I can see why cannabinoid pills are needed. There are many cancer-stricken people that find smoking and the association with a MJ culture distasteful. The poster enoughorangejuice? has some threads up about Marinol and how his docs wife is a senior and was able to regain a lot of weight with the help of Marinol. Old women are exactly the kind of people I'm talking about here.
Yeah, for the price of Marinol, you could just buy a vape. But, there's also the issue of giving people standard doses so you (the hypothetical doc) can better relate the medicine to side effects. Adults should be able to and usually do titrate doses better with smoking/vaping, but giving someone a license and letting them choose between very different strains and amounts runs counter to most medical practice.
Sativex sounds like a much better alternative. Faster working, extracted from standardized plants, THC and CBD, sublingual/buccal spray for faster relief and easier dose titration than capsules. It's too bad I don't think the US even uses it.