The long-awaited breakthrough in cannabis-based treatments has finally arrived for thousands of patients in England. The National Health Service (NHS) has approved two cannabis-based medicines – Epidyolex and Sativex – for specific patient groups, following rigorous recommendations from the National Institute for Health and Care Excellence (NICE).
Epidyolex, containing cannabidiol (CBD), has been approved for treating two rare and severe forms of epilepsy in children and adults: Lennox-Gastaut syndrome and Dravet syndrome. These conditions are often resistant to conventional treatments, with patients experiencing multiple seizures daily, severely impacting their quality of life. Clinical trials have shown that Epidyolex can significantly reduce seizure frequency when added to existing antiepileptic regimens.
Sativex, an oral spray containing both tetrahydrocannabinol (THC) and cannabidiol (CBD), has been approved for adults with moderate to severe spasticity caused by multiple sclerosis (MS). This approval is specifically for patients who have not responded adequately to other anti-spasticity medications and who demonstrate a clinically significant improvement during an initial trial period. Spasticity, characterised by muscle stiffness and spasms, is a common and debilitating symptom of MS, affecting up to 80% of those with the condition.
The move represents a significant shift in the availability of cannabis-based treatments within the UK healthcare system, building on the 2018 change in law that allowed specialist doctors to prescribe cannabis-based medicines. Prior to this, access was extremely limited, often requiring private prescriptions or compassionate use applications. While some patients have been able to access these drugs privately, the NHS approval ensures broader, equitable access for those who meet the strict clinical criteria.
Patients and their families have campaigned tirelessly for wider access to such treatments, particularly for conditions like severe epilepsy where existing therapies often fall short. The thorough assessment by NICE underscores the evidence base supporting the use of these specific medications for their approved indications. It is essential to note that this approval does not extend to the general prescribing of cannabis for other conditions, nor does it mean cannabis will be available over-the-counter.
The drugs will be prescribed by specialist clinicians, not general practitioners, and patients will need to undergo a thorough assessment to determine their eligibility. This structured approach aims to ensure that the medicines are used appropriately and safely, targeting those who stand to benefit most, while monitoring for potential side effects and interactions with other medications.