On November 7th, Jon Liebling (Political Director) and Gavin Sathianathan (Trustee) of United Patients Alliance met with their Chief Operations Officer (COO) and Chief Product Marketing Strategist at a coffee shop in central London - Nothing clandestine about it - just a coffee and a good chat about the world according to GW and how it differs from UPAs - we did find a couple of things we all agree on.
A little background (in the spirit of full disclosure) - Their COO was appointed to GW Pharmaceuticals 5 years ago after 25 previous years involved in the pharmaceutical industry. The name rang a bell and I remembered a close medical colleague and family friend of my own parents. Their COO, it turned out, was their son. We did meet up for a coffee and worked out that we are both good people with one or two things in common that totally disagree with each other on most everything else. We did, however, agree that keeping the communication channels open would be the best way forward and we could continue to catch up from time to time.
Then a few weeks ago, this article was published:
Shortly afterwards, I received a call from their COO who suggested it would be a good idea to catch up and that he would like to introduce me to his new Chief Strategist who was interested in knowing more about the "cannabis" world, where is is, what it is and who is doing what. I have to say, that they are VERY well informed.
For the last 20 years, since their creation in 1998, they have focused exclusively, some may say, too exclusively, on their own stated goal:
"GW’s strategy is to maintain a world leading position in the field of cannabinoid science and in the research, development and commercialisation of cannabinoid molecules as novel prescription pharmaceutical therapeutic candidates"
What do GW Pharmaceuticals feel about the legalisation of cannabis? They don't. It is of no concern to their business or strategy whatsoever. Any more than legalising the production of heroin would be to a pharmaceutical company who produces Tramadol from Poppies!
What do they think about a change to the scheduling of raw cannabis in the Misuse of Drugs Act?
They don't. It really is of no concern of theirs and doesn't really effect their research in any significant way. As long as they adhere to the conditions of their license they can get on and do what they do. On the one side, it is impacting their product marketing and medical profession education and in turn that is impacting patient access in the UK, which is why they chose to invest more in other countries who have less restrictive policies. On the other side, it's current status in Schedule 1, does give them a competitive advantage which helps to maintain their current monopoly in the UK - on balance - no real consequence.
They are VERY cautious about what they say and how they say it and it really is quite obvious that, far from being "in cahoots" with the UK Government, they continue to exist in spite of them. They have spent a huge amount of time and money on working within existing policy, not trying to change it. Though it took them about 8 years, GW successfully developed the world’s first approved prescription medicine derived from the cannabis plant, Sativex, now in over 30 countries for the treatment of spasticity due to Multiple Sclerosis. They are aware of its limitations. Further product research is ongoing.
They understood at Phase III trials (human) that they had taken the wrong THC/CBD mix candidates forward from Phase II. To change the formula at this stage - according to the way policies direct drug research - would mean going all the way back to Phase I - basically starting again, losing 2 years and £20m - or - they could push it forwards to approval; the Phase III results were still a success (enough) - to finish it off, get it approved and get it out there - for patients and to recoup some of the investment.
Interestingly, and we will get some figures on this soon, the cost of Sativex on private prescription bears little relation to the cost at which it leaves their hands, nor the cost to the NHS. This needs looking at in more detail. The other fact of particular interest was that GW have absolutely no input on the scheduling of their approved medicines. That is between the Home Office and their advisory bodies to determine.
Their next product Epidiolex has a tiny footprint in the world of prescription medications. They are seeking approval for this cannabinoid medicine for severe forms of childhood epilepsy only. This is a "niche", or as they say in their own words above, "novel" medicine. About 40k patients, worldwide would be their target!
This year they are on course to lose $200M and clinical trials are very expensive to run, so the idea of a Big Pharma takeover to make huge profits is not quite the reality (yet). Sorry to disappoint the conspiracy theorists, none of this sounds like "Big Pharma" to us.
However, before you start thinking that this is an advert for GW. I was merely pointing out that they are not an enemy. They aren't our friends either! GW are a pharmaceutical company. They are in business. They have no intention of apologising to anyone about this. They are here to stay, they have goals and they plan to achieve them.
Before this meeting, I was under the impression that their new medicine, Epidiolex, was a full plant extract - it is not - it is 99% Purified (though a patent-able chemical process) CBD, with a little CBDa and no other active compounds - It’s a white powder which is then formulated into the final product. To all intents and purposes - It is CBD isolate! It does not contain the spectrum! No wonder they are taking such an interest in the future regulation of CBD. They weren’t too keen to discuss what they are up to in the US, siting the US company as separate from the UK one?
A key takeaway was around the tension between GW seeing themselves as a "medical cannabis" vs. a "pharmaceutical" company. They believe they are in the business of pharmaceutical formulation, and the fact that they are using cannabis for the constituent chemical components is almost an afterthought.
As they plan their next 5 years strategy, GW are starting to look at some of the wider implications and how/where they might fit in to the broader world of cannabis as medicine and are currently "fact finding" and talking to a few organisations they have found interesting. UPA are interesting. They enjoyed our T-Party!
They feel they really are putting patients first through their uncompromising goal of producing a consistent pharmaceutical medicine that will do no one any harm and they have very strong feelings about anyone making unsubstantiated and non-evidenced medical claims about cannabis and/or cannabis based products, especially with regards to Cannabinoid Rich Hemp Oil Food supplements. Where we may look to collaborate would be in data/research sharing, of which they have much and patient feedback of which they have little or none. I think we really can both benefit for a bit of sharing and collaborating.
They were both approachable and friendly individuals and Gavin and I had a great time getting to know them rather better. Whilst they may not be our friends; they are not our enemy either and moreover, they are the UKs ONLY Pharmaceutical Company with an interest in cannabis in the rapidly growing global pharmaceutical industry. It may well be in the UKs interests, especially post #brexit to have them succeed. I doubt Sativex nor Epidiolex will give them a significant hold on the future of cannabis as medicine. They are effectively "niche".
You can see their full product pipeline here: https://www.gwpharm.com/healthcare-professionals/product-pipeline
We look forward to our next coffee!
Jon Liebling – Political Director of United Patients Alliance
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