There is no denying that cannabis is a rapidly growing industry. In July 2018, Colorado alone had 88,143 active medical marijuana patients registered, compared with just 11,094 patients in July 2009. This trend is not unique, and with medical marijuana now legal in 31 of 50 states as well as Washington DC, it is not set to slow down any time soon.
There is a lot of positive press surrounding the cannabis industry, with claims that this humble herb can help with a whole host of physical and psychological disorders. Advocates promote it as being safe and natural, with a low risk of side effects, which is more than can be said for many drugs on the market today. So how is this relatively new player on the healthcare scene likely to affect big pharmaceutical companies? Let’s take a closer look.
Is the Cannabis Industry a Threat to Big Pharma?
Is the cannabis industry really a threat to big pharmaceutical companies? It would seem that they certainly think so! Back in 2016, Arizona narrowly missed out on the legalization of medical marijuana, with just 51.32% of people voting against the move. Among donors to the “against” campaign was the pharmaceutical company Inysys, who contributed a massive $500,000 to keep cannabis off the shelves in the Grand Canyon State. They justified their stance by stating that the legalization of cannabis would be a danger to public health and children alike.
To add further insult to injury, a few months after the ruling, Inysys released its new drug Syndros. This product is a liquid form of dronabinol, a drug containing a synthetic version of tetrahydrocannabinol (THC), one of the major chemical compounds found in cannabis. Following this move, it is hard to believe that public safety was the only reason the company was so reluctant to have marijuana legalized.
Inysis is not alone in its desire to manufacture a pharmaceutical product based on the chemistry of marijuana. Dronabinol (Marinol) and nabilone (Cesamet) are both synthetic THC derivatives and are licensed by the US Food and Drug Administration (FDA). Both are indicated in the treatment of chemotherapy-induced nausea and vomiting, and dronabinol is also used as an appetite stimulant to prevent weight loss in AIDS patients, and as a painkiller for people with multiple sclerosis (MS).
Nabiximols (Sativex) is another drug which is derived from the cannabis plant itself (not synthetic substitutes) and contains both THC and cannabidiol (CBD). This product is licensed in Canada, the UK and parts of Europe, but not in the USA.
Pharmaceutical companies seem to be attempting to jump on the medical marijuana bandwagon, but unfortunately for them, many people are still choosing to use whole cannabis, straight from the plant as nature intended.
Whether these people collect their weed from dispensaries or grow it in the comfort of their own homes, there is no profit to be made here for pharmaceutical companies. When you take into account the amount of time and money that is needed to develop new medicines, it is no wonder that big pharma is running scared!
The Impact of the Cannabis Industry on Big Pharma
Several studies have been carried out on the impact of cannabis on the pharmaceutical industry in states where medical marijuana has been legalized.
One such study by Bradford and Bradford looked at data from all Medicare Part D prescriptions filled between 2010 and 2013 to assess physicians’ prescribing habits. It found that, in states where medical marijuana is legal, the prescription of drugs for which cannabis could act as an alternative fell significantly. The authors also note that this switch in prescribing saved the program and its enrollees an estimated $165.2 million in 2013 alone!
Another study by Bachhuber et al. looked at the influence of cannabis on the use of opioids. Opioids are drugs which are commonly prescribed for acute and chronic pain. These drugs are effective, but are also extremely addictive and carry a high risk of overdose. This fact has led to one of the most publicized health crises in recent years: The “opioid epidemic.” This study concluded that medical marijuana could potentially improve this situation. In fact, in states where it is legal, the number of people dying from opioid overdoses fell by an average of 24.8%.
This news is fantastic for the general public and struggling emergency rooms alike. However, for pharmaceutical companies, this finding could signify a change which they are not likely to celebrate.
Some of the conditions for which cannabis is most commonly prescribed include: Chronic pain, nerve pain, chemotherapy-induced nausea and vomiting, sleep disorders, anxiety, post-traumatic stress disorder (PTSD), Tourette’s syndrome, glaucoma, epilepsy, and seizures. If doctors start regularly prescribing medical marijuana for all of these conditions rather than conventional drugs, big pharma is likely to take a very big hit.
How do Synthetic Cannabinoids Stack Up Against Medical Marijuana?
Pharmaceutical companies seem to be desperately trying to carve out a niche for themselves in the cannabis industry with drugs such as nabilone and dronabinol. These drugs contain synthetic versions of THC, one of the main medicinal compounds found in the cannabis plant. So how do these drugs stack up against medical marijuana? Is there any advantage to using synthetic cannabinoids over the real thing?
Cannabis has been used as an herbal medicine for thousands of years. It is thought to contain as many as 100 different compounds known as cannabinoids, but the two best known are THC and CBD. These two compounds affect the body in slightly different ways, and also have a counterbalancing effect on one another; for example, CBD has been shown to reduce the psychoactive effects of THC.
Many herbalists believe that it is always best to use the whole of any plant rather than single compound extracts for this very reason. Most medicinal herbs contain numerous compounds which may work to aid absorption, enhance the effects of other compounds, or reduce the chance of adverse effects. This relationship is known as “synergy.”
While medical marijuana has a low risk of side effects beyond feeling “high,” synthetic cannabinoids may be less well tolerated. Dronabinol can cause side effects including abdominal pain, dizziness, euphoria, nausea, paranoia, drowsiness, and vomiting. Nabilone can cause similar issues including drowsiness, vertigo, dry mouth, euphoria, ataxia, headaches, and reduced concentration. It is interesting to note that both of these pharmaceuticals can still cause euphoria, the feeling of being high that comes with using cannabis. For people wishing to avoid any psychoactive effects, a CBD-only product may be the safest bet.
Another significant advantage of cannabis over these drugs is that, in certain states, it can be grown at home, providing significant financial savings. Of course, on the flip side of this is the fact that if you get caught growing cannabis in a place where it is not legal, there could be serious consequences.
Aside from cannabis still being illegal in many places, the only real advantage that the pharmaceuticals have is when it comes to dosing. With drugs such as dronabinol and nabilone, you know exactly how much THC you are consuming with each dose, and how this is likely to affect you. If you are using medical marijuana, you may find that there is a lot of variety between strains. This means that you may be completely functional with one type of weed, but knocked out by another. Even within the same strain, you may find some subtle differences between one batch and the next.
Some people would argue that the pharmaceutical options provide an acceptable administration route for those who do not wish to smoke cannabis. However, even that opinion falls flat as there is now a wide range of CBD products available which can be taken by mouth or rubbed directly onto the skin.
There will always be doctors who are more willing to prescribe a pharmaceutical than an herb, even if it has similar chemistry. This attitude should provide some comfort for the pharmaceutical industry, but even this old mindset may eventually change.
Final Thoughts on How the Cannabis Industry is Affecting Big Pharma
Pharmaceutical companies may not be too happy about the legalization of cannabis as it seems that over time this growing industry could seriously dent their profit margins. The lengths that companies such as Inysys are willing to go to in order to slow down the cannabis industry provide stark evidence of this.
Despite of the popularity of medical marijuana, there are plenty of medical conditions which it is not regularly prescribed for, meaning that big pharma is not set to disappear any time in the foreseeable future. However, there is a chance that they will need to change their focus in order to stay relevant in our ever-changing healthcare industry.