Germany’s Bundesrat voted on November 21 to support key restrictions on medical cannabis prescribing and distribution, while rejecting proposals to ban prescriptions being sent via mail, a mixed outcome that offers both relief and concern for an industry bracing for regulatory tightening.
During its plenary session, the upper chamber adopted three core amendments to the Medical Cannabis Act (MedCanG), targeting foreign prescriptions, pricing inconsistencies and advertising practices that have fuelled the sector’s explosive growth.
What the Bundesrat approved
Members backed three core changes aimed at tightening regulatory oversight of prescribing, pricing and advertising.
First, the Bundesrat supported clarifying that foreign prescriptions from EU, EEA and Swiss doctors will not be recognised for medical cannabis. This provision is intended to ensure that all prescriptions comply with the new legal requirement for a personal consultation between doctor and patient, which German authorities are unable to verify for prescriptions issued abroad.
Second, members endorsed the reapplication of Germany’s medicines price regulation to medical cannabis. Since cannabis was moved out of the Narcotics Act, pharmacies have largely dropped prices as the market has become saturated and fiercely competitive. Should the bill be passed without further changes, medical cannabis would once again be subject to standardised pricing rules under the Arzneimittelpreisverordnung.
Third, the chamber approved a ban on public advertising for medical cannabis. This would apply the existing prohibition on consumer-facing advertising for prescription-only medicines to cannabis products, targeting the rapid growth of online platforms that promote simplified access to treatment.
What the Bundesrat rejected
Critically, proposals to classify mail-order distribution of cannabis flowers as an administrative offence did not receive majority support.
This means the controversial mail-order ban, which industry groups warned would devastate patient access in rural areas, would remain in its original form without additional enforcement mechanisms.
A separate proposal to establish new oversight mechanisms for verifying in-person consultations was also voted down, as was a state-level motion.
What happens next?
It’s important to note that the Bundesrat’s position does not determine the bill’s final content. Because the MedCanG amendment is classified as an ‘objection bill’ (Einspruchsgesetz) rather than a ‘consent bill’ (Zustimmungsgesetz), the upper chamber cannot block it outright.
The adopted recommendations now move to the Federal Government and subsequently to the Bundestag, which holds primary legislative authority. The Bundestag may adopt, modify or disregard the Bundesrat’s recommendations entirely.
If the Bundesrat remains dissatisfied with the final version, it can request mediation committee proceedings or lodge a formal objection, but in both cases, the Bundestag can override by majority vote.
The rejection of mail-order penalties will offer some temporary relief for pharmacies and patients who depend on delivery services, particularly in underserved regions. However, the underlying mail-order restrictions in the draft bill remain intact and will proceed through the Bundestag.
The foreign prescription ban takes direct aim at offshore telemedicine operators, what industry sources have described as ‘middlemen’ largely detached from the German market. This provision, if enacted, could significantly disrupt business models built around EU-based prescribing platforms.
The advertising restrictions, meanwhile, target the aggressive marketing practices that have drawn political criticism and contributed to the government’s characterisation of the import surge as ‘abuse.’
With the SPD signalling ongoing resistance to the bill’s most restrictive elements, the legislation’s final form remains uncertain. Industry observers expect further amendments during Bundestag deliberations, with a final vote unlikely before 2026.
This is a developing story
