Industry leaders fear a controversial new service allowing Australian patients to order low-dose CBD online could encourage those with serious medical conditions to ditch their GP in a bid to access medicinal cannabis in under 10 minutes.
Senior figures also believe the service could breach TGA rules on cannabis advertising and risks damaging the industry’s already-fragile reputation.
The concern surrounds the launch by CDA Clinics of a ‘digital wellness hub’ called CDA Express which enables patients to order low-dose CBD and wellness products online.
After a seven-minute virtual ‘consult’ to check eligibility, treatments from a range of brands appear for purchase on the site.
Patients are required to provide their Medicare number and GP details and give permission for CDA Clinics to send an advisory letter to their GP informing them they are planning to access the treatment online.
A patient who has used CDA Express described the process: “I didn’t speak to a doctor. The form asked basic questions to clarify my identity and medical reasons for seeking CBD. I could choose a reason from a list in a drop-down box… I was not asked about the nature of my condition.”
They added: “It was up to me to compare the products ranging in price from A$49 to $435 and in CBD concentrations from 25 to 240 mg/mL. There were no alternative products offered – it seemed more like a shopping experience than a medical consultation.”
Industry leaders expressed concern about the length and scope of the consultation process, especially for patients with serious medical conditions whom CDA appears to be targeting as customers.
CDA’s press release announcing the service names several medical conditions which it claims patients are already using low-dose CBD to treat, including anxiety, migraines, chronic pain, neuropathic pain, endometriosis, inflammation pain and fibromyalgia.
Youth website Pedestrian.TV described the move as “a deadset game changer”. But the rapid online process, unproven medical claims and paucity of transparent information provided to patients has riled industry leaders.
The Australian Medicinal Cannabis Association (AMCA) – of which CDA Health is a member – is now threatening to take action for breaching its conditions of membership and potentially flouting TGA advertising rules.
Among several concerns is how patients are being prescribed unapproved Schedule 4 drugs apparently without speaking to a medical professional.
AMCA legal board member Dr Teresa Nicoletti stated: “AMCA is surprised by the content of the press release distributed by CDA Health announcing CDA Express, the subsequent media coverage (both press and television) following that press release, and the creation of a website to promote it.
“The arrangements set out by CDA Express appear to subvert or undermine the sanctity of the doctor-patient relationship and, on their face, breach therapeutic goods laws and guidelines, and medical and ethical codes of practice. The board is currently reviewing the situation, and is in discussions with CDA Health as a member of AMCA.”
Medicinal Cannabis Industry Australia (MCIA) chair Peter Crock told Cannabiz: “This kind of behaviour is of great concern to the MCIA as it could put the industry’s reputation at risk.
He added: “We are working with our members to ensure they understand and operate within our industry code of conduct, and we will continue to engage with the regulators to enable compliance.”
Sydney-based GP Dr Brad McKay acknowledged patients’ desperation to trial CBD, but said a virtual consult would bypass their regular treating practitioner.
He added: “In Australia, CBD is still undergoing trials to assess its effectiveness in treating a variety of medical conditions, but we’re still waiting for the evidence.
“The CDA Express website says it all when its states ‘CBD is well-known for its potential therapeutic effects’. When it comes to medicine, having a ‘potential’ effect isn’t good enough – it needs to be proven.”
Vice President of the Society of Cannabis Clinicians Australian Chapter (SCCAC) Dr Joel Wren agreed the platform could isolate patients if they retreat from the conventional healthcare framework.
“Many patients I’ve seen don’t have a regular GP in the first place, so what will happen to ensure any follow-up occurs?” he asked.
GP Jamie Rickcord, founder and director of Byron Bay-based Ananda Clinics, said attempts to speed up access could rebound on an industry still battling its way out of prohibition.
He added: “Cannabis is still currently not accepted in wider society and any shortcuts to access need to be scrutinised.”
CDA Health general manager Rachael Cooney said the company was committed to improving access and patient well-being.
“CDA Express streamlines the process of patients accessing low-dose medicinal cannabis therapies, without sacrificing patient care. The core of our values at CDA Health are greater patient accessibility and affordability.
She added: “As a member of AMCA, we are disappointed at the association for not initially raising these concerns with us, before making comments in a public forum, and feel let down for not providing us the opportunity to address these concerns in an appropriate manner.”