Sativex prescriptions in England slowly increased over a decade but remain uncommon | Research

The takeaway

NHS prescriptions for Sativex (nabiximols) for multiple sclerosis increased slightly from 2013 to 2022, but the overall rate remained very low at about 5 prescriptions per 100,000 people.

UK healthcare policy makers, neurologists, and medical cannabis access researchers

5.15 prescriptions per 100,000 people in 2022

What the researchers found

Sativex prescriptions in England rose from 4.42 items per 100,000 people in 2013 to 5.15 in 2022, an average increase of 0.34% per year. Prescription costs also increased by an average of 2.43% per year. Neither trend reached statistical significance.

Why it matters

Despite being one of the few approved cannabis-based medicines in the UK, Sativex remains rarely prescribed a decade after becoming available, raising questions about barriers to access.

The numbers in context

4.42 prescriptions per 100,000 in 2013 to 5.15 in 2022; average annual increase 0.34% (95% CI -3.98 to 4.67, p = 0.860); cost increase 2.43% per year (95% CI -5.78 to 0.92, p = 0.133)

How the study worked

Analysis of primary care prescribing data from the Prescription Cost Analysis database (2013-2022) with linear regression to examine trends in prescription items and costs for cannabinoid-based Sativex in England.

What this study cannot tell us

Primary care data only, may miss specialist prescribing; cannot assess patient outcomes; no data on why prescribing remains low; linear regression may not capture non-linear trends; no patient-level data

How to read the evidence

Administrative prescribing data providing population-level trends, but lacking patient outcomes or explanatory factors.

When this study was published

2024 publication analyzing 2013-2022 data

The bigger picture

The slow uptake of an approved cannabis-based medicine in a healthcare system that covers it suggests systemic barriers beyond just legality, including prescriber hesitancy and restrictive guidelines.

Questions still open

What barriers prevent broader Sativex prescribing in England? Are MS patients seeking cannabis products outside the NHS instead? Would updated prescribing guidelines increase uptake?

Common questions

How common are Sativex prescriptions in England?

Very uncommon. By 2022, only about 5.15 prescriptions per 100,000 people were dispensed annually. The rate has increased only slightly over the decade since monitoring began, averaging a 0.34% increase per year.

Why might prescribing remain so low?

The study does not directly answer this, but possible factors include restrictive NHS prescribing guidelines, cost considerations, prescriber unfamiliarity with the product, and patient preference for other cannabis products available through private channels.

Read the original research

Trends in prescription and cost of Sativex, a cannabinoid-based medicine, in treating patients with multiple sclerosis in England.

Journal of pharmaceutical policy and practice, 17(1), 2342318

View on PubMed ↗Publisher’s paper ↗

Citation

Javid, Farideh A; Alam, Anam; Williams, Emily; Malik, Sidhra Sajid; Mohayuddin, Usama; Hasan, Syed Shahzad. (2024). Trends in prescription and cost of Sativex, a cannabinoid-based medicine, in treating patients with multiple sclerosis in England.. Journal of pharmaceutical policy and practice, 17(1), 2342318. https://doi.org/10.1080/20523211.2024.2342318