Last week, the Texas Department of Public Safety (DPS) reported the Texas Compassionate Use Program (TCUP) patient numbers for the last month of quarter three (Q3) of 2022. Since the beginning of the year, TCUP patient numbers more than doubled from just above 18,000 to over 36,500 patients. However, TCUP growth rates experienced a slight retraction since the last quarterly results. The average month over month growth during the first quarter was 11%, Q2 - 9%, and Q3 - 8%, with the slowest growth in August and September.
This decrease could be attributed to the usual reasons such as summer travel, the expansion of cannabis programs in neighboring states such as New Mexico and Oklahoma, and the apparent continued explosion of gray market actors in Texas. However, an important factor not to be overlooked is quantifying the number of living registered TCUP patients processed through the system and informed by the physicians, that do not return to purchase products from the state program.
Reasons behind this could be attributed to economics and education. There is a significant cost associated with becoming a TCUP patient and the products are more expensive than in the states with robust medical cannabis programs. Once patients go through the TCUP process, consult with a cannabis physician and receive all the medical information regarding treatment options, dosages, and product profiles that work with their specific condition, do they come back to purchase more from the state program or do a portion of them take that knowledge and apply it to the illicit market? After participating in TCUP for a while, an educated consumer or patient is now armed with more knowledge, and some may opt to seek the equivalent products at lower prices in specific decriminalized markets in Texas.
If patients are not returning to purchase additional medication because it doesn’t make financial or practical sense, the state should seriously acknowledge this as another issue that impacts the structure and growth of TCUP. One remedy could be to expand the program and the product supply mix, which would open up the market and drive down the cost to consumers. Texas should also consider not just issuing more licenses, but specifically allowing the sale of flower, as is done in all other states that have medical cannabis. The illicit market will always be a factor in the overall state regulated scheme, however, there are certain steps the state can take to mitigate its impact so more Texans will ultimately benefit in the long run.
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