Who’s to Blame for Israel's Medical Marijuana Shortage?

Pharmacists blame growers and growers blame druggists. Shortfall has grown since reforms went into effect

File photo: Cannabis seedlings are cared for by a worker in a green house of the cannabis cultivating and processing plant of BOL Pharma.
Bea Kallos / MTI / AP

Medical marijuana is supposed to be Israel’s next big growth industry. The government approved exports and on the Tel Aviv Stock Exchange until recently, the market capitalization of marijuana companies had reached the billions of shekels. At home, pharmacies have been authorized to sell medical cannabis products, and more and more doctors are getting approval to prescribe it.

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But instead of a medical marijuana boom, the Israelis who need it are encountering a severe shortage in the weeks since the reforms have gone into effect. That, in turn, led this week, to a war of words between the companies that grow and package medical marijuana and the pharmacies that supply it.

“It’s frustrating for a patient who needs a drug not to be able to get it after 40 phone calls, or to get four of the 40 grams he needs by the end of the month. These are not potheads, they’re sick people who have trouble walking, functioning,” said David Pappo, chairman of the Pharmaceutical Association of Israel and owner of the Tlalim Pharmacy in Ramle.

He said his pharmacy has not been functioning for the last three weeks. “I get between 80 and 100 phone calls a day. Each call is a minimum of three minutes, just to be kind. We are completely paralyzed,” he said.

Until March, Israelis who had prescriptions allowing them to use medical marijuana could only buy it directly from a handful of licensed growers. Now they are allowed to buy it from pharmacies as well, including nationwide chains like Superpharm.

About 25 pharmacies are approved to sell medical marijuana to 28,000 registered users.

In an interview with TheMarker, Pappo said the companies growing medical cannabis were supplying a poor product that was often contaminated with mold, funguses and traces of pesticide.

Unlike the growers supplying product directly to users, pharmacies he said, have quality standards they have to meet and can’t cannabis and cannabis products that don’t meet them.

Pappo accused the surfeit of companies that joined the original eight growers for failing to meet minimum standards.

“Wonder of wonders these companies that issued shares on the stock exchange who claim to have more than enough knowledge in agriculture are unable to grow a proper crop,” he said. “Either all their talk about the knowledge the accumulated was nothing, or something else was hiding behind their inability to provide medicine suitable for patients.”

Growers, however, deny responsibility for the shortage or for inferior products. Gil Hovesh, CEO of the Pharmocann, who’s company doesn’t supply pharmacies, went so far as to call the pharmacy association’s claims a “base lie.”

“Ninety-five percent of the complaints I receive are from patients who buy at the pharmacy and then come to me and beg to be my customers,” Hovesh said in an interview. “Our quality control -- and I believe also among our competitors -- is very strict. If there’s a seed or a plant with a problem, I can locate the harvest from which was taken.”

Hovesh attributed the shortage to the fact that at this stage only two of the eight companies – Breath of Life and Seach --now licensed to sell medical marijuana can sell to the pharmacies. Pharmocann expects to get approval in August, at which point it loses the right to sell to users directly.

Another grower, who asked not to be identified out of concern he would be targeted by regulators, blamed the pharmacies for the shortage. He said they don’t have enough secures facilities to store medical cannabis and aren’t careful enough in prescribing products.

Pappo and the health Ministry still do not recognize what is known as the “entourage effect,” where cannabis’ active ingredient THC reaches its full potential when combined with hundreds of other compounds in the plant.

What that means, he explained is that one kind of cannabis has a beneficial effect on a patient, another may not.

“With cannabis oil, it is even more extreme,” he said. “There are children for whom only have a certain kind of oil helps them …. But the pharmacies still think that you can offer cannabis oil of any kind and don’t understand why they get complaints that it’s not helping.”

In addition, the typical pharmacy only has a tiny safe, no bigger than ones installed in hotel rooms, so they are in no position to inventory medical marijuana from 4-5 suppliers.