5 years of legalization of medical cannabis in Germany: what results?

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Five years ago, the Bundestag paved the way for prescription cannabis in Germany. Since then, doctors can prescribe medical cannabis to patients with serious illnesses and in the absence of any alternative therapy.

Around 100,000 patients are currently treated with cannabis according to the latest estimates, 100 times more than before legalization where 1,000 patients had an exemption from the Narcotics Act which allowed them to enjoy access to Dutch medical cannabis. .

The German system

With the amendments made in March 2017 to the Narcotic Drugs Act (BtMG) and the Narcotics Prescription Ordinance (BtMVV), cannabis flowers and extracts as well as pharmaceutical preparations such as dronabinol can be prescribed on a dedicated prescription. narcotics at the expense of health insurance.

Patients with a serious illness are entitled to medical cannabis. Doctors must obtain the agreement of the health insurance fund before starting treatment, which can only be refused in justified exceptional cases. Patients are entitled to a maximum of 100g of flowers for 30 days or 1g of pure THC extract.

The country is supplied almost exclusively from abroad, the national production licenses having taken their time to be awarded. Cannabis imports have thus increased by 75% between 2020 and 2021 to around 30 tonnes per year, combining flowers and extracts.

Constraints to be resolved

The German market is now the largest European medical cannabis market, pending France. On the supply side, in 5 years, the supply of medical cannabis has expanded: there are now around 150 varieties and 60 different extracts available on the German market. In addition to supply difficulties based on the importation of non-negligible quantities of narcotics, patients still have difficulty accessing cannabis.

The treatment of medical cannabis by a doctor is not always easy. There is therefore no single form of therapy for all patients, who require individual and increased follow-up. The training of health professionals plays ultimately much in the accessibility of medical cannabis. If German doctors have additional training in “special pain therapy” or are trained in “palliative medicine”, they can now more easily prescribe medical cannabis products to their patients after a training session of 20 hours and continuous learning.

Medical cannabis also weighs heavily on health insurance funds. Imported, often sold to pharmacies by wholesalers who drive up the final price of the drug, it is charged almost 3 times the price of medical cannabis in the Netherlands, a significant financial burden for health insurance companies who reimburse the drug to patients.

Will the future legalization of cannabis for adults in Germany open up access to medical cannabis or, on the contrary, cause a shortage of available cannabis? See you in 5 years for the answer.

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