ASA in the News

Denis J. O'Malley, News Times

Connecticut and its more than 1,300 approved patients call it medicine. The U.S. government calls it a drug with a high potential for abuse. Health insurers don't really call marijuana much of anything at all.

"We do not know of any health plans that provide coverage for medical marijuana," said Susan Pisano, a spokeswoman for America's Health Insurance Plans, an industry trade association.

That likely will not change once Connecticut's medical marijuana becomes operational.

The state's medical marijuana law does not require insurers to cover the drug under health plans.

While the law leaves the door open for insurers to choose to cover it, that doesn't appear likely.

"There have been no discussions here as to whether insurers are expected to cover medical marijuana to any extent -- the law says they are not required to," Claudette Carveth, a spokeswoman for the state Department of Consumer Protection, said in an email. "They may choose to, but are not required to."

The reason insurers do not cover medical marijuana in health plans in states where it has been approved for medical use comes down to two factors. First, the federal government treats marijuana, no matter what its use, as a Schedule I controlled substance.

"The clear weight of the currently available evidence supports this classification, including evidence that smoked marijuana has a high potential for abuse," reads a statement by the Drug Enforcement Administration on its medical-marijuana position.

In addition, the Food and Drug Administration has not approved smoked marijuana for medicinal use for lack of evidence-based scientific testing.

"The typical approach with coverage is that evidence drives the coverage," Pisano said. "The FDA has not approved smoked marijuana ... That would certainly be a factor."

So patients who plan to use medical marijuana when the state's producers and dispensaries are chosen and set up shop "will pay for the marijuana as they would for other over-the-counter medications," Carveth said.

Just how much it will cost patients is determined by their tolerance for the drug and their preferred delivery method.

While cost can run the gamut, most medical marijuana patients choose inhalation -- either by smoking or vaporizing the drug, said Kris Hermes, a spokesman for Americans for Safe Access, an advocacy group for medical marijuana patients.

"By far, the majority of patients smoke or vaporize it, and the reason for that is it's easier to regulate the dose," he said. "It has a faster effect through the lungs than through the digestive system."

Whether it is first-time users trying to learn their tolerance and need or more experienced users gauging the effect of the product, inhaling the drug allows for a quicker trial-and-error process than does ingesting the active ingredient in marijuana, THC, through a concentrate or edible product.

"If you're suffering from nausea from chemotherapy, you want that instant reaction, which I think is mainly why people smoke it," Hermes said. "Also, if you take a dose and if you have to wait 45 or 60 minutes to see if it's effective or not for your condition, that's also not productive. You may have to take more, but you have to wait to find out."

Patients tend to opt for inhaled marijuana because it is considerably less expensive than if they were to exclusively ingest the drug.

A patient who finds a joint a day keeps the pain away could spend some $200 to $400 a month, depending on the price of the marijuana used, Hermes said.

For patients who rely on homemade concentrates or edibles, the cost can get as much as five times higher, "because you need much more (product) in order to produce that kind of variation on the medicine," Hermes said.

If they decide to keep their hands clear of the medicine in plant form altogether, buying edible products from dispensaries would likely be the most expensive option, Hermes said.

"If they rely exclusively on edible products from a dispensary for their entire regimen, then that could be even more money," he said, adding such products typically cost $5 to $10 a dose.