‘Slick lobbying machine’: cannabis vendor pushes for law reform
The country’s biggest medicinal cannabis prescriber believes laws should change to broaden access to the drug. But critics argue it is deploying the same playbook as big tobacco.
Australia’s biggest medicinal cannabis corporation has been accused of running a “slick lobbying machine”, comparable to big tobacco, pushing for legal reforms to make it easier for doctors to prescribe the drug.
Alternative medicine conglomerate Montu, the parent company of prescribing platform Alternaleaf – a brand so big it once controversially sponsored the Dolphins team in the National Rugby League – is already in a legal dispute with federal medicine regulator the Therapeutic Goods Administration over advertising of cannabis.
But Montu has also regularly hosted a national industry roundtable of legal experts, clinicians, former TGA executives and ex-staff from other government health bodies.
The roundtable, chaired by barrister Ian Freckelton KC, an academic and cannabis policy expert, is developing a policy paper to suggest cannabis prescription be moved from a “system of exception” to “everyday care”.
That would make it easier for GPs to prescribe cannabis to patients without special restrictions.
Critics have compared the process of pushing for the changes to the deceptive self-regulatory lobbying of tobacco, opioid and alcohol vendors.
Montu’s government engagement lead is Matthew McCrone, a former public servant credited with bringing medicinal cannabis to Australia through his work at the Victorian and federal health departments.
Mr McCrone said medicinal cannabis should be taken off the TGA’s special access scheme by legislation to change the evidentiary standards required for official listing. This would change the rules to broaden the drug’s availability and ease of access without expecting suppliers to present the necessary clinical evidence to meet the current standards.
“These pathways are no longer fit for purpose. They were never intended for this scale of patient access,” he told The Australian.
“Let’s look at what a framework looks like that actually addresses all of these issues from the various quarters – be it the medical fraternity, be it government, be it patients, be it industry.”
Mr McCrone said pharmaceutical companies could not and would not carry out controlled drug trials to gauge medicinal cannabis efficacy in order to secure TGA approval.
“Who’s going to do that? What’s the carrot for anyone to do that?” he asked.
“The genie is out of the bottle. Bottom line, we’re not going to entice people … to engage in the clinical trial process.”
Mr McCrone said reports of emergency department presentations caused by medicinal cannabis consumption were “not necessarily evidence-based statements”. He said he had met with a TGA official who had agreed to attend a future roundtable meeting and was “very interested” in its work.
A TGA spokesperson confirmed assistant secretary Michael Wiseman met Mr McCrone at his request last month.
“The TGA regularly meets with a range of stakeholders,” the spokesperson said.
“The meeting centred solely on Mr McCrone outlining and explaining purpose, scope and intentions of the roundtable, and (was) not related to the ongoing litigation between the two parties for alleged unlawful advertising of therapeutic goods.”
Royal Australian College of GPs president Michael Wright said regulators should be wary.
“The online cannabis industry can advocate for itself, much as alcohol manufacturers can advocate against restrictions, but that advocacy (should) be viewed in the context of what’s driving it. The world’s largest cigarette company, Philip Morris International, established a ‘Foundation for a Smoke-Free World’, now ‘Global Action to End Smoking’, to fund motivated research, for example,” he said.
“That advocacy should be viewed in light of those commercial interests and the well-justified concerns raised by doctors and patients.”
Montu and Alternaleaf are in mediation with the TGA over a Federal Court dispute in which the companies are alleged to have breached health advertising laws.
“Montu is further alleged to have operated a website during Medicinal Cannabis Awareness Week 2023 which advertised medicinal cannabis to the public,” the TGA wrote in a statement at the time.
“Despite repeated warnings by the TGA about the alleged non-compliant advertising, the companies continued to advertise medicinal cannabis.”
The policy roundtable is Montu’s latest excursion into political lobbying after forming advocacy group the Cannabis Council Australia and convening a telehealth code of practice working group chaired by former federal health minister Greg Hunt.
Former TGA medical adviser Ruth Lopert – a member of the roundtable and now an independent consultant – said the work was not biased and could improve outcomes for patients, regulators and prescribers equally.
“This work is independent and policy-focused, because I’d hate to think that we were seen as hired guns – we’re absolutely not,” Dr Lopert said. “We participate based on expertise and public interest, not commercial affiliation.
“I’m not an advocate for medicinal cannabis. I’m an advocate for regulating products in a way that ensures that they’re safe and that they (are used) in a way that benefits patients.
“If we’re not going to get the clinical trials and there’s a huge demand for the product, then we have to find a way of actually ensuring that we can use it safely and effectively.
“I don’t see it as making the conditions easier for the drug companies. I see it as making a system that works for the patients who could benefit from access.”
John Ryan, chief executive of drug policy non-profit the Penington Institute, said he was concerned about the long-term ramifications that could come from unwinding the evidentiary threshold required by the TGA at the request of a “slick lobbying machine”.
“We’ve got an expectation that our medicines meet the highest levels of evidence … I’d be reluctant to move away from it just because we’re trying to fit medicinal cannabis into that model,” Mr Ryan said. “Eroding the standards that have been created after a lot of trial and error to accommodate medicinal cannabis is a really big risk.
“I don’t want to be throwing mud. Maybe their intentions are perfectly legitimate. It’s just that with history as complex as theirs, it wouldn’t be my first priority. My first priority would be cleaning up my own backyard.”
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