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Project Twenty21 in 2022: A Message for Patients


What you have helped us achieve so far

Our medical cannabis registry, Project Twenty21, was originally designed to run until the end of 2021 (hence the name).

As you will know from your own life during the pandemic, the last two years have been full of challenges and obstacles. Project Twenty21 has navigated the vast majority, but as Covid-19 has been an all-consuming national issue we haven’t been able to give medical cannabis the spotlight it deserves. In a different world, this medicine would have been one of the biggest healthcare stories around. Yet that simply wasn’t possible.

But Twenty21 is still making a massive difference. Thanks to your involvement in our study, and to the thousands of patients enrolled, you have helped us raise awareness of medical cannabis and the issues hampering patient access. Thank you.

Here are some of the things you have helped Project Twenty21 achieve.

  1. You have helped us to publish important findings that show a dramatic improvement in patients’ quality of life, when they are prescribed medical cannabis.

  2. You have helped us to gain major coverage in the UK media about medical cannabis, and the problems patients face when attempting to access prescriptions. Such as this article in The Guardian, this in the Sunday Mirror, and this on the BBC.

  3. You have helped us to further increase awareness among policy-makers, the public and people who would themselves benefit from a medical cannabis prescription with social media campaigns that focus squarely on personal testimony, patient experience and ending decades-old stigma.

  4. You’ve helped us to collaborate with influential groups - such as the British Pain Society, PLEA and the Medical Cannabis Clinicians’ Society - strengthening our patients’ voices to government and initiating the conversation with the NHS.

  5. You’ve helped us to build on the strength of our Medical Cannabis Working Group, consisting of leading experts who have the ear of government.

  6. You’ve helped us to become a strong voice in the global conversation about medical cannabis, as Project Twenty 21 has generated much media and political interest around the world.

All of this has allowed ProjectTwenty21 to establish a clear pathway for patients to seek out and access medical cannabis, at a time when such legal access is more confusing – and exclusive – than ever.

What’s next for the project, and what this means for you

As we move into 2022, we now have to plan for the next stages for the project.

In our December Update we announced changes to our eligibility criteria, that we’re opening up the study to anyone with any diagnosed condition that can be treated with medical cannabis at one of our participating clinics, providing you meet the clinic’s eligibility criteria of course. We’re also no longer mandating that you need to have previously tried two licensed medications before trying medical cannabis – we’re leaving this up to the clinics to decide. We hope that these changes will allow Project Twenty21 to reach more people who could benefit from medical cannabis treatment.

Another thing we have to look at is price.

We’re proud that Project Twenty21 has brought down the exceptionally high price of private prescriptions for so many patients. And when we set our initial price cap of £150 for Twenty21’s Formulary products, we drew a line for medical companies where none had already existed. However, as so few private prescriptions had been issued at this point, we weren’t able to draw simple comparisons with national average pricing. What we did know was that £150 for 30g of cannabis flower was going to be very competitive when compared with the illicit market.

In the two years since, we have seen the cost of a medical cannabis prescription reduce dramatically and have no doubt that Project Twenty21 has been instrumental in encouraging this change.

Based on our partner supplier feedback, we knew that such a competitive price cap would require review as the project progressed. The price cap was designed to run until the planned end of the project in December 2021. We can now reveal that Drug Science has been working hard with our partners to enable Twenty21 to continue beyond its original timescale.

To achieve this, and after a great deal of consultation, it has become clear that rather than use a capped pricing model for all medicines in the formulary, it’s more effective and logical to proceed with a set price per gram for flower and per millilitre for oil model, irrespective of quantity.

This will be set at £7 per gram of flower and per millilitre of oil for all Project Twenty21 formulary products, and the change will come into effect as of 1st February 2022.

The new pricing structure will provide better clarity and transparency for patients, prescribers and dispensing pharmacies. It will ensure a sustainable quality supply, and patients will pay the same per g/ml for a smaller quantity of cannabis medicine as they will for larger quantities.

We acknowledge that, while this new pricing is still extremely favourable, it may lead to an increase in overall costs for some patients.

The decision has only been taken to ensure that Project Twenty21 can continue, remain competitive, and that our producers can keep supplying the highest quality medicines to enrolled patients. As has always been the case, patients can continue to submit their data as part of Twenty21 even if they are being prescribed products that aren’t in our formulary.

By continuing for at least another year, Project Twenty21 will move us closer to our long-term goal, providing enough high quality UK-based evidence around the benefits of medical cannabis to open up NHS funding for these medicines. Because too many patients remain stuck in a limbo of legalisation without real access and your continued involvement in Project Twenty21 will help to change that.

We thank you for everything you do for us.

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