Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputy for her question. She raised two distinct issues, which I shall address in order. The MCAP is operated by the primary care reimbursement service of the HSE and is a statutory programme to enable clinicians and patients to access prescribed cannabis-based products for the treatment of three conditions as specified in the HPRA 2017 report Cannabis for Medical Use-A Scientific Review, commissioned by the Minister for Health. As the Deputy stated, the three conditions are: spasticity associated with multiple sclerosis resistant to all standard therapies and interventions while under expert medical supervision; intractable nausea and vomiting associated with chemotherapy, despite the use of standard anti-emetic regimes while under expert medical supervision; and severe refractory treatment-resistant epilepsy that has failed to respond to standard anticonvulsant medications while under expert medical supervision.

The Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019 set out the legal provisions for the operation of the MCAP and the legal obligations for healthcare professionals and commercial operators. The MCAP commenced in late 2021 and, as the Deputy said, to date 55 patients have been treated under it. The MCAP was scheduled to be a five-year pilot programme. However, the Minister for Health brought the review forward, given the passage of time, and the Health Research Board was engaged to carry out the initial evidence gathering and subsequent synthesis for presentation to a clinical review group that will make recommendations to the Minister as to whether evidence exists to expand the range of products covered by the programme. Officials in the Department of Health are working on setting up the clinical review group.

On ministerial licence patients, the ministerial licence programme enables clinicians with a licence issued pursuant to section 14 of the Misuse of Drugs Act to treat patients with cannabis products. The programme predates the MCAP, the first licence being issued in late 2016. To date, 362 ministerial licences have been issued for the treatment of 77 separate patients.

Currently 27 patients are availing of the programme. All patients currently avail of cannabis-based products manufactured by a pharmacy in the Netherlands. Having initially been set up by the Department of Health during the pandemic, the primary care reimbursement service, PCRS, of the HSE operates a monthly service whereby the products are collected from the Netherlands, transported to Ireland and delivered to patients' homes directly. This applies to all patients. For those patients treated under the licence programme for one of the three stated conditions covered by the MCAP, the PCRS directly pays the dispensing pharmacy in the Netherlands on receipt of an invoice. Patients treated for other conditions must meet the costs of the products themselves.

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