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Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years

A regulatory framework allowing legal access to medicinal cannabis (MC) products has operated in Australia since November 2016. MC prescribing by healthcare practitioners (HCPs) is primarily conducted through the Special Access Scheme - Category B (SAS-B) pathway, through which prescribers apply to...

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Autores principales: MacPhail, Sara L., Bedoya-Pérez, Miguel A., Cohen, Rhys, Kotsirilos, Vicki, McGregor, Iain S., Cairns, Elizabeth A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127064/
https://www.ncbi.nlm.nih.gov/pubmed/35620292
http://dx.doi.org/10.3389/fphar.2022.885655
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author MacPhail, Sara L.
Bedoya-Pérez, Miguel A.
Cohen, Rhys
Kotsirilos, Vicki
McGregor, Iain S.
Cairns, Elizabeth A.
author_facet MacPhail, Sara L.
Bedoya-Pérez, Miguel A.
Cohen, Rhys
Kotsirilos, Vicki
McGregor, Iain S.
Cairns, Elizabeth A.
author_sort MacPhail, Sara L.
collection PubMed
description A regulatory framework allowing legal access to medicinal cannabis (MC) products has operated in Australia since November 2016. MC prescribing by healthcare practitioners (HCPs) is primarily conducted through the Special Access Scheme - Category B (SAS-B) pathway, through which prescribers apply to the Therapeutic Goods Administration (TGA–the federal regulator) for approval to prescribe a category of product to an individual patient suffering from a specific indication. The dataset collected by the TGA provides a unique opportunity to examine MC prescribing trends over time in the Australian population. Here we analysed this TGA SAS-B dataset since inception with respect to age, gender, product type (e.g., oil, flower, etc.), CBD content, indication treated, and prescriber location. Results are presented descriptively as well as being analysed using non-linear regression models. Relationship between variables were explored via correspondence analyses. Indications were classified with reference to the International Statistical Classification of Diseases and Related Health Problems (10th Revision). As of 31 August 2021, a total of 159,665 SAS-B approvals had been issued for MC products, 82.4% of were since January 2020. Leading indications for approvals were for pain, anxiety, and sleep disorders. Oil products were the most popular product type, while CBD-dominant products (≥98% CBD) accounted for 25.1% of total approvals. Approvals for flower products increased markedly during 2020–2021, as did approvals involving younger age groups (18–31 years old), male patients, and non-CBD dominant products. A disproportionate number of SAS-B MC applications (around 50%) came from HCPs in the state of Queensland. Associations between patient gender and age and/or indication with product type were found. For example, approvals for oil products were commonly associated with approvals for pain. While, overall prescribing increased dramatically over the last 2 years of analysis, stabilization of approval numbers is evident for some indications, such as pain. Current prescribing practices do not always reflect provided TGA guidance documents for MC prescribing. While acknowledging some limitations around the SAS-B dataset, it provides a unique and valuable resource with which to better understand current prescribing practices and utilisation of MC products within Australia.
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spelling pubmed-91270642022-05-25 Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years MacPhail, Sara L. Bedoya-Pérez, Miguel A. Cohen, Rhys Kotsirilos, Vicki McGregor, Iain S. Cairns, Elizabeth A. Front Pharmacol Pharmacology A regulatory framework allowing legal access to medicinal cannabis (MC) products has operated in Australia since November 2016. MC prescribing by healthcare practitioners (HCPs) is primarily conducted through the Special Access Scheme - Category B (SAS-B) pathway, through which prescribers apply to the Therapeutic Goods Administration (TGA–the federal regulator) for approval to prescribe a category of product to an individual patient suffering from a specific indication. The dataset collected by the TGA provides a unique opportunity to examine MC prescribing trends over time in the Australian population. Here we analysed this TGA SAS-B dataset since inception with respect to age, gender, product type (e.g., oil, flower, etc.), CBD content, indication treated, and prescriber location. Results are presented descriptively as well as being analysed using non-linear regression models. Relationship between variables were explored via correspondence analyses. Indications were classified with reference to the International Statistical Classification of Diseases and Related Health Problems (10th Revision). As of 31 August 2021, a total of 159,665 SAS-B approvals had been issued for MC products, 82.4% of were since January 2020. Leading indications for approvals were for pain, anxiety, and sleep disorders. Oil products were the most popular product type, while CBD-dominant products (≥98% CBD) accounted for 25.1% of total approvals. Approvals for flower products increased markedly during 2020–2021, as did approvals involving younger age groups (18–31 years old), male patients, and non-CBD dominant products. A disproportionate number of SAS-B MC applications (around 50%) came from HCPs in the state of Queensland. Associations between patient gender and age and/or indication with product type were found. For example, approvals for oil products were commonly associated with approvals for pain. While, overall prescribing increased dramatically over the last 2 years of analysis, stabilization of approval numbers is evident for some indications, such as pain. Current prescribing practices do not always reflect provided TGA guidance documents for MC prescribing. While acknowledging some limitations around the SAS-B dataset, it provides a unique and valuable resource with which to better understand current prescribing practices and utilisation of MC products within Australia. Frontiers Media S.A. 2022-05-10 /pmc/articles/PMC9127064/ /pubmed/35620292 http://dx.doi.org/10.3389/fphar.2022.885655 Text en Copyright © 2022 MacPhail, Bedoya-Pérez, Cohen, Kotsirilos, McGregor and Cairns. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
MacPhail, Sara L.
Bedoya-Pérez, Miguel A.
Cohen, Rhys
Kotsirilos, Vicki
McGregor, Iain S.
Cairns, Elizabeth A.
Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years
title Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years
title_full Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years
title_fullStr Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years
title_full_unstemmed Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years
title_short Medicinal Cannabis Prescribing in Australia: An Analysis of Trends Over the First Five Years
title_sort medicinal cannabis prescribing in australia: an analysis of trends over the first five years
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127064/
https://www.ncbi.nlm.nih.gov/pubmed/35620292
http://dx.doi.org/10.3389/fphar.2022.885655
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