Insurance coverage for medical marijuana on the horizon, industry experts say

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TORONTO — Canadians who have been prescribed medical marijuana could one day see their insurance company footing the bill, experts predict, following the introduction of new Health Canada rules that allow for the sale of cannabis oils.

Health Canada announced revamped medical marijuana regulations earlier this month after the Supreme Court of Canada ruled that users of the drug should be permitted to consume it in other forms, such as oils and edibles, rather than having to smoke dried buds.

“You’re going to see insurance companies slowly start to creep into the sector,” says Khurram Malik, an analyst at Jacob Securities Inc., noting that the new regulations will allow medical marijuana producers to sell gel caps similar to those made from cod liver oil.

That will allow for more precise dosing, Malik says.

“When you’re trying to smoke a plant you have no idea how much you’re consuming, so that makes doctors a little nervous,” he said.

Experts say the changes are a major step towards legitimizing the drug in the eyes of doctors and insurers.

“When something doesn’t look different than other medicines, it becomes much easier for people to get comfortable with the idea that this is, in fact, a possible treatment option for patients,” says Bruce Linton, the chief executive of Smiths Falls, Ontario-based Tweed Marijuana Inc.

However, medical marijuana producers still have one major hurdle to overcome before insurers begin routinely funding the drug — cannabis currently doesn’t have a drug identification number, known as a DIN.

“If it was issued a DIN by Health Canada, it’s quite likely that the insurance companies would cover it,” says Wendy Hope, a spokeswoman for the Canadian Life and Health Insurance Association Inc.

“To obtain a DIN, the new form of medical marijuana would need to go through the full Health Canada approval process like any new drug.”

As it stands, most insurance companies don’t routinely cover medical marijuana. But some insurers, including Manulife, say they will consider making an exception if the employer has specifically requested it for one of its employees.

“It’s up to the employer to ask if they want to have it covered,” says Hope.

Earlier this year, Sun Life agreed to pay for a University of Waterloo’s medical marijuana prescription through his student health plan after the student union went to bat for him. Jonathan Zaid, 22, uses the drug to combat a syndrome called new daily persistent headache.

Some health insurance companies may pay for medical marijuana through a health spending account, says Hope. But, she adds, “my understanding is it doesn’t happen often.”

Malik says the primary reason why medical marijuana doesn’t have a DIN is a lack of rigorous, clinical research on its efficacy.

“The evidence is very circumstantial — not your typical 10-year, double-blind study that doctors and big pharmaceutical companies like to see,” Malik said.

He suspects that’s about to change.

“You’re going to see a lot of Canadian companies partnering up with universities overseas that are a little more progressive than the ones we have here, at least in this space, to drive this research forward and legitimize it in the eyes of doctors and get DIN numbers on these things,” Malik said.

Malik says there is a financial incentive for insurers to pay for medical marijuana, rather than shelling out for pricier chronic pain drugs such as opiates.

“From a dollars and cents standpoint, if marijuana is the same thing as a narcotic opiate, they would much rather cover marijuana because they’re in the business to make money,” Malik said.