Albany

More than three-quarters of the state's 13,000 or so medical marijuana-eligible patients have purchased the drug, but only half of the 13,000 are repeat buyers under the tightly regulated state program, according to Department of Health data provided to the Times Union.

Through late January, 12,933 patients had been certified by their doctors to participate in the state's medical marijuana program and 10,250 patients had been dispensed a medical marijuana product. But the number of patients who had been dispensed a product more than once was 6,403.

That data backs up anecdotal evidence about patients' purchasing habits over the first year of the program. While the five companies authorized to sell medical marijuana products have had products to offer, demand has been on a slower growth curve than the businesses would like.

These less-than-robust sales have caused issues for patients, including prohibitive prices they must cover out of pocket because insurance does not cover medical marijuana.

Diagnosing why about half of all patients aren't returning to pick up a second round of medicine isn't an exact science.

"If the implication is that only certain people are continuing on medical marijuana because they can afford it, there are probably lots of reasons for that besides just price," said Josh Vinciguerra, the Department of Health's Narcotic Enforcement Bureau director.

He pointed to the fact that medical marijuana remains a new area of treatment for a number of doctors and patients who might be willing to become certified for the program but are wary of actually taking advantage.

Vinciguerra also noted that in extreme cases, the deaths of severely ill patients who either never were able to purchase the drug or never made it back for a second round before they died might also be a contributing factor.

In other instances, medical marijuana might not be effective for some one-time patients.

But Vinciguerra said cost does remain a focus for DOH moving forward, adding that the department believes opening the program up to more companies (only five are currently authorized to operate) could also assist with price issues by adding competition to the market.

The state has taken other actions to try to grow the program, including steps to allow nurse practitioners and physician assistants, not just doctors, to certify patients; the addition of chronic pain to the list of qualifying conditions; and a decision to allow companies to make home deliveries of their products.

Pricing reforms are happening on the company level, and some have turned to discounts in an effort build up their customer bases. Etain, which grows and produces products in Warren County and has an Albany dispensary, recently instituted a repeat buyer discount program. Politico New York reported Wednesday that PharmaCann will drop prices on all of its products by 25 percent.

Still, one medical marijuana company executive said even if all 13,000 patients (as of Feb. 7, the number stood at 13,389) were purchasing products on a regular basis, they would constitute a market small enough for just one of the five current companies to handle.

"But as you now see clearly from the data, we have never had 13,000 patients," Vireo Health of New York CEO Ari Hoffnung said. "We do not even have 6,400 patients, because 6,400 patients is essentially a data point of — over the past 12 or 13 months — how many people purchased twice. You can purchase twice and never purchase again. You may have purchased in January or February of 2016 and never came back. ... There's a lot of reasons patients don't come back."

mhamilton@timesunion.com • 518-454-5449 • @matt_hamilton10