A new medicinal cannabis venture, claiming to offer express CBD oil directly to customers’ front doors, popped up in Australia this year. The company, CDA Express, is part of a larger group, Cannabis Doctors Australia, who prescribe and supply medicinal cannabis to patients with pre-existing health conditions.
The company launched the “game-changing” new service – which offers CBD oil online after just a seven-minute “virtual consult” – in response to recently changed regulations around the access of cannabis products.
In January, the Therapeutic Goods Administration confirmed they would be rescheduling low-dose CBD products from Schedule 4 to Schedule 3. This means, in theory, CBD products can now be sold over the counter in Australia at pharmacies.
However, in practice, the TGA has not yet authorised CBD products for over the counter sales in Australia – and it could be many months before they do. When contacted for comment, they confirmed with us that “there are currently no CBD medicines in the the Australian Register of Therapeutic Goods that can be supplied under Schedule 3.”
With this new venture, CDA Express is attempting to bypass regulation by allowing patients access to the medication without the hassle of full consultation. While this move has been welcomed by those seeking to access the cannabis-derived medication, industry experts have roundly condemned it, claiming the move could delegitimise the industry as a whole:
What’s Going On?
CBD or cannabidiol is one of 120+ cannabinoids found within the Cannabis sativa and Cannabis indica plants. The other major cannabinoid you’ve probably heard of is THC. That’s the psychoactive compound, the one that gets you high.
CBD is a much-hyped extract of the cannabis plant that has legitimate uses in pain management, appetite stimulation, nausea reduction, and the prevention of epileptic seizures. There is growing, but as-of-yet still not fully validated, body of evidence that CBD can also be used to manage mental health conditions like anxiety and depression as well as a whole host of other issues. If you can name a medical condition, someone out there is probably touting CBD as a treatment.
Now, Australia has been relaxing its approach to cannabis for a number of years. Our medicinal cannabis industry is going through something of an explosion, with new, multi-million dollar sites popping up across the country seemingly every week. The current market is primarily aimed at export, though there is a growing base of Australian patients accessing medicinal cannabis here at home and the industry looks to be turning inward to supply the demand.
Almost all cannabis products are officially “unregistered” medications. This means they don’t have specific recommended uses, but they can be prescribed by doctors through the application for special permits.
The TGA is the regulatory body in charge of issuing these permits and up until a year or so ago, they issued very few of them. That was largely down to the fact that most GPs did not feel they were fully trained to understand cannabis medications and would generally not prescribe them.
Then the CDA came along with specific cannabis-prescribing clinics, offering doctors who are specifically qualified and trained in the prescription of cannabis products. Through their work and others’, cannabis prescriptions shot through the roof. There are now over 100,000 prescriptions for medicinal cannabis across Australia and that number is growing exponentially each month.
However, with the interest and demand for cannabis medications on the rise, and for CBD-dominant products specifically, the current system seems unworkable for many people.
Medicinal cannabis is still relatively hard to access. It requires a GP recommendation or a referral to a cannabis-specialist clinic and the costs associated with both this and the purchasing of medication is high.
CDA Express is seeking to rectify this, making it simpler and easier for people to access.
So, What’s the Issue?
CDA Express appears to be presenting this service as a work-around of the current system. With no products approved as Schedule Three medications – those able to be sold over the counter and presumably over the internet – it seems unclear how they can do so without going through the already established processes.
Industry leaders are worried that encouraging people to ditch their GP and go straight through CDA Express might make the cannabis industry look like it’s flaunting the rules.
One one level it's no biggie (the stuff should be available off the shelf). On another it's sheer exploitation verging on medical mugging. Aren't these guys facing a whole lot of complaints to the TGA?
— AMC Signpost (@AMC_Signpost) April 28, 2021
The Australian Medicinal Cannabis Association (AMCA) – of which CDA Health is a member – has stated that they might take action against CDA for breaching its conditions of membership and potentially flouting TGA advertising rules.
GP Jamie Rickcord, founder and director of Byron Bay-based Ananda Clinics, told Cannabiz that attempts to speed up access could rebound on an industry still battling its way out of prohibition.
“Cannabis is still currently not accepted in wider society and any shortcuts to access need to be scrutinised,” he said.
Cannabiz also spoke with one person who had used the service, reporting that they did not speak with a doctor and they chose their medical condition justifying access from a drop-down list. “It seemed more like a shopping experience than a medical consultation,” they said.
We spoke with Cannabiz editor-at-large, Rhys Cohen, who was shocked at the announcement from CDA Express. He stated:
“If you went to a new doctor for the first time, you would expect them to spend more than just seven minutes getting to know you before prescribing any new medication. Personally, I also object to the way this service is advertised – I think it misleads consumers into thinking they are accessing an over-the-counter medicine, when in fact they are accessing a prescription-only medicine.”
Can you name any prescription-only drug that is prescribed to patients without the prescribing doctor speaking to the patient? Or a medical service that leaves it up to the patient to determine what prescription-only drug they should take, and at what dose? https://t.co/ST1PbHlH40
— Rhys Cohen (@rhyscohen) April 29, 2021
Speaking with Dr Ben Jansen, clinical director and founder of CDA Clinics, he confirmed that the products being sold on the CDA Express site are indeed Schedule Four medications.
“The products that we prescribe are still going through the TGA for the order approval,” he said.
This is because, as the TGA confirmed to us, “there are currently no CBD medicines in the ARTG that can be supplied under Schedule 3.”
When asked about the screening process, Dr Jansen told us that the seven-minute virtual consult is simply an information-gathering exercise and that a doctor may call an applicant if required. When asked how often that would need to happen he replied, “We only just started on Monday or Tuesday morning so we’ll find out.”
When asked how this is different to what is already being offered, he said the process was “more streamlined” and “quicker”, being able to approve and send out orders within a day.
“People are able to come straight to us without a GP referral,” Jansen says. “They just need to have medicare and a regular GP.”
From what we can understand, if you’ve been diagnosed with something complex to the individual, such as endometriosis, you’re able to access CBD medication for that condition (which “a regular doctor can already do anyway” according to Jansen) via CDA’s “streamlined” process.
In these instances, you may receive a follow-up phone call, which we imagine would be something similar to a consultation or a confirmation of information that you’ve put online, but there doesn’t seem to be any formalities such as a prescription or a referral needed to order CBD oils for your medical conditions via CDA express.
How Do CDA Profit From This Service?
The CDA claim they don’t charge for a follow-up screening call or consultation and that they’re making money here purely off of the sale of their products. They also claim they don’t make a commission from selling their cannabis medications.
“We’re a subsidiary of CDA Health, who wholesales products as well. Basically, we make a profit off the products we sell, and that profit goes to the payment of doctors, nurses, the lights, the lease… all those things,” Jansen claims.
When you get to the sales page on their website after completing their application process, you’ll be presented with a range of CBD medications to choose from. CDA own all of those medications. Granted, they have access to a wide range of products, however, prescribing patients products that you have an interest in selling to them as you’ve already purchased them wholesale seems like it could present a conflict of interest.
As these are unregistered medications, there is also no regulation around how much CDA can charge for the products they are prescribing. The cost of accessing medicinal cannabis has been a point of contention for many users. Even low-dose CBD, if taken daily or twice daily to treat pain, can cost hundreds of dollars per month.
What Makes This Service Different?
While there may be issues in the way CDA advertise their services from a regulatory standpoint, the site does operate as stated. You can get CBD delivered to your door in a matter of days and Dr Jensen confirmed with us that orders have already been shipped.
The major feature here is that the diagnosis approval – if you will – is free, and more streamlined, which basically just gets the products to you quicker, without the usual (arguably necessary) fuss that goes into prescribing CBD generally.
However, the products you may be able to access are not the same products that could end up being sold over the counter at pharmacies down the line. They are stronger, Schedule 4 products, that are being distributed in much the same way as CDA clinics already do.
In one sense this is simply a marketing tactic to entice CBD advocates and the CBD curious. In another, it will make patient access easier, though it’s unclear whether accessing prescription medication without a doctors approval is really a good thing.
The TGA stated to us that “CBD medicines that qualify as Schedule 3 medicines (i.e. once they are in the ARTG) cannot be advertised to consumers in any way, including via the internet”.
Last year, it announced that it was “conducting a review of alleged non-compliant advertising of medicinal cannabis products to the public. This work is continuing and will consider any manufacturing or supply breaches of the legislation in addition to advertising, should there be any.” It’s unclear if CDA Express will be wrapped up in this.
CBD has been shown to have amazing effects across many life-altering conditions but we encourage you to do your own research, speak with a doctor, and keep updated on new information.