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<p>NHS England and NHS Improvement are using extant systems to monitor use of the
newly rescheduled unlicensed cannabis-based products for medicinal use in England.
In England, these systems monitor the number of items dispensed and associated costs
in primary care and the volume of products used and associated cost in secondary care.
NHS England and NHS Improvement Controlled Drug Accountable Officers are also collecting
local intelligence in both the National Health Service and independent sector.</p><p>The
NHS Business Services Authority is only able to provide information on prescriptions
for cannabis-based medicines that have been dispensed and submitted to the NHS Business
Services Authority. The NHS Business Services Authority does not hold information
on prescriptions for cannabis-based medicines which have been issued but not fulfilled.</p><p>The
following table shows the number of items for Nabilone and Sativex (licensed cannabis-based
medicines) and unlicensed cannabis-based medicines that were prescribed on an NHS
prescription, dispensed in the community and submitted to the NHS Business Services
Authority for reimbursement since May 2018.</p><table><tbody><tr><td><p>Month</p></td><td><p>Nabilone</p></td><td><p>Sativex</p></td><td><p>Unlicensed
cannabis-based medicines</p></td></tr><tr><td><p>May 2018</p></td><td><p>45</p></td><td><p>183</p></td><td><p>
</p></td></tr><tr><td><p>June 2018</p></td><td><p>42</p></td><td><p>157</p></td><td><p>
</p></td></tr><tr><td><p>July 2018</p></td><td><p>48</p></td><td><p>170</p></td><td><p>2*</p></td></tr><tr><td><p>August
2018</p></td><td><p>54</p></td><td><p>161</p></td><td><p> </p></td></tr><tr><td><p>September
2018</p></td><td><p>45</p></td><td><p>172</p></td><td><p>1*</p></td></tr><tr><td><p>October
2018</p></td><td><p>50</p></td><td><p>164</p></td><td><p> </p></td></tr><tr><td><p>November
2018</p></td><td><p>46</p></td><td><p>175</p></td><td><p>2</p></td></tr><tr><td><p>December
2018</p></td><td><p>49</p></td><td><p>181</p></td><td><p>1</p></td></tr><tr><td><p>January
2019</p></td><td><p>44</p></td><td><p>167</p></td><td><p>2</p></td></tr><tr><td><p>February
2019</p></td><td><p>36</p></td><td><p>159</p></td><td><p>1</p></td></tr><tr><td><p>March
2019</p></td><td><p>51</p></td><td><p>171</p></td><td><p>2</p></td></tr><tr><td><p>April
2019</p></td><td><p>49</p></td><td><p>156</p></td><td><p>0</p></td></tr><tr><td><p>May
2019</p></td><td><p>Data not yet available</p></td><td><p>Data not yet available</p></td><td><p>2</p></td></tr></tbody></table><p>Note:
* These figures represent prescribing of unlicensed cannabis-based medicines imported
on a Home Office licence.</p><p>The following table shows the same products listed
above covering the same time period but this data relates to private prescribing on
an FP10PCD where the forms have been submitted to the NHS Business Services Authority
for reporting and monitoring purposes only.</p><table><tbody><tr><td><p>Month</p></td><td><p>Nabilone</p></td><td><p>Sativex</p></td><td><p>Epidiolex</p></td><td><p>Unlicensed
cannabis-based medicines</p></td></tr><tr><td><p>May 2018</p></td><td><p>0</p></td><td><p>1</p></td><td><p>0</p></td><td><p>
</p></td></tr><tr><td><p>Jun 2018</p></td><td><p>0</p></td><td><p>3</p></td><td><p>0</p></td><td><p>
</p></td></tr><tr><td><p>July 2018</p></td><td><p>0</p></td><td><p>2</p></td><td><p>0</p></td><td><p>
</p></td></tr><tr><td><p>August 2018</p></td><td><p>0</p></td><td><p>1</p></td><td><p>0</p></td><td><p>
</p></td></tr><tr><td><p>September 2018</p></td><td><p>0</p></td><td><p>3</p></td><td><p>0</p></td><td><p>
</p></td></tr><tr><td><p>October 2018</p></td><td><p>0</p></td><td><p>3</p></td><td><p>0</p></td><td><p>
</p></td></tr><tr><td><p>November 2018</p></td><td><p>0</p></td><td><p>1</p></td><td><p>0</p></td><td><p>0</p></td></tr><tr><td><p>December
2018</p></td><td><p>0</p></td><td><p>6</p></td><td><p>0</p></td><td><p>0</p></td></tr><tr><td><p>January
2019</p></td><td><p>0</p></td><td><p>5</p></td><td><p>0</p></td><td><p>4</p></td></tr><tr><td><p>February
2019</p></td><td><p>0</p></td><td><p>3</p></td><td><p>1</p></td><td><p>2</p></td></tr><tr><td><p>March
2019</p></td><td><p>0</p></td><td><p>3</p></td><td><p>0</p></td><td><p>3</p></td></tr><tr><td><p>April
2019</p></td><td><p>1</p></td><td><p>2</p></td><td><p>0</p></td><td><p>0</p></td></tr><tr><td><p>May
2019</p></td><td><p>Data not yet available</p></td><td><p>Data not yet available</p></td><td><p>Data
not yet available</p></td><td><p>1</p></td></tr></tbody></table><p> </p><p>Unlike
NHS primary care where all dispensed prescriptions are processed centrally, this is
not the case for secondary care. This information is collected by a third party and
not routinely published.</p><p>Intelligence from NHS England and NHS Improvement Controlled
Drugs Accountable Officers is that, up until the end of March 2019, five patients
have had private prescriptions issued for a cannabis-based product for medicinal use
in independent secondary/tertiary care in England.</p><p>145 patients have accessed
Epidiolex though GW Pharma’s early access programmes ahead of a licensing decision
by the European Medicines Agency.</p>
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