All entrepreneurs face challenges when they set up a business, but Ben Langley had to convince the Government he wasn’t intent on becoming an international drugs baron.
“We spent much of 2017 talking to the Home Office to make sure that the second we incorporated the company, we weren’t going to be arrested,” says Mr Langley, a former JP Morgan commodities trader who now runs medical cannabis start-up Grow. “We were thinking about research and development in Canada, where cannabis is legal, but we wanted to make sure that the Home Office wouldn’t come knocking at our door.”
Today the legislative framework in the UK is transformed following the recategorisation of cannabis exactly two years ago from a drug of “no medical value” to one that doctors could prescribe. The move followed a heart-rending campaign by Charlotte Caldwell, a mother from Castlederg, Northern Ireland, who was arrested at Heathrow Airport after bringing back cannabis oil for her severely epileptic son, Billy.
The same legalisation story has been echoed in many states across North America and the EU, and today the world’s biggest players in the medical cannabis market, such as Canopy Growth and Parallel in the US, are worth hundreds of millions or billions of pounds.
Legality of cannabis in the United States
In Europe, however, a fragmented market and, in some cases, residual reluctance to invest or prescribe a product that was illegal for so long, has crimped rampant growth.
Mr Langley, who aged 37, featured at No 58 on our 2020 Hot 100 list of Tech Entrepreneurs, is currently engaged on a £6m funding round that would value his company at £32m.
“It’s certainly not as easy as it should be to raise money for this industry, if you look at the excitement in terms of the growth potential,” he laments. “If this were ‘tech’ tech, everyone would be throwing money at us. Because this is cannabis, 90pc of those people disappear.”
Such reticence is not necessarily fatal, given that several venture capital firms specialising in cannabis start-ups have emerged, eager to back winners in an industry that analysts DBMR have predicted will grow at 20pc year-on-year to be worth $82bn worldwide by 2027. Indeed, Mr Langley hopes that specialist investment expertise will help shepherd Grow to stock market floatation in the next “one to three years”.
He is certainly evangelical about his product, waxing lyrical about the 150-or-so molecules in the cannabis flower (cannabinoids, in the jargon) with potentially therapeutic qualities. Of these, two are the basis of most cannabis medicines: THC and CBD. It is the former, a psychoactive constituent of cannabis, that gets users ‘high’. CBD, on the other hand, does not, and even moderates the action of THC. Most cannabis medicines offer various concentrations and ratios of these two but, says Mr Langley, one of the industry’s difficulties is that the other cannabinoids may also play a part.
Medicinal cannabis | What is CBD and THC?
“You have what’s called the ‘entourage effect’, which is basically the tail of what’s in the plant and can actually be quite important,” he says. “Frankly, there’s a lot more research work to be done.”
And therein lies the conundrum of the medical cannabis market. Most drugs undergo strict testing, usually in the form of randomised control trials (RCTs) before legalisation. Cannabis, on the other hand, was legalised before the usual battery of such trials. And doctors, used to prescribing standardised drugs in standardised doses, appear to be uncomfortable about issuing patients the new drugs.
The result is that, at present, only a few thousand patients are using medical cannabis. The vast majority of these are prescriptions through private doctors that can cost up to £2,000 per month (Mr Langley says the average cost to the 2,000 patients using Grow’s pharmacy is “less than £500 per month”).
Severe childhood epilepsy, which can involve hundreds of seizures each day, is one of several conditions for which advocates say cannabis medicines offer “life-changing” benefits. Yet so far, just three affected families have received free NHS prescriptions. Almost two dozen others are paying.
One drug that has been authorised for NHS prescriptions, Epidoylex, contains only CBD, which some parents say is not enough to control seizures. The Department for Health and Social Care insists “more evidence is needed to routinely prescribe and fund other treatments on the NHS”.
Such evidence, says Mr Langley, has traditionally taken the form of RCTs, though he says Nice (the National Institute for Clinical Excellence) “do accept real-world evidence, which I think is probably the bigger opportunity with cannabis”.
It is this switch from blind trial data to “anecdata” – testimony from patients – that is proving hard for some in the medical establishment to swallow. However, Langley insists its potential as a “multiple-compound medicine” means cannabis defies the usual assessment.
“What the Government wants, what Nice wants, is for us to look exactly like pharma has always looked like. To be honest, that’s a bit of a cop out.”
Grow is working, he says, “to educate” doctors so they may in future be less wary. He predicts that, given medicine is a highly-networked profession, a few conversions will lead to “exponential” uptake.
That is one strand of the Grow business. Its others are based on Mr Langley’s experience as a commodities trader or, as he puts it: “Essentially wholesale import/export of [cannabis] oils from Colombia to Germany, say.”
Telegraph Tech 100 2020: see the full list
Grow also runs its own R&D lab in Rothamsted, in Hertfordshire, to investigate purification and manufacturing processes with the aim of being “more precise with quantification” – that being the big hurdle to medical acceptance.
As Mr Langley puts it, variability, not safety, is the issue: “It’s a safe drug relative to most drugs out there, particularly things like opioids, but it does lack that data.”
The industry’s obsession with metrics is particularly frustrating, he insists, as we move from an era of generalised to personalised medicine, where the individual patient’s genetic make-up is revealed to have a significant effect on outcomes.
“What works for you might not work for me,” says Mr Langley. “Regulators want data, but that way of thinking about data in pharma, in the era of personalised medicine, is starting to morph.”
The success of medical cannabis, at least in the UK then, may depend on a new mindset that medical regulators and practitioners could take years to adopt, if they ever do. And yet the prize on offer, for patients and producers, appears so significant that it is hard to imagine that founders will stop trying.
Will Mr Langley be the one who changes minds and makes a fortune in the process? He knows it won’t be easy: “Potentially,” he says. “We could be a winner, if not the winner, in Europe and beyond.”
And he promises he hasn’t been smoking anything.
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