A Study Examining Efficacy and Cost-Effectiveness of Thai Medical Cannabis Products in Increasing Quality of Life of End-Stage Cancer Patients Receiving Palliative Care

Abstract

This study aimed to examine the efficacy and cost-effectiveness of two Thai tetrahydrocannabinol
(THC)-prominent cannabis products in improving the quality of life for end-stage cancer patients receiving
palliative care. This study was conducted as a randomized, double-blind, four-arm parallel-group,
placebo-controlled trial, with cost-effectiveness analysis at the forefront. Study participants were
end-stage cancer patients receiving palliative care within six general hospitals. We compared Deja oils
produced by the Department of Thai Traditional Medicine and Alternative Medicines (Deja oil) and
THC-prominent oil produced by the Thai Government Pharmaceutical Organization (GPO oil) with
placebos. The primary outcome was to determine the quality of life as measured by the EQ-5D-5L. The
study period covered November 2022 to August 2023. In total, 53 patients participated in the study after
providing informed consent. Study participants received the randomly selected cannabis product for 12
weeks or until the patient died or had adverse reactions. The research team conducted telephone interviews
every week to assess patients’ symptoms, cannabis product use, possible adverse reactions, quality of life,
and costs involved in receiving the treatment. As for the results, based on the limited sample size, neither
of the two genuine cannabis products offered any improvement in quality of life for any patients. However,
all four products statistically demonstrated significant improvement in patients’ sleep quality and there
was no statistically significant difference between products. Both of the real cannabis products were not
more cost-effective than the current standard palliative care treatment; however, the Deja oil was more
cost-effective than the GPO oil. Due to the study’s limited sample size and power, it was not possible to
positively or negatively conclude that both real cannabis products were significantly different from their
placebo counterparts in terms of either efficacy or cost-effectiveness in improving patients’ quality of life.