Conversations about cannabis: The supply process in Australia

Abstract

Background

In 2016, Australia legislated medicinal cannabis supply as a pharmaceutical product; prescription is through two pathways dependent on product registration status with the Therapeutic Goods Administration. In 2021, down-scheduling of cannabidiol allowed for easier access through pharmacies. Little is known about the perspectives of those involved in medicinal cannabis supply regarding these legislative changes. This study captures the perspectives of stakeholders who access medicinal cannabis prior to patient provision and aims to shed light on the Australian medicinal cannabis supply process.

Methods

Stakeholders involved in medicinal cannabis supply from plant cultivation to dispensing products were recruited. Individual in-depth semi-structured interviews were followed by a single focus group. All sessions were conducted via Zoom or telephone, audio-recorded, transcribed ad verbatim, coded in NVivo Version 12 software and the findings were mapped into themes.

Results

Our interview sample comprised thirteen participants and the focus group eight participants. Two major themes emerged from discussions: (1) The supply chain pathway is complex and time consuming; (2) Supply lines adversely affect healthcare professional practice. These themes were complemented by six recommendations from focus group participants to improve current policy and practice.

Conclusions

Australia’s medicinal cannabis supply process is fragmented and underdeveloped with domestic production and product registration constrained by time-consuming protocols. Consequently most supplied products are unregistered and lack safety and efficacy evaluations. Healthcare professionals are ambivalent towards medicinal cannabis supply based on its current evidence-base and complex prescribing and dispensing processes. To address this product registration needs to be facilitated and the evidence base for specific preparations accumulated.