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New Jersey’s medicinal marijuana industry generated $53.4 million last year — nearly doubling the revenue from the previous year — but the state will need to add at least 18 growers and 44 more retailers to keep pace with the rapidly expanding demand, according to a report released Monday by the state Health Department.

The latest report analyzing the nine-year-old program also found patients don’t often buy the full two-ounce maximum amount of cannabis the law allows because they can’t afford the cost. The state’s six dispensaries, or alternative treatment centers, also ration sales to stretch their limited supply of the plant.

The report concludes the program does not consistently and reliably serve the 44,000 registered patients who count on cannabis to reduce pain, reduce muscle spasms and the frequency of seizures, encourage appetite and reduce their reliance on opioid drugs.

“The Medicinal Marijuana Program has always prioritized patient needs above all else. Whether they are individuals with debilitating chronic pain, folks with end-stage cancer, or veterans with post-traumatic stress disorder, patients simply cannot wait any longer for therapy that is both more affordable and easier to access,” state Health Commissioner Shereef Elnahal said. “The need for this program is greater than ever.”

The findings bolster Gov. Phil Murphy’s plans to make medical cannabis vastly more accessible. Legislation that would loosen many of the program’s legal limits on the number of cultivators and retailers is bogged down in the political wrangling to pass a legalization bill for recreational marijuana at the same time.

“Globally, the market is keeping pace with demand, but individual ATCs have struggled to keep pace with a growing patient population, and every ATC limited patients’ purchases at points during the study period. Therefore, the current market assessment points to the need for additional alternative treatment centers,” the report said.

Since Murphy took office in January 2018, the program has grown from 18,000 patients to 44,000 patients as of March. The growth spurt followed the governor’s decision to add anxiety, two causes of chronic pain and migraines to the program’s list of qualifying conditions, among other reforms.

But the health department’s report makes clear the program could serve about 180,000 patients by January 2022 based on the passage of the medical marijuana expansion bill, (A10). Patients would be allowed to buy up to 3 ounces a month — up from 2 ounces — or an unlimited supply if they had a terminal diagnosis, according to the bill. Home delivery also would be available, and the sales tax would be phased out.

According to the 27-page report:

Patients translated into dramatically higher sales, turning what was a $29 million industry in 2017 into a $53.4 million in 2018. All six dispensaries are required to operate as nonprofit entities, but that would change under the medical marijuana expansion law. Curaleaf in Bellmawr generated the most revenue last year, at $19.1 million.

“While revenue alone does not indicate profitability, the high revenue in 2018 points to a significant increase across the entire market that bears further study,” the report said. “For that reason, the Department intends to further study the costs associated with running an Alternative Treatment Center in New Jersey. If these revenues do in fact represent profitability, then it begs the question as to whether profitability at New Jersey’s ATCs will eventually result in lower costs for patients. To date, that does not appear to be the case.”

Within the next three years, the state will need a minimum of 24 cannabis growers and 50 sellers, based on the current pace of enrollment. There are six active alternative treatment centers that grow and sell, while another six are going through the vetting and permitting process.

If the program expands as envisioned by the new medical marijuana law, the market could support up to 88 dispensaries and 34 to 58 growers depending on the size of the cultivation facility.

Less than half of registered patients live within 30 minutes in “light traffic” from a cannabis retailer. “The drive time analysis supports the need for additional ATCs,” the report said. The trip is hours longer for patients who are too sick to smoke or prefer lozenges and tinctures, manufactured only at Curaleaf in Bellmawr and Breakwater in Cranbury.

Medical cannabis prices, though expensive, are “not excessive" compared to the black market. This conclusion, however is based on a number of caveats. Veterans and low-income people on government assistance programs qualify for discounted rates, skewing the price downward. The analysis also included all "flower sales, including those of shake, or ground up cannabis that is often sold for cheaper prices,” the report said. An ounce of pot on the black market costs about $343, based on the crowd-sourcing site, priceofweed.com . The aggregate average price per ounce of medical cannabis in New Jersey last year was $372.51 without discounts and $338.81 with discounts.

Patients who don’t qualify for discounts pay as as much as $500 per ounce or about $6,000 a year, including sales tax, the report said.

“Patients have to pay the full cost out-of-pocket, which combined with high prices leads to patients purchasing less than they would otherwise,” according to the report. “The best way to reduce prices is to expand supply and increase competition and choice for patients."

Read the report and find more information about the medicinal marijuana program at the Health Department’s website.

Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio. Find NJ.com Politics on Facebook.

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