In a recent double-blinded study  examining the attitudes of pain specialists and oncologists toward the use of MMJ, only 38% of these physicians in the USA are recommending MMJ to their patients for treating the symptoms of their disease and/or the side effects of their therapy. Furthermore, among those physicians who have never recommended MMJ to their patients, 38% say they are opposed to doing so in the future.
When asked to specify their barriers to recommending MMJ, 69% say the lack of clinical studies and 62% say lack of endorsement from professional medical organizations prevent their consideration of MMJ. Unfortunately, the categorization of cannabis as a Schedule I drug by the USA, has effectively prevented large-scale trials from being conducted.
Despite these road-blocks, there is a growing recognition of the medical benefits of marijuana. Over 60% of Americans believe that marijuana should be made legal . Forbes predicts that MMJ will soon become legal across the USA due to this growing acceptance and the legalization of cannabis in Canada . As such, the pharmaceutical and biotech industries have begun to take notice. While some legislation advocates believe that pharmaceutical companies are driving the on-going resistance, these companies are also spending millions in preparation to compete with the MMJ industry.
There are 3 cannabinoid-based medications approved by the The Food and Drug Administration (FDA), and as of June 2018, pharmaceutical and biotech companies have registered 119 clinical trials for cannabinoids on ClinicalTrials.gov. Once cannabis has been removed from Schedule I status, the flood-gates are expected to open even further. With the pharmaceutical industry spending $62.1 billion on clinical trials in 2017 , how will the MMJ industry compete?
When pharmaceutical companies enter the MMJ market, they will come carrying a pile of data. THIS will be their selling proposition – “we have data backing our products.” However, this data will in turn result in a high price tag for treatments. The recently approved Epidiolex, for treatment of a rare form of epilepsy, costs $32,500 per year . The other two approved cannabinoid products, Marinol and Cesamet, respectively cost $244 and $2,055 per prescription . This is compared to the average price for a pound of marijuana of $1,386 .
So how can the MMJ industry protect against the competition from big pharma? There is one advantage that the current MMJ industry has that pharmaceutical companies do not. They have CURRENT ACCESS to physicians. Under current federal guidelines, it is illegal for an entity to promote a drug not approved by the FDA. Neither is it allowable to promote an approved drug for unapproved uses . Since 2000, pharmaceutical companies have paid over $18B in fines for off-label promotions . Nonetheless, physicians have a legal right to prescribe an unapproved therapy that they feel is clinically appropriate.
Our study with pain specialists and oncologists1has shown that resistance to recommending MMJ is partly due to the lack of trial evidence about efficacy and safety. However, most of these physicians also say they don’t recommend MMJ because they don’t know about the logistics of acquiring MMJ, nor the current science regarding the plant. Study results show that the greatest barriers to recommending MMJ are:
- Not knowing the logistics for how patients acquire a MMJ card;
- Lack of knowledge about the available strains and forms of MMJ ingestion;
- Lack of familiarity with the human endocannabinoid system and the pharmacodynamics among THC-CBD-Terpenes.
Overall, findings suggest that the MMJ industry is not viewed by many healthcare professionals as providing a legitimate treatment option. This perception is due to a number of factors, including the public image of marijuana users and the non-therapeutic names for strains and dispensary counselors (e.g., bud-tenders). However, the primary reason for the MMJ industry’s poor image among physicians is the lack of outreach to the medical community by the industry.
It is a well-known tenet in pharmaceuticals that the best professional marketing campaign is being first-to-market. In doing so, a first-to-market company has the unique opportunity to mold the market and educate healthcare providers in a way that best benefits their product line. Currently, the MMJ industry is in this enviable position, but without a concerted effort the opportunity will be lost and/or drowned out by the noise made by the pharma, tobacco, and alcoholic beverages industries.
The future of the cannabis industry will belong to those forward-looking organizations who are prepared to compete in a global market. Successful marketing of MMJ to physicians can be driven by the industry, but only if they don’t wait too long.
Our research has shown that doctors are clearly wanting more information about cannabis1, but despite the difficulty of the lack of clinical data, no other information about MMJ has been forthcoming. While it is true that many of physicians’ current questions cannot be answered given the lack of clinical studies, the information gap among physicians is not solely dependent upon this information alone.
Two-thirds (65%) of doctors surveyed say that producers of cannabis and cannabis-related products should spend more time educating physicians. While most MMJ organizations do not have the capital to support a full professional sales force, other means of providing market essential information about MMJ is well within their reach.
In preparing any outreach campaign to healthcare professionals, it is vital that the messaging is appropriate for the audience. Likewise, the forum for presenting information to physicians and other healthcare professionals should aim at delivering the data in ways that are considered acceptable and in-line with their training and experience.
The overarching goal of physicians is to improve the lives of their patients. In promoting this target, the MMJ industry should partner with the healthcare organization to assure that the physician, as gate-keeper of the patient’s healthcare, is kept informed regarding the MMJ options provided to patients. Conversely, promotions of cannabis as a medical solution that go around and/or exclude the patient’s healthcare providers will further alienate them, and will allow others (i.e., pharma, alcohol, tobacco, etc.) to widen the credibility gap between physicians and the MMJ industry.
The MMJ Industry is in a unique position to define MMJ in the minds of patients and healthcare providers. The public mind-set is driving governments and regulatory agencies toward legalization, and this opportunity is closing fast. Once missed, the industry will have no one to blame but themselves.
“Someone’s sitting in the shade today because someone planted a tree a long time ago.” Warren Buffett
Clinical realities of MMJ for Pain in the USA: Cannalytic Insights, October 2018. https://cannalyticinsights.com/mmjinsights/and Clinical Realities of MMJ for Cancer in the USA: Cannalytic Insights, October 2018. https://cannalyticinsights.com/mmjinsights/
Annual Marijuana Business Factbook (2018). Marijuana Business Daily. 6thedition.