Zerenia Clinics UK Patient Makes

Text: Dr. Guillermo Moreno-Sanz

History as First to Secure NHS Reimbursement for Cannabis Flowers

After a patient from Zerenia Clinics UK was reimbursed by the NHS for his therapy with cannabis-based oral extracts in January 2023 a second patient from Zerenia Clinics UK has succeeded in obtaining coverage from NHS to finance his treatment with dried cannabis flowers. This significant milestone represents another step towards mandatory insurance coverage for therapies with cannabis-based medicinal products in the UK, following the example of more advanced jurisdictions such as Colombia and Germany.

Cannabis therapy against Chemotherapy-induced Nausea and Vomiting

Since the legalization of medical cannabis in late 2018, only five individuals in the UK have been granted NHS funding for the prescription of unauthorized cannabis-based medications. The patient of Zerenia Clinics UK, who is the first patient to receive NHS reimbursement for treatment with dried cannabis flower, has chosen to remain anonymous to protect his privacy and that of his family. In June 2021, he was diagnosed with stage-four bowel cancer and lung metastasis. After realizing that cannabis was helping him to tackle chemotherapy-induced nausea and vomiting (CINV), he inquired about Nabilone, a THC analog approved for the treatment of CINV, but his oncologist and a group of consulted oncologists had no prior experience with it. However, one oncologist mentioned a former patient who had been prescribed medical cannabis on a private clinic, which led the patient to explore that option.

NHS approved reimbursement on 4.20.

In early 2022, he received a private prescription for medical-grade, chemotype 1 (THC-predominant) cannabis flowers for inhalation. He found several varieties that effectively helped him manage CINV while also improving other aspects of his quality of life, such as anxiety, mood, loss of appetite and sleep, as observed by his psychologist. Armed with this knowledge, the patient approached his general practitioner to apply for an individual funding request to the NHS to cover the treatment cost. At this point, he had already tried most of the antiemetic medications offered by the NHS, with minimal to no benefit and often experiencing unpleasant side effects. Unfortunately, the NHS funding panel initially declined the application and suggested trying Nabilone. However, when the patient tried Nabilone with his next chemotherapy cycle at the end of 2022, it proved ineffective in alleviating his symptoms. Conversely, using cannabis flowers after returning home allowed his nausea to subside, enabling him to enjoy dinner with his family. In January 2023, the patient switched to Zerenia Clinics UK, where he had his first appointment with the medical director, a cancer pain specialist. Moved by the patient's determination to obtain NHS reimbursement for cannabis flowers, the medical team at Zerenia offered to assist him with a new funding request. Collaborating closely with the patient, his medical team submitted the second request in March 2022. Remarkably, on April 20th, coinciding with the International Cannabis Awareness Day, the NHS panel convened and approved funding for his prescription of chemotype 1 cannabis flowers.

Dr. Guillermo Moreno-Sanz, Global Scientific Director of Khiron Life Sciences, maintains direct contact with the patient and shares his thoughts on this individual and collective milestone: "I am deeply moved by the patient's personal story and his remarkable achievement. In the face of adversity, he has demonstrated unparalleled determination in becoming the first UK patient to secure NHS reimbursement for cannabis flowers, paving the way for others to follow. This example also highlights the urgent need for medical education on cannabinoids and the endocannabinoid system among all healthcare professionals.

Chemotherapy-induced nausea and vomiting (CINV) is a welldocumented indication where the clinical evidence on the efficacy of cannabis and cannabinoids is most conclusive. It is disheartening that it took this patient over two years and significant personal resources to achieve something that should be considered a fair option. At Khiron, we wholeheartedly celebrate this historic accomplishment and, above all, applaud the patient's individual success, which further reinforces our commitment at Zerenia Clinics UK to accompany our patients with unmet clinical needs on their path to reimbursement for therapy costs."