MEDICAL MARIJUANA: PRICE A KEY ISSUE FOR PATIENTS,
OPERATORS

Maine's new network of medical marijuana dispensaries is expected to
make the drug more accessible to disabled and ill patients.

Making it affordable may be another matter, however.

While the dispensaries are state-licensed nonprofits, most plan to
charge virtually the same prices as illegal dealers charge on the
street -- from $300 to $400 an ounce. At those prices, a typical
patient with cancer or multiple sclerosis might spend $500 to $600 or
more each month to relieve their symptoms with medication that is not
covered by insurance.

"I think $300 and $350 is way too much for a weed that can grow
outside," said Andrea DiAnni, a southern Maine resident who uses
medical marijuana to treat nausea and pain from a chronic illness. "I
know what it's like to have to go without medication (because) there
were times I couldn't afford it."

Newly licensed dispensary operators say they want marijuana to be
affordable, too. But, they say, offering it at $100 or $200 an ounce
would encourage patients to sell excess medication on the black market.

"There is an unfortunate fact that there is still this black market
for this commodity," said Rebecca DeKeuster, chief executive officer
of the Northeast Patients Group, the group planning to set up
dispensaries in Portland and three other Maine communities this fall.
"If our prices are too low, it encourages diversion."

Maine's Department of Health and Human Services has awarded licenses
for the state's first six medical marijuana dispensaries, which plan
to start selling the drug to qualified patients later this year. Two
more dispensaries are expected to open early next year after a second
round of license applications is submitted next month.

State officials selected the first dispensary operators last Friday
based on their nonprofit business plans and other criteria, including
whether discounts would be offered for low-income patients. The state
is allowing the market to dictate prices, however.

State officials selected the first dispensary operators last Friday
based on their nonprofit business plans and other criteria, including
whether discounts would be offered for low-income patients. The state
is allowing the market to dictate prices, however.

"We honestly didn't take (price) into consideration," said Kathy
Bubar, a DHHS administrator who sat on the selection panel. "We did
look at (whether) the profits were excessive. We took points away for
that."

Some have argued that high dispensary prices, not low ones, will
encourage people to buy the drug illegally on the street. Patients who
buy legally from a dispensary also have to pay money to go to a doctor
for a recommendation and have to pay a $100 annual registration fee to
the state.

"If we start off lowering the prices in the medical marijuana
community, the black market would have to come down in prices, too,"
said Charles Wynott of Westbrook, a longtime medical marijuana
advocate who uses the drug to treat the symptoms of AIDS.

The patients who need the medication most are often disabled due to
their illnesses and live on monthly disability checks, in many cases
just $690 a month, according to Wynott and other advocates.

Wynott is one of a number of caregivers in southern Maine who grow the
drug on a small scale for some of those patients at $150 an ounce, or
less. For some of his sickest and neediest patients, Wynott said, "we
don't even ask for money at all."

He doesn't worry that the patients are turning around and selling the
drugs for a profit, he said, and dispensaries should not raise their
prices for that reason, either.

A growing number of patients in Maine are now cultivating their own
marijuana at home to save money. But, unless they invest hundreds of
dollars in indoor growing equipment, patients typically don't produce
enough of their own medicine to avoid buying it altogether.

Black-market prices for medicinal pot have been an issue wherever
states have legalized it, although Maine is one of the first states to
require that dispensaries be nonprofits. In California, a recent
report by the RAND Drug Police Research Center concluded that
decriminalizing marijuana use in general -- as California voters could
do this fall -- would reduce the market price from $375 per ounce to
about $38 per ounce based on production costs.

Northeast Patients Group expects to charge around $340 an ounce, which
it says is slightly less than the street price here of $360. But the
group also is promising to make sure its neediest patients can afford
the medicine.

"There would be programs for seniors and for people who are unable to
purchase their medicine (at the market price). I understand that
concern and we want to make sure that everybody who needs this
medicine can access it," DeKeuster said. "We do have a serious concern
about diversion and we also feel we will be able to come up with a
pricing structure that works for everybody."

Another operator who plans to open a dispensary in Wilton said he
hopes the dispensaries will help make medical marijuana more
affordable over time, even if the prices can't start off that way.

"I think we have a social responsibility here where our prices are not
set by the black market, but we have a sense of what the black market
is," said Tim Smale, president of Remedy Compassion Center.

Smale is projecting a price of $400 per ounce in the first year of
operation, but declining to $324 by the third year as start-up costs
decline and sales grow. Smale said the dispensary also will offer
discounts, or even donated medicine, for patients who can't afford
those prices.

"I'm a patient, too. I want lower prices over time," Smale said. "I
have never been able to afford this medicine to the extent that I need
this for my migraine therapy."

Smale said the dispensaries are a big step forward for patients, but
not the last step. "I think it will be accessible. Whether or not it's
affordable may be another story, and that's what we have to work on."

A third dispensary operator is preparing to open Safe Alternatives in
Fort Kent and has estimated its price to be $250 to $300 an ounce. But
Safe Alternatives also plans to keep prices close to market prices in
its region to limit illegal resale of the drug, according to its
license application.

Some have hope that prices will come down because of competition among
the eight dispensaries and because more patients are growing their own
or getting it from small-scale caregivers who often sell at discounted
prices.

"With multiple dispensaries and a multitude of options outside of
dispensaries, these dispensaries are going to have no choice but to
offer reasonable prices," said Jonathan Leavitt, who helped lead the
referendum effort last fall that opened the door to
dispensaries.

Concerns about diversion seem valid, up to a point, Leavitt said.