Ontario will be home to the country’s first brick and mortar cannabis pharmacy starting in June, says Rahim Dhalla, a pharmacist, medical cannabis consultant, and CEO at Hybrid Pharm, a compounding pharmacy, cannabis and wellness centre near downtown Ottawa.
Hybrid Pharm has been operating since 2018 as a full service pharmacy, and in March of this year was licensed by Health Canada for medical cannabis sales. According to Dhalla, this will mean that his pharmacy will be able to provide authorizations for cannabis for medical purposes from a healthcare practitioner, as well as provide product to them on-site the same day.
Although normally this would be done with an on-site medical practitioner, due to precautions with the current Covid crises, the pharmacy is currently offering online consultations. Registered patients can then either come into the pharmacy to pick up their order, or have it delivered within the Ottawa and Ontario area.
“That’s the big deal here. Patients have an outlet to go to, pick up their medication and walk out with it, instead of ordering it and doing an online registration and then waiting several days. The amount of emails one person gets before they can actually order it, many just get confused. Then if they have questions they have to call their licensed producer who isn’t allowed to give out medical information, and if they do, it might be incorrect.”Rahim Dhalla – hybrid Pharm
Pharmacies have been authorized to apply for a federal license to provide medical cannabis in Canada for several years now, although only, Shoppers Drug Mart has opted to go through the federal licensing process. Shoppers has only offered sales through an online platform, not through in-store sales of cannabis.
The Neighbourhood Pharmacy Association of Canada has in the past said that pharmacies are the best place to offer cannabis due to their experience with controlled substances, as has the Canadian Pharmacy Association.
The process of online sales is the same for any other licensed producer under the previous medical control regimes and now regulated by the Cannabis Act since 2018. A person can get authorization from a medical practitioner and can then register with a licensed cannabis producer and purchase those products online, to be delivered in the mail.
“Yes, you can walk into a recreational store and buy whatever you want, but you’re not going to get proper medical oversight.”
Shoppers Drug Mart was licensed for these activities in September 2018 with a medical sales and processing license. At this time, Shoppers Drug Mart does not process new cannabis products themselves, but buys and resells product from cannabis producers they have partnered with.
Dhalla says Hybrid Pharm operates in a similar way, buying and reselling products from other producers, except that they offer same-day, in-store access. Dhalla says they have more of a focus on providing unique product options for patients often seeking very specific uses when it comes to cannabis. Because a traditional LP cannot provide medical advice to those people ordering products from them online, he says this can leave many possible patients confused and not able to make best use of the product.
“We would set up a person with a consultation with our nurse practitioner, help them fill out a patient medical history questionnaire and help determine if cannabis is right for them. Then, if so, we’ll do a full consultation about what dosages they should be taking, what product they should be using, tracking their other medications, looking at dosage and titration levels, and operate as an overall point of contact for these patients.”
Because Hybrid Pharm has been operating since July 2018 as a compounding pharmacy that did offer compounding options for cannabis for authorized patients on an individual basis, sourced from licensed producers, he says has has built a good understanding of the kinds of unique formulations many patients are looking for, especially when it comes to trying to use it as a substitute for, or in conjunction with, many other forms of medication.
Dhalla said the average patient he sees is over 55 and is often using five or more other forms of medications, and doesn’t know how to navigate the online system. While people can now buy cannabis through the non medical system, those who are looking for specifical medical uses aren’t getting the kind of direction that they really need.
“Yes, you can walk into a recreational store and buy whatever you want, but you’re not going to get proper medical oversight,” he says. “Our conversations with patients over this past year and a half have helped us understand what is working and what is not, and what our patients are using. Then we seek out LPs that have the products that we want to have on our shelves.”
“That’s the big deal here. Patients have an outlet to go to, pick up their medication and walk out with it, instead of ordering it and doing an online registration and then waiting several days. The amount of emails one person gets before they can actually order it, many just get confused. Then if they have questions they have to call their licensed producer who isn’t allowed to give out medical information, and if they do, it might be incorrect.”
Rather than operating as a large scale reseller, he says Hybrid Pharm’s approach is to source the kinds of unique products offered by some cannabis producers that better reflect the kinds of products he was previously able to formulate on an individual basis.
“This is what we do as compounding pharmacists, is we try to minimize harms by offering alternative dosages,” says Dhalla. “If Grandma can’t take something by mouth, then we give her a suppository. If she can’t swallow a pill, then we can make some form of a liquid.
“So in the cannabis world, where we know how individualized cannabis is, we can know what people are asking for and what medications they are using and maybe trying to replace. This is where we can provide benefit to patients.”
He says initially he had hoped to apply for a micro processing license in addition to his sales licence, to allow him to continue to create individual compounds and formulations for patients. But this process proved to be too much to take on initially, primarily because the licence category is built around more of a commercial level of production, in addition to the need for 60 day notices for any new products.
His hope is to be able to buy cannabis products from producers and compound more niche and individualized products that he sees people asking for that are often not readily available in the medical or non medical market. These would include products like suppositories, vaginal creams, topicals, rapid dissolve strip and patches.
Dhalla says the process of licensing took about a year and he spent around $100,000 to build out a secure vault and storage area inside his pharmacy. If he were to get a processing license, he would like to do it onsite, but could also possibly have a facility operating nearby.
With a soft launch in June and a hard launch planned for July, which will include online sales for all Ontario residents, Dhalla says he hopes to prove the model a success and expand to other locations in Ontario and eventually Canada.