How long until Canadians can access medical cannabis in pharmacies?

June 10, 2024 | Tim Wilson

Earlier this year, the federal government’s expert panel called for pharmacy access to medical cannabis. Specifically, the panel’s report recommended expanding the existing model, which permits online sales, to allow for in-person cannabis access at pharmacies.

This common-sense recommendation resulted from the panel’s recognition that pharmacies have the infrastructure to dispense cannabis and that in-person access could address delays related to mail or courier delivery while also providing the all-important opportunity for counsel from pharmacists.

However, given the recommendation and broad consensus within the industry that pharmacy access makes sense, the question remains: what’s the timeline?

“It’s difficult to say when this will happen, as we may be heading into a federal election, which usually involves a cooling down period,” says Max Monahan-Ellison, Chairperson of Medical Cannabis Canada. “Ultimately, the process would likely involve Health Canada reviewing the findings, developing policy proposals, and potentially consulting further with stakeholders and potentially drafting amendments which could be subject to public comment. There would then be a legislative process to move the changes forward into law.”

A federal election has to be held before October 20, 2025, with some political observers believing that the government may want to go to the polls later this year. In either case, it’s unlikely that Canada will be seeing pharmacy access to medical cannabis before 2026.

Even that might be optimistic, given that access also has to be addressed at the provincial level.

“We support the report’s view that we need a regulatory pathway for cannabis access in pharmacies, and this is a critical first step, but there’s still a lot to happen at the provincial level because that’s where pharmacy scope is legislated,” says Shelita Dattani, Senior Vice President, Pharmacy Affairs and Strategic Engagement at the Neighbourhood Pharmacy Association of Canada.

The Benefit of Pharmacy Oversight

Given the public health and harm reduction role pharmacy can produce for therapeutic products, the Neighbourhood Pharmacy Association of Canada, which has significant membership representation across Canada, supports the Scientific Committee’s recommendation that cannabis health products be accessible through pharmacies.

“Given the importance of ensuring public health and safety, it’s important that associations like ours are aligned with regulators,” says Dattani. “We support the idea of pharmacists being able to authorize and dispense cannabis.”

Pharmacists are also uniquely qualified to assess and manage potential drug interactions.

“If you’re taking cannabis for a medical condition, there’s a good chance that you’re on other medications,” says Glen Doucet, CEO of the Canadian Pharmacists Association (CPhA). “Adjustments might need to be made in terms of dosage, with pharmacists able to provide timely monitoring for performance and health.”

Given the shortage of family physicians, and the fact that most Canadians live within five kilometres of a pharmacy, with some locations open until midnight—or even 24 hours—allowing for in-person access could dramatically improve healthcare delivery across Canada.

“Pharmacists see their patients 12 to 20 times a year. There’s a lot of opportunity to make adjustments, and to recommend other products,” says Doucet. “Our concern now is that many Canadians might not be benefitting from appropriate medical oversight. While physicians are amazing at diagnosing, their level of understanding of medications is not at the same level as pharmacists. As a result, pharmacists represent an important check and balance, and bring a lot of value.”

Waiting on Ottawa

Though the process of getting medical cannabis into pharmacies might be slow, at this point, its arrival seems almost inevitable, given that industry, the medical community, and government are all now on the same page.

The challenge is with regard to political will. As with other cannabis-related issues, such as excise tax reform, the problem is that governments at all levels are distracted by higher-priority issues.

“Healthcare moves fast, but governments move slowly, and pharmacy dispensing won’t happen any time soon,” says Monahan-Ellison from Medical Cannabis Canada. “All the players involved in dispensing, particularly at the provincial level, have to get together to establish an ideal pathway. Individual pharmacies will also likely need to prepare for dispensing by establishing security measures and training set out by applicable provincial and federal regulations.”

As it stands, the process has benefitted from the panel’s suggestion that cannabis be integrated into standard drug approval pathways, heavily informed by the Medical Cannabis Access Survey (MCAS).

This pathway also supports the increasing role that pharmacists are already playing in healthcare delivery.

“Across all ten provinces, pharmacists can already assess for minor ailments, urinary tract infections, gastroesophageal reflux, and some dermatological conditions,” says Dattani from the Neighbourhood Pharmacy Association of Canada. “In BC, assessment for birth control is allowed, and in Alberta and Nova Scotia a pilot is in place to broaden the scope further. We would like to see this advance with cannabis, too, and for healthcare access not to be dependent on a patient’s postal code.”

The Ontario College of Pharmacists has mandated that members complete a cannabis course. With pharmacy access across the country a near certainty, it’s likely that such requirements will extend to other provinces.

The transition for the pharmacists themselves should be reasonably straightforward.

“The CPhA has created a monograph to aid pharmacists,” says Doucet. “I don’t see it as a huge learning curve for them.”