App science

A Fair Lawn trio develops a medical cannabis ecosystem for patients, doctors and insurers


January 20, 2020 12:01 am

As a pharmacist in the middle of the last decade, Elaine Richer noticed something about some of her patients: They were coming back at a rate inconsistent with their prescriptions, even for medications advertised by drug companies as non-addictive such as Tramadol and OxyContin.

She’d started in pharmacy to help people, and she was witnessing the start of the opioid epidemic.

 

“As a pharmacist, at the end of a day, you can see how addictive or non-addictive something is because they start coming in a few days earlier and a few days earlier,” Richer said. “They’re saying where they first needed four a day, they need seven or eight a day. It sneaks up on you. It’s very easy to get that patient in trouble. Unless you pay attention to this, you start prescribing more.”

She stayed in pharmacy for 15 years, spending the latter half of her career as a district manager for Walgreens and then Rite Aid. As she saw insurance companies covering one Oxycontin script after another, it was the opioid epidemic that pushed her interests to medical cannabis.

“If the patient is being treated by [cannabis], why shouldn’t it be covered by insurance? It’s a lot less expensive than opioids but if the insurance has a $10 copay on Oxycontin, which costs thousands of dollars, why shouldn’t they be covering medical cannabis for the patient?” Richer said.

She, fellow pharmacist Slava Malen, and husband and social worker Jacques Nir, based in Fair Lawn, developed a mobile app to legitimize medical cannabis as something insurance companies saw as worth covering, and something that would improve the medical cannabis experience for patients and doctors.

It started from Richer and her team collecting data from about 350 studies, which demonstrated that not all available strains treat symptoms and illnesses in the same ways. The cannabinoids and terpenes that make one strain ineffective at treating irritable bowel syndrome might make it highly effective at treating symptoms associated with cancer. While the composition of another strain might make it a useful remedy for anxiety, it could be the wrong choice for someone looking to treat Tourette’s syndrome. With this data, they created what they dubbed the canna-meter within their app MyCureAll, which is meant to provide recommendations for treatment based on ailment.

Related Constituencies

MyCureAll serves four types of users: patients, physicians, insurance companies and dispensaries.

Patients enter their experience in the app to collect their own data and share it with their doctor, insurance company, and dispensary if they so choose. Through an interactive portion of the app called Puff, they provide information about the cannabis they’re consuming (strain, CBD/THC ratio, terpenes, etc.) and compare how they feel at the time of consumption to how they feel 20 minutes later. As the patient uses it, the app will provide better cannabis recommendations; and as more patients use Puff, their reports will be incorporated into the canna-meter. Their feedback helps physicians and dispensaries better understand what to recommend to others with similar ailments, and help insurance companies understand what to cover.

“If we’re seeing that Pineapple Express is great for post-traumatic stress disorder, but based on the anecdotal evidence it’s the Pineapple Express specific on the East Coast—because the other issue is just because you’re getting one thing from Dispensary No. 1 doesn’t mean you’re getting the same thing from Dispensary No. 2—we’re really trying to break it down to CBD, THC, CBG, terpene levels. Based on their reporting, the information [on the canna-meter] might change.”

The more accurate MyCureAll’s cannabis recommendations are, the better for all parties.

“For the insurance company reason for [MyCureAll], they’ll say ‘we know you were diagnosed with IBS; 90 percent of patients with IBS are satisfied with this strain and this quantity, so that’s what we’re going to give you money for,” Richer said. “We’re giving them a way to protect themselves. They’ll be able to give specific suggestions because it takes a while for patients to know what they need to take.”

The MyCureAll team is working with University Hospital to put together a study of a substance abuse treatment program using medical cannabis with the app. University Hospital is one of only four hospitals in the state that can engage in studies related to medical cannabis.

Richer’s business partner and husband Nir, who has put time and effort into the development of the study, said he would be seeking 75 to 80 patients. The patients would be divided into groups, with one group only receiving suboxone or methadone, another receiving those medications along with medical cannabis, and one receiving no medicine for treatment at all.

As a social worker in New York City, Nir has seen opioids and substance abuse disorders destroy communities and families. “We’re looking for reduction of opiate use, no opiate use within that [three to six month time] frame, compliance with the program,” Nir said. ”Usually the dropout rates [of substance abuse programs] even with suboxone and methadone is high, and it’s very hard for the lower socioeconomic class to get a hold of suboxone. Usually, the first time [a patient enters rehab], you have a 5 percent compliance rate within the first six months. These findings would be incredible.”

As it stands, since it’s illegal to transport cannabis over state lines, they still need to partner with an in-state alternative treatment center to produce the medicine.

They’re still looking for interest.

“Right now [the ATCs] are just trying to get by day by day with the product they have,” Richer said.

In addition, it’s hard to convince the ATCs to get behind letting insurance companies to cover medical cannabis because they’re currently a cash business, she explained, though insurance coverage would benefit dispensaries in the future when the market is saturated and patients are looking for one reason to choose a dispensary over another.

“On the West Coast there’s a lot of dispensaries and product. They’re really fighting for survival. For a dispensary to stand pat as an expert in medical cannabis, to say they’re growing the strains that will help with certain med conditions is only a plus,” Richer said.

MyCureAll is currently running a beta test with approximately 300 patients across three dispensaries in Pennsylvania. The beta test runs from Jan. 15 to Jan. 31; and the app launches the next day in Florida, New York, New Jersey and Pennsylvania.

The 513,000 patients across the four states are treated by only 6,000 physicians, and only have 346 dispensaries to access their medicine. Physicians are slow to sign up for the program due to a lack of education, and when they’re in it, a lack of available information prevents them from providing in-depth advice to their patients on what strain of medical cannabis to take and how to consume it. Richer said the MyCureAll team has been working with Jeff Brown, assistant commissioner in charge of the Health Department’s Medical Marijuana Program, to give information to physicians about the endocannabinoid system, the body’s system that interacts with cannabinoids, “to dispel some of the myths there are about cannabis.”

Clients interested in participating can email Richer at ericher@mycureall.com. Richer and Nir encourage people to sign a petition to allow cannabis to be used to treat substance abuse disorder possible here.