Accessing and Prescribing
Indications
The TGA has approved SAS applications including, but not limited to, the following:
- Chemotherapy induced nausea and vomiting (CINV)
- Refractory paediatric epilepsy
- Neuropathic and chronic pain
- Palliative care
- Cancer pain
- Anxiety
- Insomnia & Sleep Disorders
- Post Traumatic Stress Disorder (PTSD)
- Spasticity from neurological conditions (e.g. Multiple Sclerosis)
- Anorexia and wasting associated with chronic illness (e.g. cancer)
Prescription Pathways
Most medicinal cannabis products are classified as ‘unapproved’ products and are not available as registered prescription medicines. This means the pathways to gain access are different from normal prescription medications.
Kind medicinal cannabis products are available with an approved prescription via the Therapeutic Goods Administration (TGA) Special Access Scheme (SAS-B) or through Authorised Prescriber applications. The TGA has a wealth of information and resources for healthcare professionals to reference on how to access medicinal cannabis, starting here. Below we have provided a brief summary.
Authorised Prescribers
Authorised Prescribers are doctors who have met the TGA’s requirements and been approved as an Authorised Prescriber. Authorised Prescribers do not need separate approval to prescribe medicinal cannabis to patients under their care.
The TGA outlines requirements to become an Authorised Prescriber. Applications can be lodged via the TGA’s online portal. There are also other independent groups that teach healthcare professionals how to become a prescriber, such as CanView’s Medical Professional Support portal.
Special Access Scheme B (SAS-B)
To prescribe a patient medicinal cannabis you must first obtain an SAS-B approval from the TGA for them, unless you are an Authorised Prescriber (see below). SAS-B requests normally take around two days to be approved, after which time you can issue the patient’s medicinal cannabis prescription for fulfilment at their pharmacy.
SAS-B applications can be lodged via the TGA’s medicinal cannabis SAS-B portal or via other platforms like CanView’s Medical Professional Support portal. TGA and state or territory health department authorisations can be applied for simultaneously. The request process is streamlined enough that we suggest completing it during your patient’s visit.
Some information you’ll need is as follows:
- an outline of the patient's symptoms or diagnosis;
- details of relevant past treatments and procedures trialled or considered, including reasons why therapeutic goods currently included in the ARTG may not be the most appropriate treatment for the individual patient in the particular circumstance;
- an appraisal of the expected clinical benefits versus the potential risks of the proposed treatment.
There are no restrictions on the medical conditions for which a prescriber may apply via the SAS to access an unapproved medicinal cannabis product for their patient, provided the prescriber has the appropriate knowledge of the condition being treated and the medicinal cannabis product they wish to prescribe.
Refer Your Patient
The responsibility and decision to prescribe any therapeutic good, including unapproved products rests with the prescriber. You have the right to decline to prescribe a medicinal cannabis product if you believe there is insufficient clinical justification or evidence to support the safe and effective use of the product.
However, if you believe that your patient may benefit from medicinal cannabis as a treatment and don’t feel comfortable assisting them with access, you can refer them to a medicinal cannabis specialist for consultation. There are many medicinal cannabis specialist doctors and associated clinics in Australia that can guide your patient through a robust screening as an initial step, such as CDA Clinics.
