We know that accessing medicinal cannabis can be a daunting process for new patients. In this blog post, we’ll provide an overview of the ways to access medicinal cannabis in Australia to support patients starting their journey. 

Medicinal cannabis eligibility

Before evaluating which pathway is right for you, it is important to consider whether you are likely to be eligible for a medicinal cannabis prescription. The first requirement that determines eligibility is a history of a chronic medical condition or symptoms that may potentially be treated with medicinal cannabis. The TGA has granted approval for medicinal cannabis across a range of conditions that include: chronic pain, anxiety, insomnia and other sleeping disorders, depression, epilepsy, chemotherapy-induced nausea and vomiting (CINV), PTSD and fibromyalgia.

This list is not exhaustive and only gives insight into some of the common conditions that have received approvals. Currently, there is no comprehensive list of conditions that the TGA will approve for the use of medicinal cannabis, but healthcare professionals can apply for any condition if other eligibility requirements are met.  

The second requirement is that you must have attempted other treatments for your condition prior to applying for medicinal cannabis. Although major strides have been made in Australia, cannabis is still not considered a first or second-line treatment option. You don’t have to exhaust all other options, but you must demonstrate that multiple treatments have been tried before lodging an application. 

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These treatments are not strictly limited to other prescription medications. Non-pharmacological interventions, such as psychotherapy, exercise, acupuncture and meditation, amongst others, may also support an application.

If other treatments have failed to relieve any symptoms or improve your quality of life, then a case can be made for the use of medicinal cannabis. Likewise, if other medications produce intolerable side effects, then continuing to use them as a treatment is not an option. You are likely to be eligible for a medicinal cannabis prescription if your condition is chronic (i.e. symptoms lasting longer than 3 months) and other treatments have not provided satisfactory relief.

Special Access Scheme B (SAS-B) pathway

In every Australian state, all doctors and most nurse practitioners can make requests to the TGA to prescribe medicinal cannabis. A Special Access Scheme (SAS) application allows health practitioners to prescribe certain therapeutic goods (such as medicinal cannabis) to a patient.¹

The SAS category A (SAS-A) pathway is reserved for patients with terminal illnesses and the SAS category C (SAS-C) pathway is reserved for therapeutic goods with an established history of use. The majority of SAS applications for medicinal cannabis products will fall under the SAS category B (SAS-B) access pathway. This pathway is for patients that don’t meet the criteria for SAS-A or medicines that don’t meet the criteria for SAS-C.

To apply for a SAS-B approval, your doctor or nurse practitioner will have to provide certain information to the TGA through an online portal. This information includes a patient diagnosis, a clinical justification for the use of medicinal cannabis, expected patient outcomes, safety and efficacy data and details for monitoring adverse effects.

SAS-B applications for medicinal cannabis are based on product categories. Your doctor will need to select a category of products suitable for the treatment of your condition. The full list of medicinal cannabis product categories and their criteria can be found on the TGA website.

If your doctor is prescribing multiple products of the same format from the same category (e.g. high THC dried flower), they will not need to submit a separate SAS-B application. However, if they are prescribing products from different categories or formats, then separate applications will be required.

Once submitted, your doctor will hear back from the TGA within 72 hours. If approved, a script will either be given to you or directly to a pharmacy. A pharmacy will place the order within 72 hours and arrange a pickup or delivery with you for the medicinal cannabis products.  

Authorised Prescriber (AP) pathway

Authorised Prescribers (APs) are doctors who have received authorisation from the TGA to prescribe specific products for a condition or class of conditions.²

Not all doctors can become APs. The approval process is lengthy, and doctors must demonstrate proficient knowledge of medicinal cannabis (e.g. indications, effects and administration) and the conditions they want to prescribe for (including traditional treatments).

APs can prescribe medicinal cannabis to patients under their immediate care without seeking individual TGA approval. You may be able to receive a prescription immediately following an initial consultation with an AP if they approve medicinal cannabis as a suitable treatment for you. 

Scripts will cover a single product but multiple scripts can be written if necessary. You will typically receive your medication within a week of receiving a prescription from an AP.

Clinical trials

Participating in clinical trials is another pathway to accessing medicinal cannabis for some patients.³ Clinical trials are often used to collect safety, efficacy and dosage data for medicinal cannabis treatments. These studies can be observational or interventional and may cover a wide range of medical conditions. 

This is the least used access pathway for most patients, mainly due to the specificity of individual trials and their unique requirements. However, clinical trials can be a good entry point for patients if medicinal cannabis treatments are being studied for their condition.‍

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Clinical evidence to support the use of medicinal cannabis as treatment for specific conditions is important for both doctors and regulators. As such, there are a number of clinical trials being run at any given time. If you would like to learn more, you can talk to your regular health provider and search for any current or upcoming Australian clinical trials on the Australian New Zealand Clinical Trials Registry (ANZCTR) website.

Conclusion

The best first step is to speak with your regular healthcare provider who is familiar with your medical history. They should be able to assess your eligibility criteria and whether medicinal cannabis is a suitable treatment. As your regular GP is normally in charge of monitoring your medical treatment, it’s important to keep them in the loop when you are considering medicinal cannabis.

Your GP may also refer you to a specialist cannabis doctor or cannabis clinic. Most clinics are run by doctors who specialise in assessing certain medical conditions and prescribing medicinal cannabis as a treatment. Because they are well-versed in the application process and some have APs on staff, this pathway can sometimes be more straightforward.

There are a number of clinics to choose from in Australia, and they will each set their own fee structure for initial and follow-up consultations. You should consider the ongoing and annual clinic fees when assessing your medicinal cannabis treatment over the long-term. Some clinics require a referral from your GP or have product affiliations, so it’s best to enquire prior to booking an initial consultation.

It’s always recommended to do your own research and prepare questions before speaking with a doctor or clinic. Please feel free to reach out to us if you have any questions. We are here to help throughout your medicinal cannabis journey.

References

1. Therapeutics Good Administration. (2021). Special Access Scheme [online]. Available from: https://www.tga.gov.au/form/special-access-scheme [accessed 4 August 2022].

2. Therapeutic Goods Administration. (2021). Authorised Prescribers [online]. Available from: https://www.tga.gov.au/form/authorised-prescribers [accessed 4 August 2022].

3. Therapeutic Goods Administration. (2021). Clinical trials [online]. Available from: https://www.tga.gov.au/clinical-trials [accessed 4 August 2022].

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