Project Twenty21 - Costs and Progress

Update from the Director

Project Twenty21 Roadmap


In November 2019, Project Twenty21 was announced to the public. This announcement marked the very beginning of the project.  Project Twenty21 is not a clinical trial. Instead, it is a registry/database which is being developed to address the challenge of controlling the cost of medication, supporting doctors, and building evidence of health benefits for those prescribed medical cannabis.

The registry has been developed by scientific experts, to ensure that appropriate data is collected during the clinical consultation. This will inform us and the NHS about medical cannabis. The two underlying questions we want to explore are in which circumstances is medical cannabis beneficial to the patient and where might it cause harm. The project will provide scientific information for doctors, patients, and decision-making NHS and government groups. Setting up the project has had its challenges; private clinician time is limited and expensive.

Access to medical cannabis in the NHS is currently limited to a few areas (severe treatment-resistant epilepsy, MS-related spasticity, and chemo-induced nausea and vomiting). Project Twenty21 understands that cannabis is used for a much larger range of health issues. In order to engage with patients suffering from the named indications of the project (anxiety, chronic pain etc.…) we must involve the private sector, as this is where medical cannabis can be prescribed off-license under specialist clinician supervision. Up until now, for many, the cost of private medication has been a massive barrier. Project Twenty21 has partnered with five licensed producers to provide a varied formulary of cannabis-based medicines at a significantly reduced cost of £150 a month per product prescribed. With hundreds of pounds taken off the market price, the project can now support more patients in need.

Up until March 2020, THC products could not be stored in the UK in any significant quantities, importation could take up to six weeks, which meant that patients often discovered their prescription was no longer valid.  Since the launch of the project, regulations have changed to allow the importation of up to three month’s supply of medication. This change, in part, will help patients receive continued prescriptions once they have got through the first prescription authorisation from the Home Office.

The number of UK doctors with medical cannabis expertise is continuing to grow. Project Twenty21 is supporting an increasing number of doctors to be able to prescribe medical cannabis by collaborating with the Medical Cannabis Clinicians Society to provide quality education.

During March 2020, COVID 19 hit the UK. Although this caused major disruption to the overall development of the project, it also supported one of the aims of Twenty21. It opened up the ability for clinicians to do online virtual clinics, which meant that it reduced the cost of private consultations and eliminated the issue of patients being able to physically attend the limited number of clinics available in the UK. The Project Twenty21 team completed the first test phase of the registry at the end of May 2020. Now the focus of the project is to increase the number of doctors who can prescribe medical cannabis, aiming for an official launch to patients in summer 2020.