The cumulative number of authorizations for individual patients in Brazil to import nonregistered medical cannabis products reached 18,650 at the end of March, according to data shared with Marijuana Business Daily by the country’s health regulator.
National Sanitary Surveillance Agency (ANVISA) approvals to import the products have been growing rapidly in the past year, and although this route is intended to be a special access scheme for exceptional cases, Brazil has become the largest market in Latin America.
Nonregistered medical cannabis products, regardless of THC content, can be imported only by individual patients after a doctor and ANVISA have signed off.
The health agency does not restrict the products to only CBD, but in practice CBD represents the majority of imports.
During the first quarter of 2020, almost 3,000 patients received authorization to import nonregistered products, an increase of 25% over the previous quarter and 123% higher compared to the same period in 2019.
Authorizations granted through 2019 were originally valid for one year, but earlier this year, the health regulator automatically extended those allowances for 12 more months.
MJBizDaily estimates the maximum number of patients authorized to import was 11,317 as of the end of March.
No over-the-counter CBD or foodstuffs with CBD are authorized in Brazil.
This type of access to nonregistered products – often called “compassionate use” – is common throughout the region.
While it certainly represents an opportunity, it also comes with disadvantages, as it is inefficient to ship to individual patients.
At the end of 2019, Brazil approved new rules allowing cannabis products without proven efficacy via clinical trials to obtain a “sanitary authorization,” valid during the early years of commercialization.
Unlike nonregistered products imported by individual patients, these can be manufactured domestically, and distribution in pharmacies is allowed.
The new rules, which took effect in March, created enthusiasm in the industry. But so far, expectations that “sanitary authorizations” would expand access – and business opportunities – largely failed to materialize.
On July 16, ANVISA told MJBizDaily that only one product was approved under the rules so far and that the agency did not have a single pending application to evaluate.
Although proven efficacy through clinical trials is not needed in the early years of commercialization of these products, other pharmaceutical-quality requirements have been set by Brazilian health regulations, including:
- Good Manufacturing Practice certification. The new regulations determined that until December 2022, ANVISA will accept GMP certifications issued by health agencies of PIC/S countries. After December 2022, only ANVISA certifications will be allowed.
- Data demonstrating that the quality of the product remains stable throughout its shelf life in the climatic conditions commonly found in Brazil.
These and several other requirements are proving to be a challenge for cannabis companies.
Approval of such products can be granted only for a maximum of five years – including possible renewals.
After the fifth year, the company must be able to prove efficacy and safety and the medical cannabis product must be registered like any normal medicine or it must be removed from the market.
Alfredo Pascual can be reached at [email protected]