Sativex, a cannabinoid medicine made by GW Pharmaceuticals, is a multiple sclerosis drug recently approved for the French market. Photo: BSIP/Universal Images Group via Getty Images

The pharmaceutical industry is gingerly placing more bets on developing drugs with cannabis — but, absent federal legalization, drugmakers are limited in their ability to conduct clinical trials or R&D.

What they're saying: “The doctor is the gatekeeper of the patient’s health,” said John Taenzler, an independent cannabis market researcher. But “pharma’s got their hands tied.”

The big picture: Big Pharma isn’t actively pushing for full legalization — indeed, some painkiller manufacturers have fought legalization in the past. But drug companies are starting to invest more time and money in cannabis research now that 33 states and D.C. allow medical marijuana.

  • The industry has sponsored more than 120 federal clinical trials involving cannabinoids.
  • GW Pharmaceuticals received federal approval last year for the epilepsy treatment Epidiolex, the first prescription drug derived from cannabis.
  • Novartis is partnering with Tilray to distribute medical marijuana internationally.
  • Israeli researchers are investing in cannabinoid patents, and U.S. biotech companies like Emerald Bioscience are trying to make their own patented formulations.

1 big "if": The investment floodgates will break open if these products are removed as Schedule 1 drugs.

  • Yes, but: Pharma would have billions of dollars and clinical data, but they would have to break past the ongoing relationships medical cannabis suppliers and dispensaries currently have with doctors.

More unknowns: Nobody can say what pharmaceutical companies might charge for their cannabis-based medicines, if doctors would prescribe them, and if health insurers would pay for them.

Ouch: Epidiolex has a price tag of more than $32,000 per year — a tough cost to swallow.

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