When Randy Mire first heard about efforts to get medical cannabis law passed six years ago in Louisiana, he immediately saw the opportunity to help patients while growing his business. Mire owns six pharmacies across Louisiana that supply specialty medicines (not cannabis) in 35 states nationwide.
With a PhD in pharmacy from Xavier University in Louisiana and a decade of business experience, Mire knew he was a good candidate to start a cannabis dispensary. “I felt we were able to apply for a medical marijuana license as it showed that we understood the quality control and parameters to do it correctly,” he says. “I was excited because it would be treated as a drug and pharmacists would run it.”
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There were many risks involved in starting a new business, especially in the cannabis industry where license fees, construction costs, tax liabilities, and banking costs all tend to be higher, but Mire felt ready. “I love being up to date with pharmacies and medications that can help patients,” he says.
The Capitol Wellness is located in a 4,000 m² building. Facility in the Baton Rouge medical corridor near the two largest hospitals in the area, giving patients easy access to its facility. Despite many challenges, including more than expected building security requirements and limited products, he is happy with the results so far.
“We couldn’t be happier when we got into the cannabis room,” he says.
Although medical cannabis has been technically legal in Louisiana since 1978, when Governor Edwin Edwards signed a bill legalizing it for glaucoma and chemotherapy patients, according to the New Orleans Times-Picayune, the state never put in place a formal program. Then, in 2015, Governor Bobby Jindal signed a bill that set the legal framework for medical marijuana in the state. Over the next two years, Governor John Bel Edwards signed bills that allowed doctors to recommend medical marijuana and expanded the number of qualification requirements.
As of August 2019, Louisiana was the first state in the Deep South to provide medical cannabis to patients. The Louisiana Board of Pharmacy approved nine pharmacies (referred to as “Licensed Pharmacies”) to operate in the state. Referrals are only available to patients with a qualified diagnosis, and patients must receive a referral before they can purchase medical marijuana.
According to state law, cannabis cannot be consumed or smoked in its raw form. Approved products include oils, extracts, sprays, capsules, pills, solutions, suspensions, gelatin-based chewable tablets, lotions, transdermal patches, suppositories and metered dose inhalation.
Upon hearing of the opportunity, Mire assembled a team of pharmacists and applied for a license to operate in the Baton Rouge area. Earlier this year, the Louisiana Board of Pharmacy voted 9-0 for him, and Capitol Wellness Solutions opened its doors in August.
“From cancer patients to autistic people to victims of chronic pain therapy, many of the pain medicine professionals recognize that this could be an additional therapy,” says Mire. “The educational piece was really great. They realize that besides opiates they have another alternative. “His first patients included a marine veteran with post-traumatic stress disorder and a cancer patient.
Mire says his background in medical compliance made him a competitive candidate to open a pharmacy, but he wanted to put together a team of experts to help. When he applied, he hired iComply Cannabis, a national consulting firm, to help him comply with regulations and better understand the cannabis industry, he says.
BUMPS IN THE STREET
The two biggest challenges Mire faces so far have been the limited number of products in Louisiana and the inability of patients to use credit cards. That’s starting to change, but Mire hasn’t found a credit card company to work with yet.
“That was one of the most frustrating things – people need the product, but they don’t have the option to pay for it,” he says, adding that he is now working with a new company to get a deal.
Questions about cost have surfaced across the country as some doctors say patients find the cost of medical cannabis too high and, after years of waiting, drive it off the market. Currently, the only cannabis product that consumers in Louisiana could buy was a concentrated liquid form in bottles of up to 30 milliliters. Prices for a single tincture bottle at Capitol Wellness range from $ 98 to $ 198 for a typical 30-day delivery. Some people may need a larger dosage so they may need a bottle and a half for a 30 day supply
“Patients want more access to a variety of products, particularly those used to treat acute pain,” says Mire.
Additional products, particularly higher strength tinctures, could help bring prices down for consumers. “With the more concentrated tincture oil, a patient who may need to purchase three bottles of the current strength may be able to buy less, and with a package price the cost should be significantly lower,” says Mire.
One of the biggest things Mire sees going forward is the need to educate patients and doctors about the benefits of the treatment. Unfortunately, cannabis still has a stigma and many people aren’t educated about it, he says. “It’s amazing that most people still see this as a last resort. If we were more aggressive about education, we could turn to it sooner. ”
Although many of the state’s doctors are waiting, the number of doctors involved is growing, Mire says. In order to recommend medicinal cannabis to patients, doctors must obtain a fingerprint and undergo an additional series of background checks with their licensing agency.
“Many doctors waited for the program to start and received feedback from their patients about their requests,” says Mire. “Doctors are registering now. We see that growing fast. Part of the reason they waited was because of possible delays in the products. “
A unique aspect of Louisiana’s approach is that patients go through a consultation with a pharmacist before receiving their medication. It takes about 15 minutes. “We go through everything,” says Mire. “Are you cannabis naive, what are the possible side effects, how you take the medication. It’s really different from an experience standpoint. This creates compliance. “
Although Capitol Wellness Solutions has only been open for less than a year, Mire is delighted with its effects. “The patient reports are amazing,” he says. “Countless patients can now reduce their opiates and have a better quality of life. Many are already receiving a follow-up recommendation. They have seen so much benefit that they are now returning monthly. ”
Louisiana’s approach is also being closely monitored by other states, Mire said.
“We are seeing other states following the same model, a purely medical approach, where a pharmacy dispenses the drugs and a doctor is involved in the recommendation,” he says. “I often get calls from politicians and industry leaders in other states who want to repeat what we’re doing in Louisiana.”
Mire has already identified a larger, 7,500-square-foot building that he could expand into, he says. Given the industry’s growth so far, he wants to be ready. “The more doctors join, the greater the patient’s awareness, and the stigma will continue to be removed. I think we’ll keep growing,” he says.
Lee Chilcote is a Cleveland-based freelance writer and editor whose work has been featured in Vanity Fair, Next City, Belt, and many literary magazines.