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A year later, high cost a barrier for medical marijuana

A year after medical marijuana became legal in Minnesota, program supporters are hoping a surge of patients seeking treatment for intractable pain can help bring down the drug’s high cost.

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Maren Schroeder is vice president of Sensible Minnesota, a volunteer organization that educates medical marijuana patients.
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A year after medical marijuana became legal in Minnesota, program supporters are hoping a surge of patients seeking treatment for intractable pain can help bring down the drug's high cost.

Beginning today, patients with chronic pain that cannot be controlled well with existing treatment can register for the state's medical cannabis program. On Aug. 1, those patients can begin buying marijuana at one of the state's eight dispensaries.

Minnesota Medical Solutions CEO Dr. Kyle Kingsley said the company's offices have already been receiving plenty of calls from patients struggling with pain who are eager to enroll in the program.

"We're excited for additional patients because it will help bring down costs and allow us to build more jobs for folks," Kingsley said.

Minnesota has one of the strictest medical marijuana laws in the nation, only allowing medical cannabis to be used in pill, liquid or oil form. Patients must have one of 1 0 qualifying conditions such as cancer, multiple sclerosis or epileptic seizures to qualify for the program. Before patients can get the medication, they must first be certified as having one of the qualifying conditions by a physician, physician assistant or advanced practice registered nurse.

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As of June 23, 1,548 patients statewide have been approved to buy medical cannabis. Kingsley said the number of people signing up for the program is on the low end of the company's original estimates from a year ago. But he said the company is expecting a "modest increase" in enrollment once intractable pain patients can begin signing up. For physicians, Kinglsey said medical cannabis offers a viable alternative to prescription opioid pain relievers.

"We're seeing a lot of patients at the end of life with a terminal illness or cancer that are able to reduce their opioid use. And that's a pretty amazing thing because this medication is tolerated much better than opioids," he said.

Minnesota Medical Solutions owns a marijuana dispensary at 3456 E. Circle Drive NE in Rochester. The company is one of two in the state authorized to sell medical marijuana. As of today, there are eight dispensaries open in the state — one in every congressional district.

Since the Rochester location opened last July, Kinglsey said he's been "pleasantly surprised" by the the number of patients visiting the site. At this point, he said the dispensary is open two or three days a week. He said he is particularly pleased with how medical cannabis has helped patients with terminal illnesses and cancer and children suffering from seizure disorders.

Kingsley acknowledged that patients remain concerned about the high cost of the drug. On average, patients spend $250 per month on medication — although the amount can range from less than $100 to much higher. Part of the problem is that medical marijuana is not covered by health insurance.

"We're never going to be able to compete with insurance-covered medications. That being said, it's still our job to make these (medications) as affordable as we can, and that's a big mission for us," Kingsley said. "We're excited about increased patient volume because I think it's going to help with the cost."

'Illusion of a program'

The drug's high cost has proven a major issue since the state launched its medical cannabis program on July 1, 2015. A recent survey by the Minnesota Department of Health's Office of Medical Cannabis found that 89 percent of program participants who responded said that the medication is at least "somewhat unaffordable."

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"It's very frustrating. Patients are very, very frustrated. We're very frustrated and price is probably the biggest issue, said Maren Schroeder, vice president of Sensible Minnesota, a volunteer group that works to educate patients on cannabis.

Often, she hears from patients who will buy as much medical cannabis as they can afford legally and then supplement it with cheaper marijuana purchased on the street. She said the state's current program simply isn't meeting the needs of patients and some major changes are needed. She said it's time for the state to consider allowing more companies to sell cannabis in the state in order to boost competition and drive down prices.

"In reality, how this is playing out is the illusion of a medical cannabis program. To the public's eyes, to people who are working in it, it looks like we have a working medical cannabis program when we have something that is barely functional," Schroeder said.

Michelle Larson, director of the health department's Office of Medical Cannabis, said she's not surprised by the slow rate of patients signing up for the program. She said several other states have seen similar numbers in the first year after legalizing medical cannabis.

"I think we've done as well as we can with the legislation that we were given to work with. We really tried to make it the best program within that framework that we were set up with, so I'm very proud of that," Larson said.

She said department is looking at putting together a list of suggestions on ways to improve the program that will be sent to the governor's office. She declined to provide details on what those suggestions may include.

Physicians on board

Since the beginning, the state's medical cannabis program has been winning over skeptical physicians. A total of 570 health care practitioners have registered to certify patients for the program. Olmsted Medical Center President Dr. Kathryn Lombardo is one of them.

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Lombardo said she decided to sign up for the program because patients in the region needed reliable information about medical cannabis. The psychiatrist is one of three clinicians at OMC who certifies patients. She said many patients she has met with have been deterred by the drug's high cost.

"I have had more discussions with patients about the use of medical cannabis but then they've decided not to go on and be certified because they couldn't afford it," she said.

Lombardo said she has already heard from several patients with intractable pain who are interested in the program.

"I have a number of (intractable pain) patients now waiting to be seen — more than I've actually had during the whole first year for any of the other medical conditions," she said.

Kingsley, a former emergency room physician, said preliminary data shows medical cannabis is helping improve people's lives. He pointed to a recent health department survey that found 88 percent of patients who responded have seen a moderate or substantial benefit from the medication.

"I need to be clear — not everybody responds. We're not flag wavers," Kinglsey said. "But we believe for some folks, this is a remarkable opportunity to step outside of the more conventional medication box."

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Lombardo

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