The myth of high-cost medical cannabis in Australia

Australian media has in recent years reported on the high costs of medicinal cannabis (also known as medicinal marijuana), quoting numbers as high as $40K per year for patient treatment.

But does it actually cost this much?

In most cases the numbers quoted are referencing patients with epilepsy who are taking extremely high dosages.

Numerous studies have shown the benefits of medicinal cannabis for patients with epilepsy, with substantial reduction in the frequency of seizures for many cases. Products prescribed are usually preparations of cannabidiol (CBD). The dosage requirements however, are very high –  usually in the range of 10-20mg per kg body weight, per day (Devinsky et al. 2018).

According to the recent study of pricing in Australia, done by Cannabis Access Clinics, the average price for CBD in Australia is $0.21 per mg (before pharmacy markup). So a 30 kg child prescribed a high dose of 20mg per day will indeed cost (20mg x $.21 x 30) $126 per day or $45,990 per year. Clearly, and sadly, a bank-breaking sum for all but the wealthiest of families.

But what about the costs for other conditions? The most common prescriptions for medicinal cannabis in Australia are for chronic pain, something that affects around 5 million Australians. Does medicinal cannabis for chronic pain also cost in excess of $40,000 per year here in Australia?

The short answer is No. Far from it.

Prescriptions and dosages for chronic pain are very different from epilepsy.

Firstly, the products used are different. For chronic pain, doctors typically prescribe products which includes the active ingredient  tetrahydrocannabinol (THC) as well as CBD.

Secondly the dosage is very different. Prescriptions usually start at a low dose of 2.5mg per day of each active ingredient and patents increase dosage until effects are optimized.

So how much does it cost? According to the Cannabis Access Clinics pricing study, average monthly costs for patients with chronic pain were $353 per month.  Still an eye watering amount for many patients but fortunately far from the medicinal marijuana price numbers the media typically shouts to their readers and viewers.

There is the hope that as the volumes increase, the costs of medicinal cannabis will come down. There is also a hope that insurance companies and perhaps even he federal government with the Pharmaceutical Benefits Scheme (PBS) will come to the party and help offset the costs of medicine. But for now the burden is on the patient. Not to the tune of $40,000 per year, but certainly at a level that most people will need to experience significant benefit to justify the cost.

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