• Medical consultants can now make application to register for MCAP
• Ministerial Licence Programme – courier collections to continue

The Minister for Health, Stephen Donnelly TD, is pleased to announce that the Medical Cannabis Access Programme (MCAP) is now open for medical consultants to make an application for themselves and their patients to be registered for the programme. Registration by consultants and their patients on the Cannabis for Medical Use Register, to be operated by the HSE, is required for the prescribing of cannabis-based products under the MCAP. This is a further important step in the ongoing roll out of the MCAP in Ireland. 

The Minister said: “Today is a significant step forward in the ongoing delivery of the MCAP. This step forward will greatly assist patients who, under the supervision of their consultant, need to avail of medicinal cannabis products to alleviate the effects of their severe medical conditions. I now hope the programme continues to go on and grow and expand further, to best meet the needs of patients and families around Ireland.” 

The MCAP will require a dispensing fee to be agreed with community pharmacists and this process is ongoing.

Ministerial Licence Programme – courier collections to continue 

In addition to the MCAP, the Minister for Health will continue to operate the Ministerial Licence programme, enabling some 63 patients to avail of medicinal cannabis products, sourced from a pharmacy in the Hague in the Netherlands. Since April of last year, owing to the COVID-19 travel restrictions and quarantine requirements the Department has organised courier collections of patients’ cannabis products in the Netherlands and had these products delivered to them at their homes. This initiative will continue. It is hoped that over time as more acceptable products are made available on the MCAP, the Ministerial Licence Programme patients may be treated under the programme. However, this is a clinical choice to be made by the patients and their clinicians. 

What is the MCAP
The MCAP is Ireland’s Medicinal Cannabis Access Programme. It is designed for patients who suffer from three specific medical indications.
These indications are:

• spasticity associated with multiple sclerosis
• intractable nausea and vomiting associated with chemotherapy
• severe, refractory (treatment-resistant) epilepsy. 

Registering for the HSE Cannabis for Medical Use Register
Regulation 5 of these regulations provides for the establishment by the HSE of a Cannabis for Medical Use Register.
Treating clinicians can now apply to be registered on the Register and prescribe for their patients any cannabis products that have been accepted for use under the programme and placed in Schedule 1 of the Regulations.
Products that may be prescribed under the MCAP
Currently, 4 products have been placed on the Schedule for use in the programme, one of which is now available. A second product is to be made available later this year.
It is anticipated that other acceptable products will be made available for use over time.

Legislative base
The MCAP was established by the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019.
The Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019, established the MACP and provided a legislative framework for the prescribing and dispensing of medicinal cannabis products to Irish patients for the purposes of the MCAP.

Regulations
Regulation 2 (Definitions) specifies what a “specified controlled drug” is for the purposes of the programme and which can be prescribed for patients.

Consultant role
A “medical consultant” is clinician registered on the Specialist Division of the Register of Medical consultants maintained by the Irish Medical Council. Only consultants may join the programme.
Medicinal cannabis products which have been accepted for use on the MCAP may be listed in Schedule1 of the Regulations and may be prescribed by consultants for dispensing by pharmacists to their patients.

HSE Cannabis for Medical Use Register
The HSE has established a Cannabis for Medical Use Register on which consultants may register themselves and their patients to enter the MCAP.
Certain data as provided for by Regulation 5 shall be captured by the HSE.

Timeframes
The MCAP is a five-year pilot programme and subject to review.