Amanda Daley on how doctors are learning about medical cannabis

Amanda Daley, VP, medical sales and education, Canopy Growth, recently joined MM&M’s executive editor Marc Iskowitz on MM&M’s Transforming Healthcare webcast, which offered a sneak peek into some of the cutting-edge educational content in store at May 8’s Transforming Healthcare event. The following interview has been condensed and edited.

Marc Iskowitz: As VP medical sales & education, for Canopy Growth and Spectrum Cannabis, you oversee the commercial medical strategy for Canopy, including the medical sales team, and the creation and implementation of CME programs. Lay some context on that.

Amanda Daley: I’m responsible for the Spectrum Cannabis commercial business in Canada. Spectrum Cannabis is Canopy Growth’s international medical brand. It’s our healthcare professional and patient-facing identity in medical markets in Canada and around the world. Spectrum Cannabis is focused on the simplification of healthcare interactions, and my role is to oversee the team efforts around the work we do with the healthcare community, patient and professional organization partnerships in addition to overseeing our Customer Care function that we provide to our medical clients here in Canada.

Canopy Growth, for anyone who isn’t familiar with us, is a world-leading diversified cannabis and hemp company, offering distinct brands and a collection of cannabis varieties in a variety of product forms—presently dried, oil and softgel capsule forms. We’re listed on both the Toronto and New York stock exchanges and have operations in 15 countries across five continents along with 10 licensed cannabis production sites with over 4.3 million square feet of production capacity, including over 1 million square feet of GMP certified production space.

Iskowitz: In Canada, is “medical sales” the equivalent to our “medical science liaisons” here in the U.S., which typically sit under medical affairs along with CME and scientific communications?

Daley: Not quite. Our medical sales function consists of our field team who are developing relationships with healthcare practitioners and providing support and education to help these medical professionals navigate the complexities of medical cannabis. We do have a CME team involved in medical education through partnerships with clinical experts and scientific organizations, and the intent is to expand our medical affairs team in the near future in order to continue to meet the needs of HCPs and the medical community.

Iskowitz: Your background includes 15 years in the pharma industry, including a decade at Pfizer Canada. Why, and how, did you transition from pharma to the cannabis industry?

Daley: It was about five years ago when new regulations were introduced in Canada that allowed for companies like Canopy Growth to participate in the medical cannabis industry. What was missing at that time was the ability to deliver evidence-based education for doctors, which is something I had many years of experience in at Pfizer. I had worked in the field of pain and after doing my own research, medical cannabis seemed like a promising space. It felt like it was time for a change and I decided to make the leap into cannabis.

The way doctors learn about medical cannabis is very different compared to other medications.

Iskowitz: Medical marijuana is marijuana with or without the THC or the CBD component. What is the regulatory situation in Canada with regard to this? What kinds of form factors are available, and how are they dispensed?

Daley: Medical cannabis is medicine derived from the cannabis plant and may contain THC, CBD or both and they both have their own respective therapeutic benefits. THC and CBD are cannabinoids, of which there are more than 100 that have been identified in cannabis. The pharmacology of the most prevalent cannabinoids, THC and CBD, has been well researched. The human body has its own “endocannabinoid system”—so these constituents of the plant have a target.

While many people think that CBD is the medicinal property/cannabinoid and THC is a non-medicinal aspect of the plant, they both have potential therapeutic benefits. While THC is responsible for the traditional euphoria inducing effects of cannabis, the “high,” it has been shown to be beneficial for various symptoms including treating chronic pain, spasticity due to spinal cord lesions, nausea and vomiting, as an appetite stimulant and as a sleep aid.

CBD, on the other hand, does not cause euphoria, or the sensation of being “high” that recreational users are looking for—in this way, it is “non-psychedelic” but still has a “psychotropic” effect meaning that it can have an effect on the brain by way of neurotransmitters. CBD has been shown to be effective in certain clinical settings including functioning as an anti-inflammatory to improve pain, as an anti-epileptic in treatment-resistant seizure disorders and potentially as a treatment for anxiety, among others.

Patients will most often use different varieties, often called “strains” (or ratios of THC to CBD) to treat different symptoms. Cannabis for medical purposes has been legal in Canada since 2001 and requires an authorization from a healthcare professional—either a physician or a nurse practitioner. Cannabis is also legal for recreational use in Canada, as of October 2018.

Licensed producers such as Spectrum Cannabis, which are regulated by the federal health authority, Health Canada (similar to the U.S. FDA), are permitted to grow, produce and sell medical cannabis and extracts from cannabis to customers who have a medical authorization from their HCP. Depending on the patient’s needs, this can be in a form that can be inhaled (dried flowers) or, as is increasingly popular, ingested (cannabis oil or softgel capsules). Additional innovation enabled by regulations expected later this year will bring more formats into the medical cannabis market.

Iskowitz: How have you increased doctors’ comfort level with medical cannabis? What kinds of med ed and marketing tactics are resonating?

Daley: It’s important to understand that the way doctors learn about medical cannabis is very different compared to other medications. It’s generally not taught in medical school, and the same resources that doctors have access to once they’re practicing don’t exist.

Our role is to provide that education, combined with leveraging key opinion leaders to assist in our efforts to educate HCPs—ensuring that what we present is evidence-based, balanced and credible. Ensuring that we have content that is presented in a variety of both academic and community environments is key.

Simplification is also resonating with doctors, as medical cannabis is complex. There are different varieties or strains and formats, including whole-flower, extracts, and softgels, not to mention terpenes which is a whole other area to consider. It’s not a one-size-fits-all approach and often means a trial-and-error approach for the patient to find the product that best meets their needs. The ability to simplify this understanding for both the HCP and their patients is key. Our approach to product selection is through the use of Spectrum’s color-coded system that categorizes products based on THC and CBD levels in the product

Something that has also helped raise doctors’ comfort level with medical cannabis is patients’ lived experience—the fact that it is having a meaningful impact on their health and wellness.

A research gap does exist, and the work we are doing on this front is also important. We’re developing a comprehensive body of evidence to complement existing real-world evidence. We are committed to conducting rigorous clinical studies on cannabis and are hyper-focused on developing and researching clinically ready cannabis drug formulations and dose-delivery systems.

The strategies and tactics in pharma marketing are highly applicable in medical cannabis. Most of our marketing and sales team comes from pharma.

Iskowitz: Do you see medical marijuana integrating with the prescription drug business or growing parallel with it? What are the major differences?

Daley: Until there are more patented cannabinoid therapies, cannabis really should be seen as running in parallel to traditional drug treatments. There are significant unmet medical needs for patients, particularly with conditions such as chronic pain, where standard therapies have produced sub-par results. We see medical cannabis as either an alternative or not necessarily replacing, but as an adjunctive option for patients.

In North America especially, the opioid crisis has left patients and physicians looking for new answers, and we see medical cannabis as another care pathway. The opioid crisis is an issue that we as a company felt the need to do something to help find solutions for, so we’re currently funding research by way of a $2.5 million donation to the University of British Columbia and the British Columbia Centre on Substance Use, which will be conducting research and controlled trials examining the possible utility of cannabis in addressing the overdose crisis.

Ultimately what will drive this is research, pre-clinical and clinical, to enhance understanding of safety and efficacy of medical cannabis for various indications that will bring more physicians and more patients. Additionally, as that research advances through drug registration, eventually we will start seeing prescription drugs, products with a drug identification number derived from cannabis, come to market that are very focused on very specific indications.

This will help to grow the market overall, but medical cannabis will also continue to grow outside of the more traditional prescription drug business because not everything will be the subject of a drug registration—take, for instance, natural health products that mainly contain CBD.

Iskowitz: What is Canopy’s global expansion strategy? Is the firm looking to partner with established pharma manufacturers who might want to add a CBD offering to their pain management portfolios?

Daley: We have initiated operations in over a dozen countries across five continents where there is a legal framework for medical cannabis, and it is our intention to continue to do that as more countries introduce medical cannabis regimes. We are always open to value-added partnerships across all of our global and regional business units, in particular where such partnerships enable us to deliver more and/or better products and services to our communities.

We see ourselves as innovators in a disruptive space. Our goal is to become a global medical company that is focused on improving the lives of patients around the world.

Iskowitz: As marijuana becomes legal here in the U.S., and as that business expands here, how can those in pharma marketing who are interested leverage parallels between the two industries?

Daley: Whether pharmaceutical, medical cannabis, or over-the-counter CBD products, it still all boils down to safety, efficacy and doctor/patient engagement. Our view is that the skills, strategies and tactics in pharma marketing are highly applicable in medical cannabis and in fact, most of the marketing and sales team at Spectrum Cannabis comes from pharma.

To hear more about the applicability of pharma marketing skills to medical cannabis, come to the MM&M Transforming Healthcare conference on May 8 in New York City, where Daley is slated to give the closing keynote. Click here to see the agenda and to register.