In Pennsylvania, the wait for medical marijuana is almost over.
The first cannabis products are shipping this week to a half-dozen dispensaries scattered across the state. Two of those dispensaries are opening in the Philadelphia region on Saturday: Terra Vida Holistic Center in Sellersville and Keystone Shops in Devon.
Gov. Wolf, who signed the bill legalizing medical marijuana in April 2016, took a rhetorical victory lap on Tuesday to announce the start of marijuana sales.
"Pennsylvanians have been waiting years for this moment," Wolf said in a statement. "Medical marijuana is legal, safe, and now available to Pennsylvanians suffering from 17 serious medical conditions. In less than two years, we have developed a regulatory infrastructure, approved physicians as practitioners, certified patients to participate, and launched a new industry to help thousands find relief from their debilitating symptoms."
But key questions remain: Once patients get a look at the price tags on the medicinal oils and tinctures, will they bother to stay in the program? Or will sticker shock drive them out and into the illicit market?
Retail prices for all of the products remain unpublished and unknown. Because the federal government considers all forms of marijuana to be illegal, no insurance plan will pay for the medicines. That means patients will have to cover the entire cost out of pocket.
Patrick Nightingale, a Pittsburgh lawyer specializing in marijuana law, said he expects prices to start high but eventually become competitive.
"If I can get a gram of live resin for $45 on the illicit market, and the dispensaries are selling the same thing for $60, there's not a lot of incentive for me as a patient to buy at a legal dispensary," Nightingale said. "Eventually, they'll have no alternative but to compete with the black market."
Live resin is a highly concentrated cannabis extract, one of the many forms of medical marijuana available to Pennsylvania patients.
Initially, only one of the 12 state-permitted grower-processors is providing product for the entire state. Cresco Yeltrah, of Butler, was the first to plant and first to harvest. Other growers are expected to start shipping within the month.
More than 17,000 patients have registered to participate in Pennsylvania's marijuana program. About 4,000 of those have been certified by a physician. The agency says 376 physicians are approved to write recommendations.
With only one supplier, some experts are expecting limited inventories.
"I wouldn't be surprised if there are shortages immediately," said Becky Dansky, legislative council for the Marijuana Policy Project, a national advocacy group. "One supplier can't provide medicine for all 1,000-plus patients for any extended period. It's not reasonable to expect that."
Along with limited quantities, Dansky said, she also was concerned about prices. She warned that Pennsylvania could suffer the same fate as two other medical programs that began as cannabis oil-only markets.
"In New York and Minnesota, about half of patients never returned to a dispensary after their first visit," she added. "In both cases the reason was that cost was prohibitive. Patients returned to the illicit market and businesses took huge losses."