CLHIA warns of unintended consequences in Health Canada’s proposed pot rules

While the Canadian Life and Health Insurance Association acknowledges that Health Canada’s proposed approach to the regulation of marijuana aims to improve patient access, it’s expressing concern that some of the proposed changes may result in unintended consequences.

“In general, we support the proposed approach to the regulation of cannabis that maintains the current medical cannabis system, including licensed producers, requirement for a prescriber’s signature on a signed medical document, etc.,” wrote Joan Weir, the association’s director of health and disability policy, in a letter to Health Canada’s cannabis legalization and regulation secretariat. “In addition, we support the new proposed regulations for the recreational stream would apply equally to medical cannabis, such as product and packaging limitations.”

Read: Benefits plan must cover medical pot, human rights commission rules

However, there are a number of proposed changes that the insurance industry believes will have unintended consequences. Weir expressed concern, for example, about Health Canada’s proposal that, besides buying from a federally licensed seller of marijuana for medical purposes, patients over the age of 18 would also be able to grow their own cannabis or designate someone to do so on their behalf.

“If not restricted to federally licensed producers, there is the possibility that insurers may not recognize home-grown medical cannabis as a reimbursable product under benefit plans as there is no verification process insurers can take to validate plants were grown at home and consumed,” the letter noted.

Read: CLHIA warns high prices for recreational marijuana will push users to medical system

The CLHIA also responded to Health Canada’s proposal to remove the current 30-day limitation period during which a licensed producer can’t fill multiple orders for the same patient. ”The proposed change does not clearly indicate if the multiple orders would be limited in quantity or if 30 days of quantity could be filled multiple times without limit in a 30-day period. If the limitation is completely removed, we would expect to see increased drug diversion to the street and potentially increased fraudulent orders,” the CLHIA said in its response.

To manage the risk, the CLHIA suggests the limitation should mirror the prescription drug model.

“If a prescription drug is dispensed with a 30-day supply according to the prescriber’s directions for use, the insurance industry would not expect to see the next fill until at least a certain proportion of the medication is depleted, typically around 66 per cent. We would propose following the same limitation. In addition, there might be exceptional circumstances where an earlier fill is required, such as a loss of medication. The licensed producer can fill the order but should be required to document the exceptional circumstances.”

Read: Key steps to implementing a policy addressing marijuana in the workplace

While Health Canada has also proposed maintaining a scientific, evidence-based approach for the oversight of prescription health products, it also recommended that, where a health product contains lower levels of tetrahydrocannabinol and cannabidiol, makes less serious health claims and is found to be safe without the oversight of a practitioner, it could be available on a non-prescription basis. The result could be a new pathway to market for non-prescription health products that contain marijuana.

“The industry recommends that it be made clear in the proposed regulations that this new pathway to market would not require a medical document nor a prescription, and would be equivalent to other over-the-counter type products, meaning that it would not qualify as medical cannabis,”  the CLHIA responded.