It’s now five months since the German Federal Cabinet adopted draft amendments to its pivotal Medizinal-Cannabisgesetzes (MedCanG) bill, and its finalisation is expected in the coming weeks.
Since MedCanG was implemented alongside CanG in early 2024, Germany’s medical cannabis market has grown at a rate that has surprised even its most bullish advocates. Imports nearly tripled in 2025 alone, investment has flooded in, and North American operators have scrambled to secure a foothold in what is now comfortably Europe’s largest regulated market.
The proposed amendments, which target online prescriptions, mail-order delivery, advertising practices, and foreign prescriptions, threaten to reshape the conditions that drove that growth. Whether the result will be better for patients, the industry, or both depends largely on who you ask.
The coalition government remains split on which measures to enact and to what extent, with the SPD and Greens pushing back hard against the bill’s most restrictive elements. The final law, when it comes, is likely to look significantly different from what Health Minister Nina Warken originally proposed.
For Cansativa, one of Europe’s largest pharmaceutical cannabis distributors, a regulatory clampdown is in the best interests of the industry in the long run.
Jakob Sons, who co-founded Cansativa alongside his brother Benedikt, told Business of Cannabis: “Regulatory tightening benefits compliance-focused infrastructure providers. Higher enforcement standards increase barriers to entry and strengthen competitive moats.”
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The bill and the fault lines
The draft amendment, adopted by the Federal Cabinet in October 2025, was framed as a corrective to what Health Minister Warken has described as ‘clear abuse’ of the framework.
This assessment is based on assertions that medical cannabis imports into Germany rose by over 400% year-on-year in the first half of 2025, but statutory health insurance prescriptions only increased modestly. The government’s conclusion, therefore, is that self-paying patients are using the swathe of online prescription services to obtain medical cannabis for recreational purposes.
To rectify this dynamic, the proposed amendments sought to impose requirement of mandatory in-person consultation between doctor and patient before any cannabis prescription can be issued, ban mail-order delivery of cannabis flower by pharmacies, and introduce stricter advertising restrictions. A fourth measure, refusing to recognise foreign EU prescriptions in German pharmacies, was proposed by the Bundesrat but rejected by the federal government on EU law grounds.
The bill received its first reading in the Bundestag in December, followed by a public expert hearing in the Health Committee in January. While no decisions were made during the hearing, a consensus that telemedicine platforms, loosely regulated and prone to aggressive advertising, were the key issue.
The advertising issue is already being tested in the courts. In January, the Frankfurt Regional Court granted an injunction against telemedicine platform Bloomwell, prohibiting it from using celebrity endorsements, including German rapper Sido, to advertise medical cannabis, and from offering free prescriptions as a purchase incentive.
A broader case before the Federal Court of Justice, examining whether Bloomwell’s entire model constitutes prohibited prescription drug advertising, remains pending.
Jakob Sons explained: “Telemedicine platforms contributed to short-term price compression by enabling competitive bidding dynamics between manufacturers seeking listing visibility. That dynamic created short-term distortion but not structural demand weakness. As regulatory tightening progresses, we expect equilibrium to return.”
As the parliamentary debate continues over which proposals to push through, fault-lines appear to have hardened. The CDU/CSU needs SPD support to pass the bill, but that support is far from forthcoming.
SPD health policy expert Serdar Yüksel has warned that restricting telemedicine access ‘will particularly affect people who cannot find an experienced doctor locally,’ pointing out that many general practitioners have limited experience with cannabis, leaving specialist practices, often operating nationally via telemedicine, as the primary point of care for many patients.
His colleague Matthias Mieves added: “I don’t think a general ban on the mail-order sale of medical cannabis is the right approach.”
Meanwhile, the Greens have called for a ‘standardised online prescribing system’ rather than prohibition, and have separately cited an expert opinion concluding that an outright ban on online prescribing violates EU law.
Notably, even within CDU/CSU there is reported internal disagreement, with health spokesperson Simone Borchardt confirming the party is actively exploring compromise positions with its coalition partner.
As such, it’s unlikely the proposals will make it into law without significant concessions, if at all. The emerging cross-party consensus points toward mandatory genuine medical consultation for initial prescriptions, with video consultation remaining permissible where medically justifiable, alongside tighter documentation standards and stricter advertising rules. The full telemedicine ban and the mail-order ban are both unlikely to be brought forward in any form that resembles the initial proposals.
Jakob stated: “We expect stronger enforcement around prescription integrity, telemedicine oversight and advertising rules for prescription medicines. Germany applies strict pharmaceutical advertising laws and medical cannabis will increasingly be treated consistently within that framework. The direction of travel is clear. Physician oversight will be reinforced, pharmacy dispensing will remain central and loosely regulated digital steering mechanisms will face tighter scrutiny.”
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What will it mean for the sector?
Whatever form the final amendments take, Cansativa’s co-founders are confident on where the market is heading and how long it will take to get there.
“For investors, regulatory clarity reduces volatility,” Jakob continued. “A pharmacy-centred system with enforceable standards creates long-term stability.”
That stability, in Cansativa’s view, is the precondition for Germany realising its full potential. As Benedikt Sons set out in the first part of our interview, the company estimates Germany’s long-term annual market potential at approximately €8bn, with the broader European opportunity exceeding €20 billion.
Reaching that scale, he argues, requires several structural shifts to occur in parallel. “Physician education must continue, reimbursement pathways should expand, and regulatory clarity must remain consistent,” he said.
“Cross-border European harmonisation will further accelerate growth. A realistic horizon for reaching that scale is four to seven years, assuming continued consolidation and regulatory stability.”
“Importantly, this projection reflects not only domestic demand but Germany’s role as Europe’s central distribution hub. Europe is early in the adoption curve, and medical cannabis represents one of the most significant emerging healthcare segments on the continent.”
The recent wave of M&A activity suggests the market is already organising itself around that thesis without waiting for legislative certainty. The caveat is that a softer legislative outcome than Warken originally proposed would leave some platform-driven models more intact than Cansativa’s thesis implies.
Jakob Sons believes that regardless of the legislative outcome, the direction of travel is clear.
“Germany embedded medical cannabis within its pharmaceutical system from the outset. The key lesson is that infrastructure must scale alongside access. Markets driven primarily by digital channel arbitrage are volatile. Markets anchored in healthcare compliance are durable.”
The second and third Bundestag readings are expected in the coming weeks. Whatever emerges, the industry is already looking ahead to the next phase of the market.
