Two Veterans, Same Diagnosis, Different Rules: DVA's New Medicinal Cannabis Framework Creates a Two-Tier System

Imagine two veterans. Both served. Both are diagnosed with cancer this year. One received DVA-funded medicinal cannabis last year for a separate condition. The other is coming to the scheme for the first time.

Under the Department of Veterans' Affairs' updated Medicinal Cannabis Framework, announced today, those two veterans will not be treated the same.

The veteran already in the system keeps their existing arrangements — at least for now. The newly diagnosed veteran must find a Fellow of an AHPRA-accredited medical specialty to prescribe, attend an in-person consultation first, and navigate new THC concentration and dosage caps on dried herb products. All of this, effective immediately.

It is a two-tier system, created overnight, for people who may be facing some of the worst moments of their lives.

What DVA Has Actually Done

DVA has been funding medicinal cannabis for eligible veterans under the Repatriation Pharmaceutical Benefits Scheme (RPBS) since 2018, for conditions including chronic pain, chemotherapy-induced nausea and vomiting, palliative care, anorexia and wasting from chronic illness, spasticity from neurological conditions, and refractory paediatric epilepsy.

That list of conditions has not changed. DVA is not withdrawing funding for these indications. But for any veteran accessing the scheme for the first time from today, the rules are significantly different.

New patients must now be prescribed by Fellows of an AHPRA-accredited medical specialty, a requirement that immediately excludes the GP-led and telehealth-based prescribing models that have brought medicinal cannabis within reach of veterans in regional and remote Australia. The first consultation must also be in person.

Additionally, a daily dosage cap and THC concentration limit have been introduced for dried herb medicinal cannabis products for new patients, on the basis of what DVA describes as "increasing evidence of harm associated with high concentration THC products and/or high doses of THC, with insufficient evidence of benefit."

That framing, insufficient evidence of benefit, will raise eyebrows among clinicians and researchers who work in this space, particularly as it applies to patients in palliative care, where quality of life and symptom relief, rather than curative outcomes, are the measure of what works.

The Access Problem Nobody Is Talking About

Australia has a well-documented specialist shortage, and it is not evenly distributed. Veterans in metropolitan areas may be able to find a Fellow of an AHPRA-accredited specialty with relative ease. Veterans in rural and regional communities, who are disproportionately represented in the veteran population, face a different reality.

For a veteran in outback Queensland newly diagnosed with a terminal illness, "find a specialist and attend in person first" is not a neutral administrative requirement. It is a genuine barrier to care, arriving at the worst possible time.

The telehealth prescribing models that DVA is now effectively closing off for new patients were not a loophole, they were a considered response to the realities of Australian geography and veteran demographics.

A Grandfathering Period That Asks Questions of Its Own

Veterans already receiving DVA-funded products containing high-concentration or high-dose THC will continue under their current arrangements during a six-month grandfathering period, after which they will need to meet the new criteria.

DVA frames this as a transitional measure to allow "prescriptions to be adjusted in a safe way." That is a reasonable description of what it is. It is also a six-month countdown for some of the most vulnerable patients in the scheme, including those in palliative care, to restructure their treatment under new constraints.

If high-concentration THC products carry the risks DVA now cites, the question of why those patients were funded in the first place deserves an answer. If those patients' treating clinicians believe the current regimen is clinically appropriate, the question of why DVA's Framework now supersedes that clinical judgement also deserves an answer.

What DVA Isn't Funding — And Never Has

DVA has reiterated that it does not fund medicinal cannabis for mental health conditions. Given that PTSD remains one of the most prevalent and debilitating conditions in the veteran community, and given the volume of emerging research into cannabinoids and trauma-related disorders, that exclusion continues to represent a significant gap between the lived experience of veterans and the conditions DVA is willing to fund.

That policy has not changed today. But in a document full of changes justified by evidence, its absence without explanation is notable.

The Bottom Line

DVA says these changes are about ensuring it funds treatments that are "both safe and effective." That is an unimpeachable goal. Nobody disputes that prescribing standards matter, or that THC concentration deserves clinical oversight.

But policy intent and policy impact are not the same thing. The practical impact of today's announcement is that a veteran receiving a serious diagnosis from tomorrow onwards faces a harder, slower, more expensive path to the same funding their comrade next door has held for years, not because their need is lesser, but because of the date on their paperwork.

That is worth saying clearly.

This article reports on a government policy update and represents editorial commentary on that policy. It does not constitute medical advice. Decisions about medicinal cannabis treatments should be made in consultation with a qualified healthcare professional. More information on the updated Framework is available at dva.gov.au.