Stepping into CBD
CBD products represent a key market opportunity for many DME pharmacies. How do they move into that market?
Pain management is a key element of any DME pharmacy’s business. Whether it’s over-the-counter or prescribed painkillers, compressions items, wraps, hot/cold therapy, or TENS units, they offer a lot of ways to help their customers manage their pain and discomfort.
Bearing that in mind, any responsible DME pharmacy is regularly looking to broaden their range of pain management offerings, and the latest offering is CBD. Only CBD isn’t like previous offerings. CBD is one of the compounds called cannabinoids produced by the cannabis plant. The first cannabinoid most everyone has heard of is THC, the psychoactive component in recreational marijuana. CBD, also known as cannabidiol, is the cannabinoid often used in managing chronic pain, insomnia and anxiety.
CBD products are sold in varying dosages that might or might not contain very small percentages of THC, as well. The products range from tinctures taken under the tongue, capsules, gummies and lotions. Consumers can buy them online and depending on what state a person lives in, they can buy it at retail establishments.
THE MARKET OPPORTUNITY
In fact, CBD use has grown so widespread according to market researchers the Brightfield Group, the global CBD market could expand to $22 billion by 2022. Another study from Cowen and Company projects the CBD market to hit roughly $16 billion by 2025. Low or high, those estimates speak to considerable market demand.
“There’s such a growing interest market, because the product itself has so many benefits that it could definitely bring additional cash flow and new business and return business to these pharmacies,” says Victor Velazco, CBD advocate for Oliver’s Harvest (oliversharvest.com) which is produced by Coast to Coast Natural Inc.
“Everywhere you look, people are talking about it or they’re a company that’s selling it,” notes Jon Fedele, CEO and owner, PurWell LLC (purwell.com). “I just had a conversation with a Physician two days ago who said that he has, at minimum, four or five patients every day that ask him about CBD. He’s just a General Practitioner.
“So it’s a growing market. I think there’s a great opportunity for DMEs and pharmacies alike,” Fedele continues. “I think they’re poised to succeed in this market for several reasons, but most importantly because their customers know and trust their healthcare advice. They look to them to advise them on products that are going to help with their overall health and wellness.”
But it’s a market that has sat in an uncertain legal landscape for several years. The Department of Justice and the Drug Enforcement Agency considered any part of cannabis — and that includes CBD — a narcotic, but they have not enforced any laws when it comes to what is called “industrial hemp” products that include less than 0.3 percent THC, which covers most CBD products. As a result, many farmers and others further down the CBD economy have been reticent to participate in the business — until now.
FEDERAL AND STATE LAWS
The 2018 Farm Bill, which was passed at the very end of the 115th Congress in late December, removed industrial hemp production from the Controlled Substances Act. This gives Federal protection to both hemp farmers and CBD sellers.
That said there are still state statutes. In the 10 states where cannabis is entirely legal for medicinal and recreational use — Alaska, California, Colorado, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont, and Washington — it is clearly legal to sell and use CBD oil, according to CBD producer Green Roads. And, in the three states that legally prohibit all cannabis-derived products — Idaho, Nebraska, and South Dakota — CBD sales remain illegal.
In addition to those states, there are 23 additional states that allow medical marijuana, including CBD. The remaining 14 states have more nuanced or narrow limitations on the sales and use of CBD or medical marijuana. Both Green Roads and the National Organization for the Reform of Marijuana Laws provide useful state-by-state resources on their web sites, greenroadsworld.com and norml.org.
So, what’s a DME pharmacy interested in CBD to do? How do they make sure they’re above board?
“I would say is, the best advice for pharmacies considering the sale of hemp/CBD products would be to consult with an attorney on the laws specific to their state,” Fedele says. “There are several prominent attorney firms that only do cannabis, marijuana, cannabis, hemp related legal advice and oversight.”
Another issue is quality control. DME pharmacies that are interested in offering CBD need to get educated on not just CBD, but the ways CBD is manufactured.
Right now, there is not a lot of standardization. According to Jamila Mammadova, a researcher for Coast to Coast, the Federal Drug Administration does not currently do product testing, but has formative rules on CBD products that it is preparing to detail and enforce. In the meantime, retailers want to make sure that products meet their criteria, such as ensuring that the THC component is below 0.3 percent. After that they need to research vendors.
“Another thing is you want to show that there are no heavy metals, there is no microbial life and any other toxins in your extract,” she says. “Companies typically will, just privately, offer third-party lab reports and show it to consumers to guarantee that the concentration is accurate and that the extract is high quality.
“… One of the things I would recommend them to do is to use broad spectrum hemp extract with less than 0.3 percent THC or zero percent,” Mammadova continues. “The first option would be full spectrum and the second option is broad spectrum.”
Mammadova says that rather than just seek a high dosage isolate, it is better to have the full and broad spectrum varieties, because those products contain other chemicals found in the plant that work together with the CBD to increase its efficacy.
“We call that ‘entourage effect’ and it’s not just double; it actually grows exponentially,” she explains. “And there are so many studies that demonstrate that. Once you have full spectrum and broad spectrum, these chemicals start to interact with each other and they work synergistically. The result is much stronger.”
What should be clear to any DME pharmacy is that we are looking at an evolving landscape both from a regulatory perspective and a business perspective. There is a clear, “hear and now” market opportunity and customer demand for these products. The key is for smart owners and managers to tap into legal resources to ensure they comply with state and Federal requirements, and do their homework on the product side to ensure they are stocking quality items.
This article originally appeared in the DME Pharmacy April 2019 issue of HME Business.