Hippocratic Growth: Exclusive Interview with Cannabis Access Clinics Director Dr Sanjay Nijhawan

Medical marijuana is on the rise in Australia, and the latest figures published by the Therapeutic Goods Administration (TGA) show that more than 6,000 patients have been approved for cannabis prescriptions.

But experts estimate that there may still be as many as 100,000 Australian patients treating their symptoms with cannabis that was illegally obtained from the black market.

Clearly, access is still a serious issue, and sometimes it can be impossible for patients to find a doctor who is willing to apply for SAS approval. However, some companies are working to change that

As part of our coverage of the Hemp Health and Innovation (HHI) Expo, The Green Fund spoke with the Medical Director of Cannabis Access Clinics, Dr Sanjay Nijhawan, in an exclusive interview.  Cannabis Access Clinics (CAC) is a privately-owned company that only employs doctors that display a "complete clinical independence from a prescribing perspective". This allows CAC to prioritise patient well-being by remaining fully independent when it comes to choosing specific cannabis products to prescribe over others.

The company's centres are staffed with GPs and specialists who are able to consult with patients for a wide-range of different illnesses and conditions, including MS, PTSD, anxiety, epilepsy, HIV, chronic pain and chemotherapy-induced nausea.

Last year the company also entered into an agreement with Bod Australia (ASX:BDA), to make its sublingual cannabis wafer available to CAC's patients once the product's phase I clinical trial is complete.

CAC already have clinics in several major Australian cities—specifically Sydney, Melbourne, Brisbane and Perth—and are in the process of establishing an additional clinical practice in Adelaide later this year.

"For us now it's about more than just patient care. It's also about pursuing research and development. We're looking to support our patients as a whole category."

– Medical Director of Cannabis Access Clinics, Dr Sanjay Nijhawan

CAC also operate a clinic in Auckland, New Zealand, giving it coverage of two of Australasia's biggest medicinal markets.

Prior to overseeing CAC's network of clinics, Dr Nijhawan worked as the Head of Clinical Development for the Primary Healthcare Group, and had little previous exposure to the medicinal cannabis industry.

"I was asked to join Cannabis Access Clinics 18 months ago because they wanted clinical governance introduced into their centres."

"My background is purely in clinical governance and mainstream medicine."

"I'm an MBBS, a member of the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine, so I'm very much mainstream," Nijhawan said.

Although medicinal cannabis is becoming more popular by the day with Australian consumers, Nijhawan admits that we still have a long way to go to catch up with our overseas counterparts.

Treatment costs are still are serious issue for many patients, as medicinal cannabis products are not currently covered by the Pharmaceutical Benefits Scheme (PBS). Most GPs are also still reluctant to prescribe cannabis-based medicine, and only a small amount of the product is actually available in Australia as much of it is exported overseas.

However, Dr Nijhawan says that CAC still has a clear plan for future growth, despite how few qualifying conditions and patients there currently are in Australia.

"I think it's important to remember that we have a very similar population type to Canada, and we know for a fact that Canada now has 50-60,00 patients," he said.

"Australia currently has very tight controls from the TGA—as they should be—so for now it's still quite hard to access medicinal cannabis. But we expect this to open up in future, and we're currently in the process of setting up clinics in Adelaide and other cities."

Although it seems unlikely that Australia's regulatory environment will close the gap with Canada's in the near future, the company is still determined to push ahead.

The general manager of Cannabis Access Clinics, Belen Gomez, has previously stated that the company wants to be one of the first parties to break into the fledgling medical market.

CAC predicts that the eventual effect of this will be "free-falling" product prices and improved outcomes for Australian patients.

"We expect to gain another few thousand patients in twelve months' time. Australia already has 5,000-6,000 [patients] and we control approximately one third of that."

– Medical Director of Cannabis Access Clinics, Dr Sanjay Nijhawan

According to Dr Nijhawan, Cannabis Access Clinics is likely to see "exponential growth" over the next two years, as the company expands its' services and builds its patient base.

"We're currently looking at setting up a free service for veterans, to see whether CBD based treatment would be effective for their PTSD-related issues."

"We are also constantly working with the NSW government and the TGA to monitor for legal changes, while conducting regular follow-ups with patients so we can monitor their health as well."

"In 24 months' time we expect to see an exponential growth. You only have to look at Canada to see what they've been able to do there. We're predicting similar numbers in Australia. We're still finding new applications, we've got MS, Crohn's disease, epilepsy, PTSD."

As part of the company's mission to ensure that patients are provided with appropriate treatment options, CAC undertook an extensive study into the cost of medicinal cannabis-based treatment.

The report—entitled Australian Medicinal Cannabis Pricing Analysis—is the first of its' kind in Australia, and was published late last year.

CAC's study claims that the current prices paid by many patients "fall within the limits of what is considered affordable".

However, it still expects them to decline further over the next 12-18 months as more companies compete to deliver better quality products at lower prices, and more efficiently managed supply chains are established.

The study states that prices of entry-level cannabis products have already fallen by 47 percent since the TGA moved to relax the regulations surrounding them in February 2017.

"There is [also] a double-blind trial being done across 8 hospitals in NSW in oncology units using THC and CBD to suppress excessive vomiting and other medication side effects."

"It's estimated to be a $4 billion industry at some stage. Our focus is clinical care, and we hope to maintain that well," Nijhawan said.

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Hugo Gray
Hugo Gray

Hugo Gray is a Melbourne-based journalist with a body of work that covers a diverse range of topics, including immigration law, sex technology, and now the rapidly expanding cannabis industry.

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