Veterans Affairs has no plans to lift cap on medical marijuana reimbursement

Veterans Affairs Canada plans to hold the line for now on its policy for medical marijuana after a move that capped reimbursements reversed years of rapid spending growth in the program.

Treasury Board directed minister to report on impacts of new reimbursement policy

Veterans Affairs Canada spent less on the coverage of cannabis for medical purposes in 2017-18, reversing a trend of rising costs. (CBC)

Veterans Affairs Canada plans to hold the line for now on its policy for medical marijuana after a move that capped reimbursements reversed years of rapid spending growth in the program.

"At the present time, there are no plans to change the maximum daily reimbursement limit of the three grams per day, or to amend the criteria for the exceptional approval for reimbursement of the more than three grams per day," said Sandra Williamson, the department's senior director for health care programs.

An internal departmental briefing note from February indicated that a review could be in the works, and referenced a directive from Treasury Board to report on the impacts of the new reimbursement policy.

"Due to the greater than expected use of the exceptional approval process, the lack of appropriate supporting documentation, and the large increases in grams being requested, a review of the policy, including the exceptional approval process, is being considered," Deputy Minister Walt Natynczyk wrote.

CBC News obtained the briefing material through access to information.

The briefing note indicated that the cap responded directly to recommendations by the auditor general "to focus on the health and well-being of veterans, as well as cost containment."

New policy announced in 2016

The department announced the new medical cannabis policy in November 2016.

It slashed the reimbursement limit to three grams of medical marijuana per day from the previous 10. Those already getting more than three grams were given a transition period of six months.

The move came in the wake of a report by the auditor general that was critical of the 10-gram daily coverage limit, citing the advice of external health professionals.

The new three-gram limit came fully into effect in May 2017, not long after the start of the new fiscal year. It has been criticized by some veterans.

Since that date, an "exceptional approval" process has applied to all requests to exceed the limit.

And since the cap came into effect, the year-over-year increase in federal spending on medical cannabis for veterans has been reversed.

As recently as five years ago, Veterans Affairs spent only $409,000 annually on medical cannabis.

By 2016-17, that number had jumped all the way up to $63.7 million.

In 2017-18 — after the policy change — the cost came in a shade under $51 million, despite the fact that thousands more veterans used the service.

More than one in five veterans in the medical marijuana program have gotten the green light for coverage over and above the three-gram-a-day limit, according to statistics provided by Veterans Affairs.

Such requests go through the "exceptional approvals" process that requires vets to obtain supporting documentation from medical specialists.

At the end of the last fiscal year, nearly 7,300 vets were being reimbursed for medical cannabis.

Since the new policy was announced, 1,535 got approval for reimbursement of more than three grams per day. (Just over 300 other requests were not approved.)

'Terrible, egregious decision'

Michael Blais, president and founder of Canadian Veterans Advocacy, is one of those who was granted an exceptional approval. He is critical of the new process and the burdens it imposes on veterans.

Michael Blais, president and founder of Canadian Veterans Advocacy. (CBC)

"It was a terrible, egregious decision made with no consideration for the quality of life of the veteran that Veterans Affairs Canada is mandated to support," Blais said.

​"I have spoken to ... if not dozens, hundreds of veterans or their spouses who have been affected by this obscene decision.

"I don't think the Canadian public understands how severe the trauma that is incurred during war or peacekeeping missions such as Yugoslavia or Rwanda, where our sons and daughters, Canada's sons and daughters, were witness to something you will never, ever, God willing, see in this nation."

He said medical marijuana has significant benefits for veterans who have suffered adverse affects from other drugs.

"This is purely a cost-saving endeavour," Blais said.

Costs had been expected to jump over $88 million

The internal briefing materials obtained by CBC News suggest that Veterans Affairs Canada initially expected those costs to keep going up, to more than $88 million in 2017-18.

The actual number ended up being more than $37 million lower than initial projections.

Williamson said that earlier forecast included "previously high utilization rates."

She added the department is now working on estimates of the full extent of the impact of the policy going forward, and hopes to have that information by the end of the summer.

About the Author

Rob Antle

CBC News

Rob Antle is producer for CBC's investigative unit in Newfoundland and Labrador.

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