Project Twenty21 - Patients
With Project Twenty21, eligible patients can access affordable medical cannabis treatment, monitored by Drug Science. The project aims to create the UK’s largest body of evidence for the effectiveness and tolerability of medical cannabis. Drug Science hope that the findings of Project Twenty21 will provide evidence for NHS funding where the benefits of treatment with medicinal cannabis is proven to outweigh the potential risks.
How can I get prescribed medical cannabis through Project Twenty21?
What is Project Twenty21?
Please watch our quick and easy 3 minute animation of how the project works.
Project Twenty21 is a UK registry aiming to monitor the health outcomes of patients using cannabis based medicinal products (CBMPs), creating the largest body of evidence in Europe for the safety and efficacy of CBMPs. Drug Science hope that the findings of Project Twenty21 will provide evidence for NHS funding where the benefits of treatment with medicinal cannabis is proven to outweigh the potential risks.
This real-world registry aims to target the following indications:
- Anxiety Disorder
- Chronic Pain
- Multiple Sclerosis (MS)
- Post-Traumatic Stress Disorder (PTSD)
- Substance Use Disorder
- Tourette’s Syndrome
- Adult Epilepsy
New clinics will come on board as the project progresses, meaning that there will be more options available to patients in the future. If the current available clinics do not suit your needs.
Please join our mailing list for project updates:
How can I get medical cannabis under Twenty21?
To enrol, patients must provide their chosen clinic (not Drug Science) with both:
- A confirmed diagnosis of one or more of the following indications:
- Anxiety Disorder
- Chronic Pain
- Multiple Sclerosis (MS)
- Post-Traumatic Stress Disorder (PTSD)
- Substance Use Disorder
- Tourette’s Syndrome
- Adult Epilepsy
- A history of (at least) two licensed medications, both of which must have been prescribed and proven ineffective at managing the patients’ condition. This information must be documented in a medical summary or a referral letter from their GP practice.
Which medical cannabis products are available?
Project Twenty21 has partnered with licensed producers to subsidise the cost of private medical cannabis to £150 per product per month (maximum amount is capped based on dosage guidance from the Medical Cannabis Clinicians Society). Smaller quantities of product (at lower costs) are available if the maximum dosage is not required each month. Medication, dosage and costs should be discussed at your consultation.
Some cannabis-based medicinal products that may be recommended by the clinician will not be subsidised through Project Twenty21. Patients can accept these medications but must expect to pay for these products at full price. Alternatively, patients can refuse these prescriptions if they are unable or unwilling to pay for these products. The prescribing doctor will send the Twenty21 medicinal cannabis prescription to the pharmacist. Patients will be contacted by the pharmacist to make payment for the medication, this process may vary for each product. Medication will be delivered to the patients’ address following payment.
Please note that dispensing and delivery costs (normally charged for private prescriptions) are NOT covered for any non-Twenty 21 products that you may be prescribed.
To receive medication at a subsidised rate, patients must consent to have their medical data collected by Drug Science. This information will be anonymised and kept confidential. The data will be used to examine the benefits and side effects of CBMPs. We hope that this analysis will inform future medical cannabis policy in the UK.
We have a range of products from these licensed producers:
- Lyphe Group
- Khiron Life Sciences
- Bod Australia ltd
- Cellen Therapeutics
- Jamaican Medical Cannabis Corporation (products arriving 2021)
The Project Twenty21 formulary now includes a range of indica & sativa flower products with varying CBD & THC ratios as well as an increased number of different oils plus some alternative options including a synthetic medication.
We are aware that the Twenty21 formulary might not suit all patients. This is why clinicians have the freedom to prescribe whatever product is best for the patient, from all the products they are able to access, if the patient’s needs are not fulfilled by a Twenty21 product. Your health data can still be collected and submitted into our registry and you will still be part of the project.
What happens at the consultation?
Before:
Please note that medicinal cannabis consultations are not intended for the diagnosis of a condition. Some patients may require an additional appointment at a charge if further assessment is necessary.
Patients should inform the clinic that they wish to participate in Project Twenty21 before their consultation. When contacting a clinic make it very clear that you are a Twenty21 patient to access subsidised products.
Any products prescribed which are not included in Project Twenty21 are not subsidised and will incur prescription, dispensing and delivery costs.
Before scheduling a consultation, most clinics offer a pre-assessment involving a review of patient healthcare records. Please check with individual clinics as to whether there is a charge for this.
During:
Consultations will either be conducted remotely via telemedicine (access to video calling required) or face to face.
Patients must ensure that the doctor is aware they wish to participate in Project Twenty21.
The doctor will complete an initial assessment and questionnaire covering:
- Diagnoses
- Previous and current medications for a condition
- Other therapies which have been undertaken
- How symptoms affect the patient’s quality of life e.g. impact on sleep, mobility etc…
- Any previous cannabis use, including cannabis-based products. The clinician should be informed of:
1. What has been most effective at managing symptoms?
2. How this is taken – by oil, edibles, balm, smoking or vaporizing?
3. Any issues or side effects experienced from using cannabis previously
The doctor will decide whether to prescribe medicinal cannabis products based on the patients’ medical history and clinical need.
Attending a consultation does not guarantee a medical cannabis prescription will be provided.
After:
Clinics will determine the frequency and cost of follow up consultation, with data collection occurring every 3 months. Patients must attend follow-up consultations to continue receiving their medication.
How do I choose a clinic?
Project Twenty21 health outcome data will be collected by a network of private clinics. Private clinics retain control over their consultation fees therefore patients will need to fund the cost of their consultation. This cost will vary between clinics and initial consultation prices will be listed alongside the clinician’s biography on the Drug Science website. The clinic directory contains details of all participating clinics, including details of specialities and consultation fees to help patients decide on which clinic they would like to register with.
How much does medical cannabis cost under Project Twenty21?
* At the discretion of the clinic
** Dependant on product
Project Twenty21 is now able to accept patients presenting with Adult Epilepsy. Clinic consultation costs are the same regardless of your condition and can be found on our Clinic Directory. Due to epilepsy requiring high doses of CBD-dominant products, there is a separate capped maximum price for a month’s epilepsy treatment of £550. If a lower dose is required the cost could be £375. Your clinician will be able to tell you more about the specific range of products and dosages for epilepsy patients.
We hope to expand the project to include childhood epilepsy by June 2021, once there are a sufficient number of Paediatric Consultants available to prescribe.
"My pain in all areas is significantly reduced by medicating with cannabis, my head is clearer, I am more relaxed, I am much happier, and I have only had mild withdrawal symptoms from stopping pharma medications, thanks to cannabis helping during that time too. The future looks much, much brighter now. "


Belfast
"Now I can get up in in the morning and even if I'm in the most unbearable amount of pain, and feel like passing out and being sick, I can take my medication and be able to function and focus and live my life."


Cambridge
"Project Twenty21 has given us the access to our proper medication that we need to live and function the way we could back in Canada, when we were first prescribed"


Hitchin
"My relationships with friends and family have improved. Even work and general life satisfaction has improved since medical cannabis, and I feel hope"


London
"Medical cannabis has made it possible for me to begin to remove the medications that I am on because they no longer help me, but come with horrible withdrawals"


Tiptree
How can I track my progress?
Alta Flora, a Twenty21 founding industry partner, has launched an app called Eva for patients who are prescribed medical cannabis. Eva enables the collection of real-time patient self-reported data on symptoms, interactions with other drugs, and effects on symptoms and Quality of Life.
The app is now available to download on iOS and Android, find it in the app store.
Eva is a support tool for the patient use only, although you can choose to share this data with your doctor at your appointments. This data cannot be accessed by Drug Science and is not at all linked to our own data collection for the project.
Patient questionnaires for the project data collection are sent out by email once the patient is registered with a clinic and has received a login for our data collection system. Please contact your clinic if you require any further support around filling out questionnaires.
Why is it hard to find information about medical cannabis products?
A ‘licensed medicine’ is a medicine that has a marketing authorisation from the UK Medicines & Healthcare products Regulatory Agency (MHRA) or European Medicines Agency (EMA), enabling it to be prescribed in the UK. The issue is that medical cannabis is an 'unlicensed medication', which makes it very difficult for producers to provide detailed product information and price lists because of the strict 'marketing' restrictions. Producers cannot state any claims about its benefit for medical conditions, the required dose or how to take it. Your doctor or dispensing pharmacist can answer questions on dosage and administration.
To what standard are Project Twenty21 products produced?
All products available on Project Twenty21 (oil, whole flower, granulate etc.) are from licensed producers who have been awarded an GMP (Good Manufacturing Practice) licence or international equivalent. This licence indicates that the products have been grown and manufactured to the highest internationally recognised medical standards. GMP regulations are extremely strict, and GMP approval is a legal requirement for any product to be prescribed in the UK. Patients can therefore feel confident that the product they receive is continually analysed to maintain the highest possible standards, quality and consistency. These standards are audited and approved by the relevant UK authorities.
How many places are left on Project Twenty21?
We have no maximum number of patients allowed onto the study. The more data we can gather, the stronger our evidence of outcomes will be, so we need more patients and prescribers to come forward and help us gather this data.
When will Project Twenty21 be complete?
We have no fixed deadline by which people must join or leave the study. We aim to collect health data for a minimum of 2 years. Participating clinics and consultants are responsible for submitting patient health questionnaires through our data collection system.
If I still have questions, who should I speak to?
We’re unable to answer all queries because we’re a small team and we receive a large volume of emails. We encourage you to use the following sources of information and support:
Patient Led Engagement for Access (PLEA) - provide support for patients - to access PLEA’s peer-support network, become a community member for free here.
MedCann - an educational hub for parents and carers looking to learn more about cannabis and how it could potentially help their children. It taps into the latest research and is in collaboration with the world leaders in cannabis use for paediatric care.
Cannapedia - The UK's first and only publicly editable encyclopaedia for medical cannabis. Information provided here will always be free and unmoderated* It operates exactly like Wikipedia; anyone can add/edit/remove content. *To prevent abuse/spam, new account edits will require approval.