The Twenty 21 project opens up to British patients. Unveiled in November 2019, Twenty 21 is a registry that will track the health data of 20,000 patients using cannabis-based medicines, creating the largest body of evidence in Europe on the safety and efficacy of CBMP.
The registry system developed by scientists and experts will collect patient data during medical consultations to finally answer the main questions about medical cannabis, whether the benefits of treatment are proven and outweigh the potential risks. The project will produce scientific information for doctors, patients, and decision-makers in the UK health system (NHS) and the UK government.
Limited access to medical cannabis
On 1 November 2018, medical cannabis was legalized in the United Kingdom, allowing doctors to prescribe cannabis-based medicines. However, so far, there are no public issued prescriptions, and only private, which provide access to medical cannabis at costs that are too high for most patients.
Medical cannabis permitted in the United Kingdom for only a few conditions (epilepsy, spasticity, nausea, or vomiting resulting from chemotherapy) that can be covered by the NHS. The patient must also find a doctor who trained to prescribe medical cannabis, a training that has not been contracted by the state.
Another obstacle is the lack of data or evidence. Until recently, unless a company obtained a license from the government, it was not allowed to research cannabis. For the NHS to authorize the use of this drug, it requires sound scientific evidence that the treatment works and is cost-effective. Since November 2018, the Department of Health and Social Welfare has requested more research into medical cannabis so that it assessed and approved for use in the NHS. That is why Project Twenty 21 established.
For 2 years, the Twenty 21 project will provide cannabis to 20,000 patients for the following conditions:
- Anxiety disorders
- Chronic pain
- Multiple Sclerosis (MS)
- Post-Traumatic Stress Disorder (PTSD)
- Substance Use Disorder (as a Harm Reduction Strategy)
- Tourette’s Syndrome
In June 2020, the Project Twenty 21 team began beta testing the patient pathway and opened access to Medical Cannabis Clinics for 100 patients. It is now open to the remaining 19990 patients who can now register for the project and prescribed medical cannabis.
To join the registry, patients must choose a clinic from among those participating in the project and provide a diagnosis of their disease and a history of two “classic” and previously prescribed drugs that have proven ineffective in treating. The initial clinic consultation will determine whether the patient can use medical cannabis products based on his or her medical history and clinical needs. Costs of the clinic remain at the patient’s expense, between £110 and £150 vary by the clinic.
Project Twenty 21 then partnered with medical cannabis producers to limit the cost to £150 per product per month, with the remainder covered by Twenty 21. This fee provides access to :
- up to 20 mg THC / day alone – 600 mg THC oil per month
- up to 100 mg CBD / day alone – 3000 mg CBD oil per month
- up to 1g cannabis flower/day alone – 30g dried flower per month
Different ratios of CBD and THC will be available. For the time being, Project Twenty21 is working with Khiron Life Sciences (Latin America), Bod Australia, Cellen Therapeutics, and Senzer Pharmaceuticals (UK) and the Jamaican Medical Cannabis Corporation to source cannabis.
Patients must report the effects of cannabis on their symptoms as well as any side effects at quarterly clinic visits to remain on the registry. Project data analysis will begin in late 2022.