Carola Perez: “If I have to choose, I'd rather pay for cannabis at the community pharmacy than go to the hospital pharmacy for free”

The President of the Spanish Medical Cannabis Observatory (OECM), Carola Perez, said last Thursday in Madrid that, if she had to choose, she would rather pay for medical cannabis at the community pharmacy than have to wait two years to use it for free. to the hospital pharmacy. “We patients are already used to paying for most of our treatments, that's the reality”, she found, warning that the hospital model will not work. “It will not be effective. If I have to choose, I'd rather pay a proportional percentage at the community pharmacy than go through the bureaucracy of the hospital pharmacy, with so many procedures and difficulties", he said, adding that the process can take two or more years and that, therefore, he prefers to have a faster means of access.

Carola Perez spoke on the sidelines of the cannabis, which this year took place within the Farmaforum, the largest pharmaceutical industry fair in Madrid. The room was completely full and more chairs had to be added to accommodate all the people who wanted to attend the debate, which took place in the year that Spain finally regulated medical cannabis. Many people stood up to hear the participants of the round table dedicated to the reality of medicinal cannabis products in Spain. Moderated by David Molinero, director of DEVECAN, the panel was also attended by Roberto Algar, Managing Director of Curaleaf in Switzerland and Concha Porras, Brand Manager Pharma at Neuraxpharm Spain.

Carola Perez suffered a skateboarding accident as a teenager, which left her in permanent chronic pain.

Carola Perez recalled that the legislation in Spain, which provides for the dispensation of medical cannabis only through the hospital pharmacy, “was not made with patients in mind”. But "the political battle is not over," said Perez, who warned of the long road that patients still have to go. “The products will not be available anytime soon”, she said, while revealing that she faced a very complicated process in the Spanish Parliament, during the debate for the regulation of medical cannabis. “It was a very discreet process, but very cruel. We had to face problems within the political parties themselves and between them, which became quite complicated. In the political meetings we had, they wanted to leave pathologies like cancer and fibromyalgia out, they decided only on hospital discharge… it’s very unfair”, she lamented.

“We had three different laws, it was stone after stone on the way, and it wasn't fun at all. It was a very hard and unfair process, but we trust the technicians to carry it out in an effective, fast and safe way. That doctors can prescribe and help patients”, he asked.

Patients should be at the forefront of business thinking

Roberto Algar, from Curaleaf, also defended that patients should be in the first line of thinking in companies, remembering that “we are all in the same boat”. Algar gave as an example the case of Portugal, where, four years later, there is only one product in pharmacies. “Political will is lacking, it is the politicians who have to move and the companies and associations involved have to work with the regulators, because it is, in fact, very complicated”. Living in Switzerland, where the process is now “quite simpler than it was at the beginning”, Roberto Algar also stated that access to medical cannabis has to be “effective and easy – first for the patient, then for the doctor”. Algar defended the Swiss model, in which any doctor can prescribe and any pharmacy can dispense. “Prescribing depends on the doctors' will and there is still very little training, a situation that is transversal to several countries”, he continued. “The stigma still exists and the endocannabinoid system is still very much unknown. Why is this not studied more in the faculties of Medicine?”, he asked.

Pharmaceuticals suggests following the Infarmed model
Concha Porras, said that there is less and less stigma, but education is important: “in the medical community there are very positive advances but a lot of training is needed, scientific societies have to come together to share training and information on how to use cannabis”.

Neuraxpharm's pharmaceutical company also set the example of Portugal in the registration of quality medicines. “We all agree that we need to register quality products, similar to what Infarmed does in Portugal. We can perfectly register in Spain without phase III clinical trials, as is done with ACM in Portugal,” she said. “We have to wait and see. It’s not something like a standardized pill and we have to help the regulator with our experience,” she said. Concha Porras also mentioned the example of Germany, where the master formula is used and where any doctor can prescribe. “We are not going to restrict specialties, this is complicated”, she warned, also saying that if Germany is more advanced, then it should harmonize among the countries of Europe. However, the drugmaker criticized the fact that Germany had "left out many indications, although there is already enough evidence".

Roberto Algar also anticipated the problem of access in Spain, similarly to Portugal, anticipating that companies would focus more on production for export. “It will be a little controversial. Do we produce here and make it available to other countries, without the Spaniards having access? The system has to be fair and equal for all patients, not only in Spain but in all countries,” he said.

CBD situation is “a disaster” in Europe

Carola Perez also addressed the CBD “fad” and warned that medicine is not based on just one cannabinoid, but on many. “It’s not just CBD, there needs to be more debate and training in the administration of different cannabinoids. If we form badly from the start, we are going to do a lot of harm to patients,” she confessed.

“CBD is a disaster because there are no rules,” said Roberto Algar. The OECM president was also concerned about the difficulty of traveling with cannabis and said that she was working to change the situation: “patients have a life and they also travel to other countries. we suffered a lot stress when we have to cross borders, that's why we are working so that there is a unification of criteria between the regulations of different countries”.

Finally, Carola Perez insisted on the possibility of self-cultivation, as “not all patients have access to a club”.