Around 6,000 Swiss citizens will soon have legal access to adult-use cannabis after officials approved a new pilot project this month. But patients say they are still struggling to get the medicinal products they need.
The Swiss Federal Office of Public Health has given the go-ahead for a fifth pilot project monitoring the sale of adult-use cannabis products in another step towards policy reform.
Known as the Safer Cannabis – Research In Pharmacies Trial (SCRIPT), the study was authorised by the Swiss Federal Office of Public Health (FOPH) and the Cantonal Commission of Ethics and the Ethics Commission of Northwestern and Central Switzerland last week.
It will see over 1,000 residents permitted to purchase regulated cannabis products from selected pharmacies in the cities of Bern, Lucerne and Biel, when it launches later this year.
The three-year study, which is due to run from October 2023 to April 2026 will assess the health and social effects of cannabis sales in ‘strictly-regulated, non-profit’ pharmacies, with outcomes monitored by the Universities of Bern and Lucerne. Only people who already use cannabis for recreational purposes and who are at least 18 years old will be able to participate.
The project closely follows those previously announced in Basel, Zurich, Lausanne and Geneva, bringing the total number of citizens soon to have legal access to cannabis to around 6,000.
But while the country takes steps towards the legalisation of recreational cannabis, patients say they are still struggling to get prescriptions and paying high prices for medicinal cannabis products.
Challenges facing medical cannabis patients
In August 2022 the Swiss Federal Narcotics Act was amended to allow doctors to prescribe cannabis without needing to apply for a government permit first.
However, Franziska Quadri of the Swiss patient organisation, Medical Cannabis Verein Schweiz (MEDCAN), told Cannabis Health that awareness and understanding of cannabis among the medical profession remains low and patient numbers are thought to be under 10,000, with many still struggling to access the products they need.
“Doctors don’t know anything about cannabis and how we use it as a medicine and many still have doubts,” she explained.
“We get a lot of messages from patients who want to know where they can find a doctor to prescribe, so it’s still a problem eight months on. We only know very few patients who can easily get a prescription from their doctor.”
Franziska Quadri, Medical Cannabis Verein Schweiz (MEDCAN)
There are also a limited number of products available on the market and these remain expensive. In Switzerland medicinal cannabis is not widely covered by the country’s compulsory health insurance scheme unless in exceptional circumstances.
According to Quadri, patients are currently paying around 760 Swiss Francs per month for a cannabis oil extract. While some flower-based products have been authorised she says it is ‘difficult to get a doctor to prescribe these’.
As a result many patients are still accessing cannabis through the illicit market, including Quadri herself, who was left quadriplegic following an accident in 2009 and uses it to manage severe neuropathic pain and muscle spasms. She says accessing the amount of flower required to keep her symptoms under control legally would cost around 4,000 Swiss Francs per month.
She’s concerned that patients are being left behind as the focus switches to recreational access, and is calling for them to be included in conversations about policy reform. None of the adult-use pilot projects which have been announced permit self-cultivation of cannabis for personal use, which she says would make it more accessible for many patients.
“I don’t think they ever really focused on the medical situation [in Switzerland],” she continued.
“In Basel residents can already purchase flowers for recreational use, while as patients we are still fighting for access to flower products and we are not able to grow it ourselves.”
Quadri added: “They have to involve us in the discussion around the legalisation of cannabis.”
Medical v recreational – ‘what fits one doesn’t fit the other’
Luc Richner, CEO of Vigia AG/Cannavigia, a Swiss software company providing track and trace software for companies operating in the cannabis sector, believes the adult-use pilots will have little impact on the medical market.
Luc Richner, CEO of Vigia AG/Cannavigia.
“In my opinion, the pilot trials for adult use will not affect the medical market that much. And Switzerland is also looking for a basis for insurance claims,” he told Cannabis Health.
“Everywhere in the world there is justification for both the recreational and the medical market. It should be very much separated. What fits for one does not fit for the other.”
READ MORE: What do Germany’s plans for cannabis reform mean for patients?
But says Richner, prices are coming down as demand and competition increases.
“The medical market in Switzerland has undergone some nice dynamics and significant changes since August 2022,” he continued.
“The demand is slowly increasing and Swissmedic has issued more licences. In the pharmaceutical industry, Switzerland has a history of being an important processor and the country can take a similar position in the cannabis industry. The country has many cultivators and producers and suppliers are gradually increasing.
“Historically, extracts have been more expensive. I can imagine that this pricing is still based on when there was only one supplier in the market in the last few years. Due to their monopoly, they had the power to set the prices. However, now that there is competition, this will slowly drive prices down.”
When asked if he thought recreational access could lead to an increase in the numbers of patients self-medicating, he added: “People in Switzerland had easy access to cannabis in the past. Someone who wanted to self-medicate could have done so. I don’t see legal access as a driving factor.”
