Project Twenty21

Drug Science launched Europe’s first and biggest national medical cannabis registry, called Project Twenty21, on the 7th November 2019.

Project TWENTY21 aims to enrol 20,000 patients by the end of 2021, creating the largest body of evidence for the effectiveness and tolerability of medical cannabis – with an aim to demonstrate to policymakers that medical cannabis should be as widely available, and affordable, as other approved medicines for patients who would benefit from them.

TWENTY21 is a registry, not a clinical trial.

It will also support prescribers across the country to feel confident in providing medical cannabis to patients. We hope that the findings will make a powerful case for NHS funding, by proving the favourable risk/benefit ratio of medical cannabis in seven key identified conditions. In the first instance, this real-world registry will be targeting the following patients and situations:

  • Anxiety Disorder
  • Chronic Pain
  • Multiple Sclerosis (MS)
  • Post Traumatic Stress Disorder (PTSD)
  • Substance Use Disorder (as a harm reduction strategy)
  • Tourette’s Syndrome

*Although Project Twenty21 aims to collect health outcome measures in cases of intractable epilepsy, for reasons outside of Drug Science’s control, we have been unable to subsidise the cost of medication for this condition. We are working hard to find a solution for this and will keep patients updated. In the interim, if patients wish to seek Cannabis-Based Medicinal Products for this condition, they can receive treatment at a private medical cannabis clinic, but this will be outside the scope of Twenty21 subsidised costing, at this time.

Furthermore, medical cannabis clinics will only accept patients who have attempted two different licensed medications to treat their condition, both of which must have proven to be ineffective.

The Twenty21 team has created an animation explaining the process to help you navigate the project. For more information see our latest update.

Project Twenty21 treatment will be provided at a network of private clinics. Private clinics retain control over their consultation fees therefore patients will need to fund the cost of their consultation. This cost will vary between clinics, initial consultation prices are listed alongside the clinician’s biography on the Drug Science website. The clinic directory contains details of all participating clinics, including details of specialities and consultation fees, to help patients decide on which clinic they would like to register with.

If you are patient with one (or more) of the conditions named above, and wish to hear more about Project Twenty21, please submit your name and email address below.


PLEASE NOTE: Prescription of medical cannabis will remain the decision of the provider, dependent on full clinical assessment and physician recommendation. Drug Science takes no responsibility for clinical oversight.

If you are a GMC registered consultant psychiatrist, neurologist or pain specialist and are interested in contributing to Project Twenty21 data collection when prescribing medical cannabis to your patients, please email The primary objective of Project Twenty21 is to develop a body of evidence using a real-world data (RWD) registry to document efficacy, safety, QALY, and patient reported outcomes with regards to medical cannabis use.

Our Scientific Oversight Board


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.