924 17th Ave SE Apt. 303 Minneapolis, Minnesota 55414 Sensible policies, safer communities. Representative Rob EcklunD, Chair Labor, InDustry, Veterans, anD Military Affairs Finance & Policy 409 State Office Building St. Paul, MN 55155 Re: House File 600 (Winkler) Cannabis Legalization Dear Chair Ecklund and Members of the Committee, I write toDay on behalf of Sensible Change Minnesota, in support of House File 600. We first want to thank Representative Winkler for his collaborative anD thoughtful approach in Developing this legislation. As an organization, we have done substantial work on improving Minnesota’s medical cannabis program. Our team has worked for the addition of intractable pain, post-traumatic stress disorder, autism, Alzheimer’s disease, and chronic pain as qualifying conditions, and oral dissolvable medical cannabis proDucts. We have also repeatedly engaged the legislature in an attempt to pass patient- centric legislation that will make medical cannabis more affordable and accessible for some of Minnesota’s sickest patients. We know: • the cost of meDical cannabis is extremely high in Minnesota, and insurance Does not cover the cost of this effective medicine for patients who are often disabled and limited in their ability to work; • Minnesota has a low percentage of its population in its meDical cannabis program compareD to states with more effective programs; • patients face limited options and access due to the limit of two medical cannabis manufacturers; anD • Minnesota’s two meDical cannabis companies have struggleD to turn a profit. We also know that cannabis prohibition was founDeD in racism anD irrational policy making, anD that the lasting effects of this faileD policy have disproportionately damageD communities of color. Law enforcement resources continue to be used for pursuing cannabis, while clearance rates on crimes such as rape, burglary, anD arson remain well below 50%i. Our existing policies have faileD Minnesota. We now have an opportunity to begin rectifying the Damages of cannabis prohibition anD the associated irrational policies put in place to oppress communities of color, prevent access to natural changemn.org 924 17th Ave SE Apt. 303 Minneapolis, Minnesota 55414 Sensible policies, safer communities. meDicine, anD interfere with inDiviDual freeDoms. Just a few benefits of HF600 incluDe: • More afforDable anD better access to meDical cannabis for patients with post-traumatic stress disorder, severe pain, seizure disorders, and epilepsy, among other conditions; • Marketplace variety for patients with an expanDeD roster of proDucers anD proDucts; • RegulateD, contaminant free cannabis proDucts, which are safer for Minnesotans who are consuming cannabis from the illicit market currently; • Rectification of DecaDes of harm imposeD on communities of color through Disproportionate enforcement of cannabis prohibition; • Putting an age limit on who can legally buy cannabis, making it harder for our youth to access cannabis products – drug dealers don’t check ID; and • Opportunities for jobs anD economic growth throughout the state, with a special focus on the communities harmed by prohibition and economically depressed areas of greater Minnesota. This isn’t just “recreational” marijuana legalization on the table – it is improving our meDical program, providing adults an alternative to alcohol for winding down and social gatherings, and creating an equitable industry for all Minnesotans. Please vote “yes” on HF600. Respectfully, Maren SchroeDer Policy Director, Sensible Change Minnesota Attachments: - Sensible Change Minnesota, Minnesota Medical Cannabis Pricing and Patient Experience Report, February 2020 - Sensible Change Minnesota, Medical Cannabis Program in Minnesota – Program Information - Americans for Safe Access, 2020 State of the States Report i Minnesota Bureau of Criminal Apprehension, 2019 Uniform Crime Report; https://dps.mn.gov/divisions/BCa/BCa- divisions/mnjis/Documents/2019-Minnesota-Uniform-Crime-Report.pdf changemn.org Minnesota Medical Cannabis Pricing and Patient Experience Report Produced and published by Sensible Change Minnesota February 3, 2020 www.changemn.org Minnesota Medical Cannabis Pricing and Patient Experience Report Sensible Change Minnesota About Sensible Change Minnesota Sensible Change Minnesota grew out of our sister organization, Sensible Minnesota, to allow for more flexibility to advocate for sensible drug policy reforms unburdened by its 501(c)3 lobbying restrictions. Our team worked on many of the expansions of Minnesota’s medical cannabis program, including: • Intractable Pain, effective August 2016 • Post-Traumatic Stress Disorder (PTSD), effective August 2017 • Autism Spectrum Disorder, effective August 2018 • Alzheimer’s Disease, effective August 2019 • Reducing the qualifications for a patient to have a caregiver in the program, effective August 2019 (HF766, Section 6) • Chronic Pain • Oral dissolvable products 25,608 of Minnesota’s 28,522 registered patients (89.7%) qualify for the program because of a condition that Sensible Minnesota worked to add via the Commissioner of Health. Sensible Change Minnesota’s Board of Directors is comprised of grassroots activists, patients, caregivers, legal professionals, and union organizers. We amplify the voices of patients and consumers at the legislature. This section last updated: February 15, 2021 Questions on this report can be referred to Maren Schroeder, Policy Director, [email protected]. Page 2 of 18 Minnesota Medical Cannabis Pricing and Patient Experience Report Sensible Change Minnesota Key Findings ● 86 percent of surveyed registered medical cannabis patients reported price as the primary treatment barrier; 76 percent reported access to raw cannabis plant material. ● Inhalation oil cartridges are 52 percent more expensive than raw cannabis plant material on per mg of THC basis on average; capsules are 75 percent more expensive than raw cannabis plant material on a per mg of THC basis. ● 99 percent of patients surveyed by Sensible Change Minnesota support the addition of raw cannabis plant material as an allowable delivery method. Recommendations ● Permit raw cannabis plant material as an allowable delivery method. ● Remove limitations on allowable delivery methods, or at the very least, allow Minnesota manufacturers more flexibility in product development. ● Provide for more patient care centers (dispensaries) throughout the state. ● Create marketplace competition by increasing the number of medical cannabis licenses available. ● Provide funding for pricing audits by Minnesota state regulators. Page 3 of 18 Minnesota Medical Cannabis Pricing and Patient Experience Report Sensible Change Minnesota Introduction Medical cannabis was legalized in Minnesota in 2014, and the first patients purchased products on July 1, 2015. Minnesota’s program is the only established medical cannabis program in the country that does not permit any access to raw plant material. Minnesota has limited marketplace competition with only two vertically integrated manufacturers vs 715 on average (45 excluding Oklahoma with 4063) amongst other medicinal cannabis states. Initially Pennsylvania mirrored Minnesota’s permitted delivery methods but modified the program by adding licensees, allowing raw cannabis, and other adjustments to adjust patient concerns regarding access and affordability. This analysis sets forth pricing information for Minnesota, in comparison to Arizona, Florida, Illinois, New Mexico, Oklahoma, and Pennsylvania based on information that is publicly available. Oklahoma did not implement their program until 2018, so revenue numbers for 2018 are unavailable. Oklahoma is included in this paper, with limitations, in order to compare patient numbers and product pricing with a new program. Analysis within will be revised as data is made available. Data provided within: ● Patient numbers; ● Cultivation and dispensary license numbers; ● Revenues; ● Per milligram of THC of cartridges, bulk oil, infused products, and cartridges; ● Per milligram of THC for raw cannabis products; and ● Sensible Change Minnesota patient survey results. Additionally, Sensible Change Minnesota conducted an online survey on barriers to access for patients. The findings of that survey are found within this paper. Finally, Sensible Change Minnesota’s recommendations to the legislature on accessibility are included in the conclusion. Methodology Data was collected using various sources (see endnotes), that were publicly available online. The author attempted to seek out consistent prices, but historical pricing of products was not found online. Patient numbers, revenues, and licenses are based on end of year numbers for 2018, except for Illinois, which provides data on a fiscal year basis, with their fiscal year ending on June 30, 2019. Page 4 of 18 Minnesota Medical Cannabis Pricing and Patient Experience Report Sensible Change Minnesota Sources include state regulators’ websites, statutes, rules, industry publications, and credible regional news sources. Additionally, pricing information was obtained from either dispensary websites or using the menu function on Leafly.com for the menus available via Leafly. Patient Numbers Minnesota had 18,127 enrolled patients, as of November 14, 2019, and has registered 30,187 patients to date; that is a loss of 40% of registered patients over four years. Data was collected on each state, the year it implemented medical cannabis, its most recent patient registry numbers, and its population. The