Podcast Diaries: The Cannabis Conversation E26

Why we love it:

The Cannabis Conversation is a much needed podcast which gets deep into CBD as an industry. We know a lot of you are avid readers so as usual, hit play, read along (or just listen) and see what all the hype is about. We get so many questions about CBD, lots of which we aren’t allowed to answer due to regulation so hopefully all the episodes we highlight from The Cannabis Conversation help answer all of your questions. To be clear, this is an external resource and we, as BeYou, are simply providing this as a resource. We urge you to research any claims by yourself.

That said, we’ve been listening to this podcast since it started so please do give it a listen – and as always go and find it on your favourite podcast app  if you like it. There’s so much to know about CBD before you buy CBD. Check it out.

Listen & Learn:

The Transcript:

The Cannabis Conversation. A European perspective on the emerging legal cannabis industry.

Welcome to The Cannabis Conversation with the Anuj Desai, where we explore the new legal cannabis industry by speaking to the professionals that are helping to shape it. So, I'm back from holiday, back from the Ardèche in France, which was absolutely beautiful, and I would highly recommend. Followed hot on the heels by Product Earth, which was this weekend up in near Coventry. It was fantastic. And I'll talk a bit more about it at the end of the show, but a really great event.

Coming up today, we've got Hari Guliani from Grow Biotech who will be talking to us about medical cannabis in the UK. Unfortunately, the recording came out a bit like it was a phone call, which was not expected, but hopefully the content is good. Enjoy.

Okay. Today we've got Hari Guliani on the show. Hari is COO of Grow Biotech, which is one of the leading medical cannabis companies in the UK and at the forefront of getting medical cannabis to patients in the UK. Hari is an ex-lawyer, like myself and has made the jump to a kind of more entrepreneurial game. So it'd be great to hear from him on a number of levels. Welcome Hari.

Brilliant. Hi, thanks very much.

Yeah, no worries. No worries. I've been trying to get you on the show for a while and now glad that you're doing some media. So, thanks for agreeing to do this.

Yeah, no problem. I think your show is doing really, really well. I think it provides some quite good insight into the industry and all the different moving parts. And, so I've been enjoying listening to some of the episodes myself.

No worries. That's great to hear. Thanks, Hari. Cool. Okay. Well, let's get straight into it. Maybe worth having a bit of a brief recap on what the law is in relation to medical cannabis? Obviously there were announcements made last November, but what's actually happening?

So, I mean, I guess from a very high level, medical cannabis is now legal and permitted in the UK. However, many patients or many of the people who've been using cannabis for medical, therapeutic reasons for a long time are really frustrated because there isn't the widespread access to medical cannabis that they'd hoped for or that they've been campaigning for.

So, at the moment, medical cannabis is available if a specialist consultant decides that, so that's a senior doctor in a particular field, decides that they think it might be appropriate for one of their patients. So that automatically restricts the number of people who are able to write a prescription for medical cannabis, because obviously that excludes GPs, and obviously it excludes people who are still relatively early in their career in developing specialist knowledge. But, it does make sense when you dig into it and you try and think about the rationale for why it's there.

So, legally, specialist consultants can write prescriptions, but at the moment, the NHS isn't supporting medical cannabis. And the main reasons for that have been set out recently in a NICE report. So, the National Institute for Care and Excellence, and the report effectively says, first of all, there isn't enough data for us to generally say, yes, we think medical cannabis makes sense for the NHS as a whole.

And second, where there is some data in relation to very specific products, the cost benefit analysis doesn't make it make sense for patients. So, the end result is that the patients who've been campaigning for many years, the people who have been relying on the black market, are unsatisfied because they don't have access to it in the way that they would other medicines.

That's a great little summary there. I mean, if we talk about the report to begin with, my reading of the report that was a fairly kind of conservative approach to this particular issue. What's your kind of insight on that? And as a business, were you quite disappointed in the outcome of that report?

So as a business, we've answered questions from NICE during the last few months to try and give them some insight into how the cost of medical cannabis in a private setting, which is where all the prescriptions are at the moment, how that cost ends up being what it is. And, so we were not as surprised by the approach, the sort of the areas that they were looking at. Being realistic, it's not unreasonable for the position that NICE are taking. They haven't said, "No, we'll never consider this." What they've said is, "We need to develop evidence."

So there are a couple of different ways that you could look at gathering evidence and the traditional methods that people might use if they wanted to normally launch a medicine into a market, is they go through a clinical trial process where they have, they'll control it and maybe have some patients on a placebo and some patients on the real medication and try and show efficacy that way. And then there is another way that people sometimes demonstrate efficacy, which is through observational trials. So patients will sign up to a trial, which means that they test out the medication and then data is gathered that people can then compare and contrast to see how effective the medicine is.

So where we're at now, I think is, the law does allow patients who can afford to go and see private consultants who are working in the areas where medical cannabis appears to be most relevant. So, if they can pay the private consultation and they can pay the fee of buying the medicine themselves, they can access it. But, the second piece of it is that the legislation almost provides a route through for clinical studies to be done in the UK, and what it appears NICE and the regulators and policymakers are looking for is evidence that's developed within a clinical setting within the UK.

There's a lot of interesting things there. It's understandable that NICE have perhaps reached their conclusions based on their existing and legacy way of thinking and approaching medicine in the UK. Does there need to be a change in the way that they do that? Do they need to start being a more open to this kind of observational stuff that you were talking about?

One of the key things that underpins the approach that the healthcare system is based on is that no doctor should be causing harm to any of their patients. So, the first question that people rightfully have is, "Is this safe or not?" Now, people who've been using cannabis for the last few years to help them with their condition will say, "Well, look, obviously it's safe and it's a lot safer than brain surgery or many of the alternatives, or potentially even opioids."

I guess the key is that we need that clinical data that shows safety. One of the big complexities that I've learned about, and that people talk about with cannabis is that we're not talking about a single chemical compound and the effect that has. We're talking about a plant that has tens of compounds in them, and from one plant to the next, within a batch, from batch to batch of the same strain you end up with varying levels of those cannabinoids. And so that's an additional level of complexity, combined with the suggestion that I believe is out there, that different people's bodies react differently to this, let's say they have identical cannabinoid profiles, or identical strains.

So, I think it is a complex area, and I think that there will need to be some allowance taken for the fact that this is cannabis. And, also the fact that this is not something that's a new discovery, obviously. So, there are people up and down the country using cannabis for medical or therapeutic reasons that they've self-medicating. There are people also using it for recreational or leisure or whatever other reason as well. So, maybe the approach that needs to be taken is a little bit more sympathetic to that scenario. So, I think the conclusion that many people are coming to in the UK is we can't hide from the fact that doctors would like evidence, they'd like facts, they'd like to understand what they're telling their patients to go away and put into their bodies and what the consequences of that would be.

We had a previous guest on, and I can't recall which was the guest, but was almost talking about creating a new category of medicine for cannabis, just for a number of the reasons that you outlined. Mainly because of just the sheer quantity of active compounds in it, and the kind of possible variations and combinations of those. It may almost require a new model of thinking in relation to this to sort of help it progress.

I think, yeah. I think that's possible. And I think doctors who are paving the way in the UK are not just following a tried and tested process. They're looking at it and they're using their experience and their skillset to assess patients and to continue to learn. So, I do think that what we'll end up with is a process that takes into account all of those complexities, takes into account the black market and the availability, but ultimately it's going to need to satisfy the requirements that it's safe, that it works, and that ultimately it's a cost-effective way of achieving patient outcomes.

What do you think fundamentally, if you haven't already said it, to change in the UK to get this more widespread? Do you think it's the tests that are the real blocker or are there any other factors?

I think there's a couple of things. So one of them, first of all, we just need clinical data collected in the UK, and that will happen as doctors become more comfortable with cannabis. We're seeing that. We're seeing doctors that had no previous interest and are becoming interested and are then looking at prescribing, and I think that will help. I think building out clinical data will help significantly.

I think the other issue that we see is, because of the rapid expansion of cannabis, both from the medical perspective, but also from a recreational perspective in North America, specifically, that the rates of expansion of the market is just too fast for companies to keep up with. So, you wouldn't have to look very hard to see plenty of examples in other countries where there have been serious shortages of products.

So, I think one of the other issues that the UK has faced is that because it's a young and emerging market, it hasn't necessarily had access to a range of products that are going to be reliably and consistently available. So, that's something that we've been working on very hard at Grow Biotech with our partners, IPS Pharma, to make sure that when we bring on board new products, they are going to be available consistently and reliably and the challenge. And I think we will see that challenge falling away relatively quickly, because there's a lot of work being done across Europe and other parts of the world to make sure that the supply is met.

And so when you say products, do you mean flower or do you mean oils or do you mean pills that have cannabis compounds in them? Or all of the above?

Yeah, all of the above. There's a huge range of potential products out there. So, flower is the one that people most naturally associate with cannabis. Many people will not be aware of oils, which are effectively extracts of the cannabis flower. And that's typically used where people can't sit and vaporize a flower. In some countries, there are people with vaporizer devices similar to e-cigarettes. So you have a liquid and you can vaporize that way. But, we're also seeing pills that if you put them out on a counter, you would have no idea that it's got anything to do with cannabis. It would look like just any other generic pharmaceutical. And, so I think we are seeing some companies really trying to take on that challenge of making cannabis like a pharmaceutical.

Yeah. Yeah, I imagine from a psychological perspective, the idea of a pill, which is, we're all very comfortable with probably changes your approach to it, but that's probably a topic for another day.

Yeah.

So, I mean quickly, when you talk about what sort of things are Grow Biotech doing to sort of help? You've talked about a couple of those things in terms of bringing products into the country. Are you guys doing anything else?

Yeah, so the bit of the business that I work on is focused on solving the issue of the fact that medical cannabis is now legal, but there are all sorts of hurdles that people have to address. They might be from a purely logistic point of view, getting the products into the country and then delivering it to a patient or to the pharmacy. But also, this is a new class of medicine and doctors don't know anything about it. So, consultants will ask for information on products and we have a team of people that are from a pharmaceutical background, so they've done this with all sorts of other medical products or devices, who are able to then give information to the doctors in a way that they understand.

So, in that regard, we are trying to provide, effectively, a turnkey solution that helps doctors go from interested in cannabis to having satisfied patients. And I was on the phone earlier this morning to one of the doctors who uses our services and has prescribed our products as well as products, other products that haven't come through us, and that doctor likes the service we provide because they know it's compliant. They know that we provide a next-day delivery service to patients. So, patients get their medicine delivered at home the day after they've seen their consultant. But, today I was told by that doctor that one patient has now completely come off their opioids.

Fantastic.

As a consequence of the medication and the consultation of that doctor has been having with that patient, which is really very exciting. I think it's just a sign of maybe the potential. So, we don't make products ourselves. We look to finished products because we want to see products that have been used in other countries and that have got evidence behind them for particular indications or particular conditions. And we package up the information that's needed, so that as and when doctors want that information, we're there to support them, as well as helping them with all of the red tape that's involved with starting to prescribe a controlled substance.

So that's that, but then the other side of our business is research and development, which naturally people think is to do with making new products. It isn't, it's actually looking at the issues that we've already talked about a little bit around cannabis and its complexity and taking what is fundamentally is a plant that has been bred over many, many years for a particular purpose and has a number of issues like the consistency of the chemical compounds, or other things. And, so our research and development is around finding tools or processes that would enable cannabis to have a better medical outcome for patients.

That's great. I mean, I think, and it sounds like a very smart move from a lot of the stuff that I'd been reading. I've been seeing a lot that says that owning IP in this industry is going to be crucial to sort of winning, really, rather than just growing or having huge capacity of land, et cetera. It's about, I mean, look, that's quite a categoric statement, but I think it's going to be really key to expanding your business.

Well, I also think just to pick up on that, if you look at most other industries, people specialize in what they do, and people buy in expert services and they buy in machinery or tools or assets that help them do something in the way that they're... They've been focused doing what they do. So, cultivation is a real skill and then processing the flower once you cultivate, it is also a real skill.

And then, at the other end of it, you've got the doctors who are interacting with patients and the nurses and the clinic managers and the people that interact with patients and make all of that an experience that makes them want to come back. So, I think it's just another part of it. But, our view is that it's an area that not enough people are looking at. So it provides a big opportunity, but also means we can have quite a big impact, I think.

Yeah. Yeah. Innovation. Sounds great. Cool. Okay. Well, thank you for that, Hari. And that's a good run down and on what's happening generally, but also about how Grow's helping to sort of progress the UK medical sector. Maybe we could talk a little bit about yourself?

So, as I mentioned at the top of the show, you are a lawyer, much like myself and much like myself, you've been trying to shed that label for a while.

We're both recovering lawyers.

We're both recovering lawyers, indeed. So yeah, tell us a bit about your personal story. What were you doing before and what prompted you to sort of move into this area?

I trained and worked as a corporate lawyer in London. So I found it really interesting looking at different businesses that were being bought or sold or raising money or whatever they were doing, but I kind of wanted to be on the other end of the phone. And, so I moved in-house to a fund for a little while, but it wasn't really scratching the itch that I had to go and do something a bit more entrepreneurial, a bit more business-focused and where I felt a little bit closer to the end outcome of what you were doing.

I came into work one day and just had enough. So I sat down and, as you know, lawyers don't like spreadsheets. So, I did get a spreadsheet up and fumbled my way around it and worked out how long I could survive with the money in my bank account. And, I didn't resign the next day, but I made the decision and I was done pretty soon after that without really a plan. So, I spent a few years consulting in a range of different industries and different roles from running solo transactions to working on a few startups. I did some crisis management type work and with all sorts of different companies and I-

Both legal and non-legal type work?

Well, I tried to stay away from legal as much as possible. Quite often the route in would be through the legal background, but I really tried to stay away from that. And so I did that for a while and somebody I had worked with, who you know, who you've interviewed, Tom Gray told me he was leaving his job to join the cannabis industry. And I didn't really know what he was talking about, [crosstalk 00:20:55]. So he got-

That happens most of the time with Tom, right?

No, I was just sort of a bit surprised because my perception of cannabis was TV shows, North America, people saying that they had a medical cannabis card, but really it wasn't medical at all. I had no idea about all of the really genuine and sincere medical claims that people have made around cannabis for a really long time. But, so I came along and got involved a little bit with seeing some of the early stage companies. I went to a few events and started to see the caliber of people that were involved with a huge range of skillsets, so whether that's scientists or people with a sort of political or lobbying background, through to a level of interest from financiers and people like that. And I was quite interested by it, but more so by this entire area of the patient groups that I really just didn't know anything about.

So, I decided I'd sort of stick around. I did some consultancy work with Grow, and that was around about the time that the legislation changed to allow medical cannabis, which was again, another bit of luck. And so then I was offered a role to come on as the COO, and so I've been in it ever since. So, it's really a consequence of me looking for something that would be exciting and interesting and a little bit unchartered. The high impact, the sort of social impact it was, shouldn't be understated. But, in reality, it was just complete luck that this revolution was going on at the same time as I was looking for something like it.

Yeah. That chimes so much with where my experience as well. And I kind of feel like you, mate, like you look a bit. It doesn't happen overnight. So, that's great. And now we're going to move on to my final and traditional question of what did your family say when you told them that you were going into the weed business?

Well, I'll say what everyone else says. It's just, "Can I have some free samples?"

So in reality, so my... It's quite interesting actually, because my sister works in psychiatry, and had spent some time at a facility where people are quite seriously affected and she had witnessed the impact that some of the skunk on the street can have on people that were otherwise getting their mental illness under control. So she was initially really against it. But since then, she and I have spent a lot of time talking about it and learning from each other.

And, actually her views changed to the extent that she's seen research and evidence and is a lot more interested in it and understands that it isn't just this high THC, potent, super skunk that might be out there. I think it's also given me an understanding, and a very real understanding, that there are risks obviously as well with cannabis and that all comes back to the sort of safety and efficacy part.

With my parents, I think, I mean, I can't really remember. I think it must have been a relatively underwhelming response. It's one of those things, isn't it? You build it up in your head, and I think it's becoming increasingly easier because some of the people that are in and around the industry now were in long before anybody could really imagine it being legal in the UK. I sort of got involved just as public perception was starting to change already. And I think we've seen a huge amount. The interest level and the amount being... The amounts of people that are, sort of the number of people that are actually out there talking about cannabis, talking about CBD, talking about other things like that, I think is increasing, which I think makes it a little bit easier for people coming into the industry going forward. But naturally there'll always be some stigma, I suppose.

Yeah. Yeah, no, for sure. We've moved along quite a lot, but there's still obviously quite a fair bit to go. I think it's really useful having the London Evening Standard as a positive publication that is putting out some good stuff in relation to cannabis. So, that's certainly helping.

I think generally people engaging in the debate is a good thing. I think if we end up with, this paper is pro-cannabis, this paper is against cannabis, I don't think we'll actually ever get anywhere. I think we, both sides of the discussion should be engaged with, but I think it is great. And I think that the public interest is high. And I think the best thing about it for me is it isn't just people that want to be able to smoke a few joints recreationally or whatever, it's actually, people are really supportive of the potential healthcare angles that you get with medical cannabis.

Oh, a good note to end it on. Thank you, Hari. Really, really useful and glad I finally managed to secure you onto the show. This is good and no doubt would love to have you back as a guest in the future.

Brilliant. Well, thank you very much. And also, I think we need more people like you who are really surfacing what's going on in the industry for everyone's parents who are maybe a little less in favor of it.

I wholeheartedly agree. Thank you very much, Hari.

Thank you.

Cheers.

Thanks for joining me for that. I hope you enjoyed the show. Hari is a good friend of mine in the cannabis industry, so I'm very happy to get him on the show. Really interesting what they're doing there. So many challenges still exist, but hopefully companies like Grow Biotech are helping to address those issues.

So, as I mentioned at the top of the show, this last weekend was Product Earth Festival 2019 up in Stoneleigh Park, near Coventry. I had an absolutely brilliant time there on so many levels. First, it was great to host the seminar stage. I'd never done that before, and it was really good to actually get out in front of people. Hiding behind this mic serves its purpose, but it was good to be on stage and to meet and interact with people.

Secondly it was meeting so many people. I met loads of people through the seminars, but also attendees at the festival. And I particularly enjoyed hanging out with the guys from The Emerald Cup. For those that don't know, The Emerald Cup is the world's premier cannabis competition hosted in California in December. And they were the key sponsors for Product Earth, so they came over in force and it was great hanging out with them and they gave a load of great talks as well.

And thirdly, and probably most importantly, the speakers that were talking about hemp, I was really blown away by the story for hemp and it's annoying that there has to be a story for hemp because it's too compelling to ignore. With the Amazon burning and plastics going through the roof, we really need to look at alternative sustainable products and that hemp is just so incredible on thousands of levels. So, expect a lot more pro-hemp information for me over the next few weeks, and I'll be getting a few more guests on to speak about that.

If you're liking the show, please, can you subscribe? It would really, really help me. If you can, can you also share and like and do all those things? You can do them right now if you want and I'd be forever grateful. Okay. Until next week, have a good one.

 

Show Notes:

This week, we warmly welcome Hari Guliani, COO at Grow Biotech to the show! Grow Biotech help to bring medical cannabis products to the UK and research and develop market entry strategies and technologies for medical cannabis producers to create better, cost effective medicines.

Together, we discuss the current laws and regulations governing medical cannabis, availability, access to medicine, and hopes for the future.

Episode Summary

  • Medical cannabis was legalised last November in the UK by Sajid Javid, the Home Secretary with the aim to give more UK patients access to cannabis-based medicines. Although technically legal, only a small number of patients have access as it is only prescribed privately and only by specialist consultants who can only prescribe when they see no other options available.
  • Many patients in the UK are incredibly frustrated due to the lack of access, especially since it is not currently supported by the NHS who are concerned with the lack of supporting evidence and the cost of purchase.
  • In August 2019, NICE (The National Institute for Health and Care Excellence) published its draft recommendations on the use of cannabis-based medicinal products following a comprehensive evaluation of their clinical and cost-effectiveness. The review highlighted the lack of evidence about the long term safety and effectiveness of medicinal cannabis.
  • The draft guidance did not recommend Sativex for treating spasticity in people with multiple sclerosis because it was found to be not cost-effective at its current list price in relation to the benefits it provides, although it has been licensed in the UK to treat this problem.
  • If we want to see the widespread adoption of medical cannabis based products within the UK, we need to see the collection of clinical data. This will happen as doctors become more comfortable and informed about cannabis.
  • Because of the rapid expansion of cannabis markets, (recreational and medical), products are often becoming unavailable and cannot be bought consistently. This poses a problem for the UK medical cannabis market as medical drugs need to be readily available if patients are relying on them.
  • Hari is a former corporate finance lawyer & strategy & operations consultant with experience across a wide range of sectors. He left law behind to work across startups within crisis management and consultancy before being inspired by Tom Gray (founder of Blume Jobs) to join the cannabis industry.

RESOURCES

Join Hari on Linkedin:https://www.linkedin.com/in/hariguliani

Grow Biotech Official Website: https://growbiotech.com/

Grow Biotech Twitter: https://twitter.com/growbiotech?lang=en

NICE Guidance (Medical Cannabis): https://www.nice.org.uk/guidance/indevelopment/gid-ng10124/documents

Blog post - Does the UK really have medical cannabis?: https://blogs.spectator.co.uk/2019/05/does-the-uk-really-have-medical-marijuana/