unlikely to have your drug prescribed — that would actually be a very powerful signal.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206346

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