It has been almost exactly a month since Germany’s CanG came into effect, making adult-use consumption and possession legal, within strict limits.
While its passage has been hailed as a milestone step forward for cannabis reform in Europe, cannabis advocates and businesses have expressed their disappointment that the initial goals of the bill, to launch a commercial adult-use market, were repealed during the legislative process.
However, with the removal of cannabis from the list of narcotics, a new but not unexpected ‘medical-recreational’ market is beginning to emerge, seeing scores of new patients pursue the now simple and cost effective telemedicine route to access cannabis.
Insurance companies and pharmacies are now pushing back on this phenomenon, and speculation is stirring that reimbursement for cannabis flower could soon be much harder to obtain.
Telemedicine boom
Since April 01, and the removal of cannabis from the Narcotics List, prescribing medical cannabis has been made dramatically more accessible for patients.
This puts cannabis prescriptions on par with other prescription drugs, such as high-strength ibuprofen and antidepressants.
Previously, prescribing doctors were faced with significant bureaucratic hurdles in every step of the supply chain, seeing them have to apply for a serialised narcotic prescription. Similarly, pharmacies were lumped with a considerable workload if they chose to handle narcotics like cannabis.
Now, for a patient to access medical cannabis, they simply need to attend a short initial consultation with their doctor, and they can secure a ‘purchase certificate’ for a private prescription, enabling them purchase cannabis from their local pharmacy.
Many companies are now offering these consultations, which can take as little as 10 minutes, online, and their prescriptions can be mail-ordered to their home or a pharmacy of their choice.
Germany currently has roughly 300,000 medical patients, around half of whom get some or all of their costs reimbursed via health insurance.
However, with the dramatic increase in accessibility and many telemedicine clinics offering affordable consultation and product prices, swathes of new patients are choosing to pay for their own medication privately.
Speaking at a recent panel discussion in Germany, Managing Director of Sanity Group, Finn Age Hänsel suggested that 70,000 new patients have been added since the start of April.
Cannamedical Pharma, a GDP and GMP certified pharmaceutical manufacturer, says it has also seen a spike in demand over the last month.
“Online teleclinics such as Algea Care in particular have treated around 100,000 patients in the first two weeks since the reclassification, which poses challenges for pharmacies nationwide,” says David Henn, CEO of Cannamedical Pharma.
“The partnerships with the pharmaceutical wholesalers Krieger and Otto Geilenkirchen allow products to be delivered to the affiliated pharmacies within a few hours.”
Jochen Meyer-Dönselmann, CEO of Krieger Pharma, echoed this, stating: “We have been receiving a sharp increase in demand since April 1, 2024.”
Speaking to German publication DAZ, Cantourage, which owns telemedicine platform Telecan and offers online consultations for €49, confirmed that registrations had increased by more than 300% week-on-week in April.
Other platforms are reporting huge spikes in sales and trouble keeping pace with the new levels of demand.
Some companies are offering ‘cannabis prescriptions for just €1’, or consultations for €4.20, in a clear effort to market to this new cohort of cannabis patients.
Patients can secure prescriptions for conditions ranging from sleep problems to stress, ADHD, chronic pain, and even premature ejaculation, with a wide range of strains available at prices which can compete with the black market.
Prohibition Partners‘ Senior Analyst Alex Khourdaji told Business of Cannabis: “The MedCanG law has certainly removed many burdens associated with medical cannabis access and prescriptions for patients. This is especially notable for self-payers who can obtain prescriptions through initial video-consultations with one of the dozen telehealth clinics in Germany and receive their medical cannabis in a matter of days through mail order pharmacies.
“This has created an avenue for adult-use users who traditionally have been using cannabis for recreational purposes but also have benefited from its medical properties. One can make the argument that the easy access to medical cannabis is similar to that once seen in US states such as California, where adult-use users would enter the medical cannabis route to receive legal cannabis, albeit in a more sophisticated and digital landscape.”
Continued growth elsewhere
Despite this influx of new self-funded private prescriptions, it appears the rest of the market is also continuing to grow.
According to the latest figures, medical cannabis reimbursements through Germany’s statutory health insurance (Gesetzliche Krankenversicherung of GKV), which covers around 90% of the population, continue to expand year-on-year.
It is understood that around 50% of the 300,000 medical cannabis patients in the German market prior to April’s boom recieved some reimbursement through GKV.
Meanwhile, although CanG could also open the doors for domestic German production, for now the market continues to rely on imports.
The latest figures from BfArM (Federal Institute for Drugs and Medical Devices) show that cannabis imports for scientific purposes, some of which are re-exported throughout Europe, are also continuing to grow at pace.
In 2023, Germany imported a record 32,398kg of cannabis products, up 26.6% on the year prior.
