The Patient Experience: Impact of the Medical Pilot Program The Illinois Patient Experience 123rf Image ID : 50534654 Table of Contents 4. 3. 2. 1. implications market Healthand care findings Methodology and research summary Background and executive About Aclara Research 2 The Illinois Patient Experience spending per participant of $934 Rx Average and(3) painconditions chronic impactedby Medicaid program the in adults participating of 40% (2) $1.8B spending drug prescription Illinois (1) on based is MedicaidMillioninsavings $180 costs using annually in in sclerosis multiple treating autoimmune diseases as chronic respondents are managing pain daily medical background check and fingerprinting treatment. medical T Background Across IMPACT of As and one signed was The he the a result Compassionate Compassionate patient application of of is 9 Illinois battle medical April 2017, 2017, April disease. would not the the pain cannabis cannabis cannabis 1 OF of a qualifying condition in Illinois, Illinois, in condition qualifying a most restrictive most Study United Industryobservers into with with their result – MEDICAL 2 trouble law almost almost with 41 qualifying qualifying 41 with respondents patients condition. Cannabis Cannabis condition. States, many attributes many in in Use Use which $ 2013. 180 . sleeping, requirements which include a criminal Applying 18,000 18,000 of of Cannabis Pilot Program symptoms CANNABIS – Million chronic in Medical Cannabis Cannabis Medical the and and Illinois the have indicate such such leading symptoms of severe and Illinoisresidents are country country back they are these savings inflammation of became labelled debilitating as arthritis, arthritis, as . of chronic and shows shows that ON chronic results - to based finding relief from 86% the the HEALTH 33 the strong potential in in potential strong Pilot Pilot pain. % to 20th pain fibromyalgia conditions conditions pain, Illinois program Illinoisprogram of survey of Illinois plays on of a Program Program recent Although the Illinois impact state and a CARE registered Medicaid condition central anxiety to study for patients over Act Act legalize and and chronic COSTS their role as on 130 program – list, the STOPPED Million : impact . adult use cannabis sales cannabis use adult eight access Twenty Twenty $ to Illinois Medicaid spending: Potential Cannabis Medical Savings Americans 180 using of have expanded to include include to expanded have medical to nine states offer legal legal offer states nine all medical medical Million prescription at cannabis a cost cannabis, of on $ drugs 635 Medicaid and and Billion after 3 The Illinois Patient Experience ExecutiveSummary program program • • • • • experience The Aclara by autoimmune conditions resulting in chronic pain in America. program illuminate keyFive cannabis Health Need Demographics: cannabis patients are Retailand Experience: Spending symptom cannabisproducts using Usage study Research States: . Behavior: Behavior: Care: on insights emerged from This on focused products? on prescription prescription on : the relief? the registered buying study impact What Why Why patient has Who Who on How How conducted are patients patients are is of five key and and of of the is experience 296 are patients are patients the the selecting selecting for impact drug patient? respondents medical cannabis cannabis medical areas the usage? this study in using of first Illinois, and particularly on womenIllinois,and particularly – of How How which the cannabis? study patient is which includes the of Illinois largest perceived patients and most efficacy, since comprehensive the – cannabis who are disproportionately impacted impacted disproportionately are who inception usage of study the and medical of purchase the impact cannabis behavior of pilot the . 4 Methodology and Research Findings The Illinois Patient Experience Methodology We used a mixture of qualitative and quantitative methods for this study • • • • Topicsincluded: focus areas and invited members to respond. patients community Cannabis Medical We explored qualitative insights insights qualitative explored We partnered Research Aclara Qualitative Retail Retail Perceived Commonly Doctor experience and product selection product and experience and adult use consumers. use adult and and patient communication patient and of of product efficacy experienced symptoms experienced Illinois Illinois Community, Community, medical cannabis cannabis medical with the the with an an online across across Illinois Illinois key 1.5% of the Illinois patient patient Illinois the of 1.5% Illinois 269 respondents survey online question 71 a fielded We Quantitative Thestudy was 2017 February in and represented fielded • • • • Demographics • data quantitative collected We 27 Patient Patient Product Health Need Adult use consumers use Adult States and usagedrivers and States Care, Pain Levels and prescription drugs prescription and Levels Pain Care, spending, retail experience and product selection product and experience retail spending, usage, dosing and methods of administration of methods and dosing usage, medical medical from the cannabis online community. cannabis registry patients on the following topics:following onthe . across 296 296 across adult adult 6 The Illinois Patient Experience symptoms of chronic 86% of patients suffer with Research Research Findings: mixes of medications. of mixes hazardous potentially these taking those of thirds two nearly for accounted Women medications. of mixtures patients taking pain treatments long conditions for term were prescribed potentially dangerous pharmacy management of Express anleader benefit services,industry nearlyScripts, 60% of that indicate treat be disregarded by doctoras their “emotional” and “not real”. to likely are pain of reports their but conditions, pain chronic from suffer to likely more women are only Not Impactwomen to with chronic painconditions: symptoms. pain chronic manage to cannabis medical using are patients of 86% Illinois, in condition patient pathpurchasing to cannabis. Despite the fact severe that and chronic pain is nota qualifying symptoms these from relief Finding diseases impact women threetimes more frequently than developing chronic pain conditions, such as multiple sclerosis and rheumatoid Autoimmune arthritis. than men. A 2009 study in the Journal of Pain found that women have a substantially higher risk of symptoms cannabis there are five common symptoms across patients Illinois, in cannabis medical access to required conditions specific 41 the Across index 10% symptoms that patients treat with medical cannabis There are 41 qualifying conditions in Illinois Illinois in conditions qualifying 41 are There mental health issues that may not even exist. exist. even not may that issues health mental usage. across respondents respondents across - 50% higher for these symptoms than men. than symptoms these for higher 50% Trouble Trouble 6 sleeping, body ache, back pain and anxiety are the leading leading the are anxiety and pain back ache, body sleeping, – and female patients index index patients female and - which impact over 130 Million Americans Americans Million 130 over impact which - and five common and – which are the driver of their their of driver the are which pain . Women men. t en 5 to fifty percent higher for these symptoms 2 Thismay leadto - additional prescriptions to to prescriptions additional is step the first in the 7 Research Findings: 33% of respondents stopped using prescription drugs after using cannabis

Consistent with previous Aclara Research studies across medical cannabis markets, cannabis provided sufficient pain relief to eliminate prescription drug usage and manage multiple symptoms of pain and discomfort. Patient Experience Patient In Illinois, 33% of respondents stopped using prescription drugs – and 92% decreased the number of prescription drugs Illinois used. The Researchers at the University of Georgia have linked medical cannabis legalization to a decrease in Medicaid costs of $1 - $3.8Billion.9

Applying rates of chronic pain incidence to the adult Illinois Medicaid participant base, the state could save over $180 Million - and improve patient health outcomes for patients using cannabis to relieve their symptoms.

100 Million adults suffer with chronic pain conditions.1 Applying Total US metrics to adult Medicaid participants in Illinois could decrease prescription drug costs by $180 Million.

8 The Illinois Patient Experience program, states. different in programs marijuana medical from significantly differs base patient Illinois patients are completely NEW using to cannabis when they become a registered patient. In this the regard, registered patient. Aclara Research studies across Michigan, Oregon and a becoming before cannabis using experience have patients cannabis medical most markets, Across staff training, product labelling, patient education and outreach. patient base. product female the for This Twenty of Across the United States, women have lower usage levels Women 7% and Men 12% *Gallup, One in Eight US Adults Say they Twenty two percent of patients – users cannabis new are Research Findings: cannabis than men* trained dispensary and this is driven by women by driven is this and underscores patients six choice contrasted and percent staff and knowledgeable – Implications for retailers and manufacturers include include manufacturers and retailers for Implications the have dosing of member with need female an 12 . increased for % S - moke Marijuana, August 2016. is and this is evident across the Illinois respondents of comprehensive the dispensary male leading need respondents staff for influencer began product education members using . of knowledge, product cannabis and at retail outreach selection . for Sixty usage the across two Colorado and first in percent store education the time . state, indicate less than 6% of Patients, upon of patients as regarding registering well and indicate as particularly the cannabis for need that the 9 The Illinois Patient Experience products 75 the Colorado consumers $ rapidly 50% higher for Across CBD is industrial from CBD and markets, use adult and medical nausea. CBD cannabis 47% 47% of patients Cannabidiol (CBD) of use Increasing Women drive this usage trend Research Findings: 35 increasingly % next Billion of include not total expanded CBD CBD women probiotics across and only and use probiotics respondents, is a products derived from cannabis are available in in available are cannabis from derived products industrial available available Illinois, the demonstrates reduction the a use to variety non CBD usage market? Illinois consumer CBD over - psychoactive derived from from derived cannabinoid psychoactive . hemp. to global in . of 47 general market consumers. consumers. market general market, 40 pain, This % product % medical Commonly market use markets use daily are than men anxiety, group and consuming cannabis – – forms 7 efficacy indexing indexing daily within dominated of inflammation, known patients dosing to derived the across CBD gain benefits infused level by identified within medical a CBD and hemp variety food by food of daily pill, product and and their of tincture, and and symptoms health beverage beverage type preferred women or . benefits edible and drive products, segment cannabis . conditions, form this Across . . usage Is Similar derived patients cannabidiol Michigan, but trend to CBD and has the – 10 The Illinois Patient Experience patients serve being metrics, and Could gain within options patients Patients from relief theirmedical condition patients, program patient flower previous as production $40,000 AND spend more than 49% of patients earn $3000 Findings: Research The Illinois $480 implications relief. daily. cannabis Aclara count of 18,000 18,000 of count chronic pain patients per 7 that in medical cannabis cannabis medical in where the The in of the ounce Price Price experience chronic chronic experience Researchstudies, the high America? the health care system care health on medical cannabis neighboring question industry 47% 47% to ( equivalent to 28 equivalent( to of of health care system care health quality medical medical medical cannabis cannabis medical of in regulations patients emerges: cannabis Illinois. Illinois. decrease state and and average increase increase prescription grams) pain spend less than $1200 per year to gain of In In – – without have are . the Michigan comparison, comparison, 8 symptom and and of may the patient restrictive, exhausted prescription prescription exhausted largest cannabis are are pesticides. Prices be annual patient well drug serves now uses driven less than s - the the flower but insurers are significant. group 2 paying over cost medical grams by largest group facilitate the - 218,000 and based on on based and out out to of of relatively cannabis may cannabis of of the drug be pocket as of of low high to US household ($7,023 the averagespending for food products. cannabis medical pre of 8% than more spending are $40,000 That’s almost half of the total total the of half almost That’s earningHouseholds than less - tax income on on income tax annually) 4 11 Health Care and Market Implications The Illinois Patient Experience **Market opportunity contingent on conversion rates of eligible users within Illinois (5% *American Health Care Implications Care Health cumulative economic impact of more than $300 Million Addressing autoimmune diseases and the impact on women has a Women’s Health Care, Government Spending and Market Expansion: $130Million annually.** $130Million relief with cannabis, the industry could expand by and Crohn’s IBS, Fibromyalgia, outcomes.If 10%Illinois of residentswith autoimmune withsimilarconditions. fellow patients of efficacy perceived higher of aware not are women system care health the within met that women’s health care needs are not being are issue Cannabis continues to show efficacy efficacy show to continues Cannabis Auto women.* Previous research studies indicate indicate studies research Previous women.* - AutoImmune – immune impacting 50 Million adults ofwhich 75% diseases diseases are a women’s health care Related Disease Association 2 and improving patient patient improving and by $130 Million market the expand outcomesand care health Improve women’s Sjogren’s – and most most and in treating found Medicaid prescription drug costs. drug prescription Medicaid to savings annual $180Million a in result would participants Medicaid state to results these Applying cannabis. medical using after drugs Rx using stopped Aclara - 20) Research33%respondentsresultsindicate of prescription usage. drug medical cannabis cannabis medical within states that offer access to to access offer that states within savings to the Medicaid program program Medicaid the to savings $1B a identified Georgia ResearchersUniversity the at of Million Medicaid $180 drugs and save prescription of usage Responsibly decrease - driven by decline in - $3.8Billion $3.8Billion 13 The Illinois Patient Experience multi expectations exceedspatient and promotion pricing distribution, your Ensurethat patients have shopped atmore than one dispensary. patients are shopping multiple outlets to change the store of record. Despite this limitation, dispensary increase customer loyalty. patients make effective health care decisions and help to staff haveknowledgeable must Retailers usage. care and education at the dispensary State restrictions limit patients to shop at one one at shop to patients limit restrictions State cannabis new to completely are patients female of 26% DifferentiationInvest Loyalty: in and patient Retailer Implications Retailer - outlet shopping. outlet – and require pre require and - registration with the state - before regulations allow - over 40%over of : Loyalty andAssortment : Loyalty matter most to your patient base. patient your to most matter that products the of position stock in maintain needs these meet to assortment your Refine segments. these across products cannabis segmentation customer states. need or symptoms, specific patient need states framework Leverage de Leverage from relief find selectto Patients products Evaluate inventory assortment within a - identified customer data create to a - and find the leading leading the find and - and and 14 The Illinois Patient Experience Manufacturer Implications Manufacturer conditions. Similar to the $35 billion probiotics market, market, probiotics billion $35 the to Similar conditions. the cannabis plant to treat many auto increased focus on this non derived products are unavailable. cannabis where products CBD based hemp selecting are consumers of number increasing an cannabis, from extracts oil plant whole prefer users most While ingredient CBD could be the next ‘ next the be could CBD Health professionals and academic researchers have have researchers academic and professionals Health hemp. industrial and cannabis from sourced is CBD Cannabidiol (CBD) (CBD) – food as medicine thenext functional food - intoxicating compound of - immune ’. : Product Development improve insights drive to product innovation strategy that being done across the market framework. Identify which patient performance selection. product patient and occasion, usage cannabis done job the gets product your well how and state, need patient the understand Evaluate market product assortment and Evaluateproduct market 5key are medicalThere symptomsthe drive that Customer centric product innovation patient outcomes and market performance. – within a patient centric segmentation segmentation centric patient a within – and leverage these these leverage and ‘jobs’ are NOT are – 15 About Aclara Research: Insight to Action The Illinois Patient Experience About About innovation and improved health care outcomes. innovation strategy research are the foundation of a customer centric legal markets. Our quantitative and qualitative access time real offers customer insights acrossto patients and consumers. development and differentiateproducts benefit that product prioritize opportunities, assessmarket needs consumer and patient understand analytics. and store experience, marketing companies spans sales, across solve commercial challenges. Our background with research healthcare Our cannabis patient and consumer research panel panel research consumer and patient cannabis Our industry cannabis the within clients our help We Aclara the leading consumer Research is a team of professionals linking Aclara - market development, product product development, market product cannabis insights Research , consumer packaged goods innovation, – how to howto insights insights to in contact contact about more learn and Study insights can our opportunities. market illuminate Contact metrics. key across comparison allows markets medical business value. increase awareness and differentiation Market plans test strategy to and commercial impact. insights key uncover We overhead. is action without To review the full Illinois Patient Experience Illinois reviewTo full Patient the across experience patient the on focus Our The Action to Insight Aclara [email protected] – and then develop implementation implementation develop then and Patient Insights and Researchteamknows insight that Business Impact Aclara Researchhow learn to Aclara Research, 17 1. The Economic Costs of Pain in the United States, Darrell J. Gaskin, Patrick Richard. The Journal of Pain, 2012 2. Marijuana shows potential in treating autoimmune disease, Nagarkatti, Nagarkatti and Yang, Journal of Biological Chemistry, June 2014 3. F2015 Total Medicaid Spending, The Henry Kaiser Family Foundation, Total US and State 4. Bureau of Labor Statistics, Consumer Expenditures 2015: Food at Home and Food Away from Home Patient Experience Patient 5. The Gender Gap in Pain, Laurie Edwards, The New York Times, May 6, 2013 6. A Nation in Pain, Express Scripts, December 2014 Illinois 7. Probiotics Market Analysis By Application and By End-Use (Human Probiotics, Animal

The Probiotics) And Segment Forecast To 2024, Grandview Research, September 2016 8. Medical Cannabis and Chronic Pain in Michigan, Aclara Research, May 2016 9. Medical Marijuana Laws Associated with Decline in Medicaid Prescriptions, Bradford and Bradford, Health Affairs, April 2017 10. United States Center for Disease Control 11. National Institute for Mental Health 12. Department of Health and Human Services 13. American Academy of Pain Medicine

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