Medicinal Cannabis for the treatment of Chronic Non Cancer Pain (CNCP) sub-policy

This policy is a sub-policy of the Non-Established, New or Emerging Treatments and Services policy and they must be applied together.

Will the TAC pay for medicinal cannabis?

The TAC does not fund medicinal cannabis to treat chronic non cancer pain for TAC clients in most circumstances. CNCP is defined as pain that has not resolved within 3 months or normal healing time.

However, in rare circumstances, the TAC will consider funding medicinal cannabis for an initial trial period for CNCP. These circumstances are outlined below.

Why doesn’t the TAC fund the use of medicinal cannabis to treat CNCP in most circumstances?

The TAC supports clients to access evidence-based treatment to assist their recovery. However, there is currently a lack of demonstrated evidence on the effectiveness of medical cannabis in treating CNCP. Medical cannabis is a new and emerging treatment, and not enough reliable information exists on which to base clinical decision making.

This view is backed by international and national expert organisations. These include:

  • Australian and New Zealand Faculty of Pain Medicine
  • International Association for the Study of Pain
  • Therapeutic Goods Administration
  • Institute for Safety, Compensation and Recovery Research

By contrast, other CNCP treatment options have robust evidence supporting their effectiveness.

In addition, our clients may be at risk of harm from using medicinal cannabis. Risks can include side effects or an increase in the potential for transport accidents.

When will the TAC consider funding medicinal cannabis?

In rare circumstances, the TAC will consider funding medicinal cannabis for an initial trial period for CNCP. All of the following conditions must be met:

  1. All other reasonable established treatments and services, that have stronger evidence of effectiveness, have been trialled without success in the client’s circumstance. Alternatively, these treatments and services are considered inappropriate for client-specific reasons (such as contraindications or significant side effects).
  2. A treating pain specialist provides evidence in the form of a letter or opinion. This must support the use of medicinal cannabis in the client’s case for easing symptoms of CNCP. It must show that the risk of adverse events or dependence from the use of medicinal cannabis in the client’s circumstances is acceptable.
  3. Measures are in place to assess the effectiveness of treatment for the client and any side effects.
  4. A treatment plan is in place.
  5. An addiction specialist provides advice if the client is using an oral morphine equivalent > 100mg/day or has a history of dependency.
  6. The client’s regular treating practitioner or GP provides evidence of support.

How can a medical practitioner request funding of medicinal cannabis for a TAC client?

A medical practitioner must complete our Medical Cannabis Request Form to request medicinal cannabis funding for a TAC client. Responses should address the conditions outlined above.

A member of the TAC Clinical Panel will review the request. If approved, both the TAC client and the requesting practitioner must agree to trial parameters. After an initial trial period, the TAC will review the outcomes based on the measures and the treatment plan. This will assess if the reasonable cost of medicinal cannabis can continue to be paid.  The TAC will require an annual review of usage and outcomes from the pain physician or addiction specialist. The review will ensure clients are continuing to benefit from the treatment and no adverse effects have developed.

If TAC funding is approved, how can a medical practitioner prescribe medicinal cannabis?

Most medicinal cannabis products are unapproved therapeutic goods. This means the Therapeutic Goods Administration (TGA) has not assessed them for safety, quality and effectiveness.

However, a medical practitioner can prescribe medicinal cannabis products if clinically appropriate. The medical practitioner must first gain approval from the TGA. To do this, the practitioner can either apply through the TGA’s Special Access Scheme or become an authorised prescriber. They can then apply to the TGA on behalf of the patient. The practitioner must also meet certain requirements, obtain permits and comply with state laws.