At the start of October, a medicinal cannabis product used in the management of multiple sclerosis became eligible for reimbursement in Ireland.
Multiple sclerosis (MS) is a chronic illness affecting the central nervous system where a patient’s immune system eats away at myelin, which is the protective covering of nerves. One of the many impacts is spasticity, which causes a patient’s muscles to feel stiff, heavy and difficult to move. In severe cases, it can cause uncontrollable and painful spasms.
Various anti-spasticity medications are available – among them a formulation called Sativex (nabiximols). This is an oromucosal spray based on a cannabis extract, with each 100 microlitre spray containing 2.7 mg THC (tetrahydrocannabinol) and 2.5 mg CBD (cannabidiol).
While Sativex has proved effective as an anti-spasticity medication for MS patients who haven’t found suitable relief using other medicines and therapies, it’s expensive stuff. Ireland’s National Centre for Pharmacoeconomics (NCPE) noted in 2021:
“Assuming that 8.1 sprays are required per day (dose assumption derived from the Summary of Product Characteristics), the total cost, per patient, per year is €5,181 (including mark-up, rebate and pharmacy fees).”
Sativex was first approved for use in Ireland a decade ago, but its cost hasn’t been covered for reimbursement. MS patients have struggled to access the treatment due to its costs. But that hurdle has now been removed.
Ireland’s Health Service Executive (HSE) recently announced a Managed Access Program (MAP) for Sativex under the High Tech Arrangement, which came into effect on 1st October 2023. The arrangement is confined to consultant neurologists registered with the Irish Medical Council, who have agreed to the terms of the MAP and who have been approved by the HSE. The approved prescriber is required to submit an application for individual reimbursement approval for each patient.
MS Ireland welcomed the news.
“This announcement marks the culmination of a decade-long journey, from advocating for legislative changes in 2013 to patient group submissions in recent years,” the organisation stated early this month. “MS Ireland acknowledges the tireless efforts of its Advocacy Officers past and present in championing this cause.”