In a world first, Israel’s Teva Pharmaceutical Industries Ltd. and Tel Aviv-based Syqe Medical said they signed a distribution and cooperation agreement to market medical cannabis in an inhaler.

Under the agreement, Teva will be the exclusive marketer and distributor in Israel of an inhaler developed by Syqe Medical for the delivery of medical cannabis. The accord marks the first time that a major global pharma company has agreed to market a medical cannabis product, according to Syqe.

The Syqe inhaler has been used for more than a year at Haifa’s Rambam Hospital with the approval of the Health Ministry. This makes it the first hospital in the world to prescribe cannabis as a standard medical treatment.

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As part of the agreement with Teva Israel, the Syqe inhaler is expected to receive Health Ministry approval for home use by next year.

Israel’s reputation as a high-tech hub and a lax regulatory environment has allowed the startup nation to become a leader in cannabis technology, with dozens of local firms focusing on the medical field.The international medical cannabis market is forecast to be worth approximately $20 billion within a decade. About 1% of the global population are potential medical cannabis users at some point during their lifetime.

“Teva Israel is entering the field of medical cannabis out of a deep commitment to patients coping with pain, which is one of the company’s core therapeutic areas,” said Teva Israel CEO Avinoam Sapir, who also serves as Teva’s director for Africa and the Middle East, and as director of Innovation in Emerging Markets. “State-of-the-art technology and groundbreaking medical devices — such as those developed by Syqe Medical, and which generate tremendous therapeutic value for patients and medical staff alike — integrate perfectly into the strategy of Teva Israel.”

The accord aligns with Teva Israel’s strategy of investing in, or partnering with, local startups and groundbreaking Israeli initiatives to enable it access to innovative technologies and advanced medical devices, he said.

Precision doses

Syqe Medical, a developer of technologies for the pharmaceutical delivery of raw plants by inhalation, says it has developed the world’s first inhaler that enables the precise delivery of botanicals at the level of safety and precision of conventional drugs.

Medical cannabis is the first plant to be used in the inhaler. The company has completed clinical trials, which demonstrated the inhaler’s precision and compliance with pharmaceutical standards for the delivery of inhaled cannabis. Syqe Medical’s technology only modifies the physical structure of the plant, preserving all its characteristics and enabling safe, precise and measurable delivery by inhalation, Teva and Syqe said in a joint statement.

Until now, the quantities of active ingredients inhaled from cannabis have generally been unknown. In the absence of precise dosing, cannabis could not be prescribed as a standard medical treatment, causing difficulties for patients and the physicians who treat them.

Syqe Medical says its inhaler will allow cannabis to be regarded as a standard medical treatment, with precise control over dosage, tailored to patients, and their pain. The inhaler will allow medical professionals to prescribe an optimal dose of cannabis, alleviating the patient’s symptoms while minimizing the psychoactive effects. Another advantage of the inhaler is that it is a convenient and accessible option for patients who are reluctant to smoke cannabis.

Syqe Medical chairman Dr. Eytan Hyam, former director-general of the Health Ministry, said the deal with Teva represents an “unprecedented development” for patients who need medical cannabis.

“Thanks to the Syqe inhaler, we are effectively moving from cannabis use to cannabis treatment. For doctors, the inhaler solves the problem of prescribing plants for smoking, and offers a solution for patients in that, for the first time, they will be able to receive a precise dose of medical cannabis,” he said.

According to data provided by the companies, for 2016 there are about 26,000 patients licensed to use medical cannabis in Israel, some 90 percent of whom smoke it. The number of licenses is expected to double by 2018.

“The extent of medical cannabis use for the treatment of pain and other symptoms has increased significantly in recent years,” Prof. Elon Eisenberg, director of the Pain Research Department at Rambam Medical Center, said. “The main problem facing doctors and researchers is the inability to estimate the amount of cannabis that is administered via smoking or vaporization. The ability to do so forms the basis for administering proper treatment and conducting significant scientific research. The development of this inhaler fulfills our greatest hopes, to be able to administer accurate and reliable doses of cannabis. It constitutes a breakthrough in cannabis treatment and the medical use of cannabis in Israel and around the world.”

According to the terms of the strategic cooperation with Teva, Syqe Medical will be responsible for manufacturing the inhaler and disposable cartridges. They will be marketed and distributed by Teva Israel to relevant parties, including doctors, nurses, hospitals, pain clinics, oncology clinics and pharmacies. The Syqe inhaler is intended for patients suffering a variety of illnesses, based on indications approved by the Health Ministry.

Teva Israel and Syqe Medical are also setting up a support and training system for patients and medical professionals, consisting of a team of nurses to be established especially for this purpose.

To date Syqe has raised $33 million, including $20 million from Philip Morris International, according to data provided by the company.