924 17th Ave SE Apt. 303 Minneapolis, Minnesota 55414 Sensible policies, safer communities. Representative Tina Liebling, Chair Health Finance and Policy Committee 477 Rev. Dr. Martin Luther King Jr. Blvd. St. Paul, MN 55155 Re: House Files 813 (Edelson) / HF 907 (Gomez) Adding raw cannabis to the medical program; enhancing medical cannabis patient protections Dear Chair Liebling and Members of the HHS Policy Committee, I write today on behalf of Sensible Change Minnesota, in support of House Files 813 and 907. We first want to thank Representatives Gomez and Edelson for pursuing these pieces of legislation to enhance patient protections and make medical cannabis more affordable and accessible for Minnesota’s medical cannabis patients. Sensible Change Minnesota is a non-profit that believes our communities are safer When We create sensible drug policies. We have focused much of our efforts over the past three years on improving the medical cannabis program and are fully supportive of HF 813 and HF 907. Raw Cannabis (HF 813) This is the third year that we have pursued this legislation and appreciate the support in the House of Representatives the addition of raw cannabis has received in the past. This provision has passed in the House the past two years, and we encourage your continued support for to make Minnesota’s medical cannabis program more accessible and affordable. Patient Protections (HF 907) This bill seeks to enhance the protections that Minnesota’s medical cannabis patients are afforded under the law. Due to the incredibly restrictive nature of Minnesota’s program, and the cost of medical cannabis, patients have found themselves needing to supplement, or fully supply, their medical cannabis from the illicit market. Not only can this get them banned from the program for life, it has also resulted in criminal charges for patients, including felonies, for possession of cannabis products that are not program compliant or are not under 1.5 ounces of flower. The first section of this bill seeks to remove the lifetime ban and reduce it to one year, so that patients who may find themselves in a tough situation are afforded a second chance. The fourth section seeks to give patients the opportunity to tell the Court and a jury, if charged in a criminal matter for simple possession, that their use of cannabis is for medical purposes. One lesser-known issue patients face is termination by employers and eviction by landlords for either a failed drug test or simply for their status as a registered medical cannabis patient. We have talked to many patients who have had job offers rescinded, or have been fired or evicted, that cannot afford an attorney to pursue discrimination claims against employers and landlords. Sections three and four of HF 907 seek to “give teeth” to the anti-discrimination provisions by prohibiting retaliation, and providing changemn.org 924 17th Ave SE Apt. 303 Minneapolis, Minnesota 55414 Sensible policies, safer communities. injunctive relief, monetary damages, and attorney’s fees for entities found to have discriminated against a patient. It is our hope that these provisions will help balance the power between a patient, who is likely disabled, and their employer or landlord who may discriminate regardless of the existing law. We are hopeful With these provisions set forth by Representatives Gomez and Edelson, We can drastically improve patient experience, access and affordability for patients statewide, and ask for your support of HF813 and HF907. 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 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 percentage of the population that are medical cannabis patients in each state is then multiplied by Minnesota’s population to achieve the “MN Patient