Over the past few years, telemedicine has reshaped how patients access medical cannabis, launching a wave of digital clinics across Europe and beyond. But now, that wave is breaking.
In this special three-part series, Business of Cannabis investigates the global backlash facing cannabis telehealth. Through the lens of Australia’s prosecutions, Poland’s policy reversal, and Germany’s pending legislation, we explore how telehealth became both a lifeline for patients and a liability for policymakers, and what comes next for the industry built around it.
You can read Part 2 here, and Part 3 here.
The cannabis telemedicine industry, namely the flood of online healthcare businesses offering prescriptions virtually across global medical cannabis markets, has provided the greatest boom to the industry since the ‘green rush’ of 2018 in recent years.
Now, however, governments and medical associations are pushing back against this rapid growth in collective moves that could see some of the world’s fastest growing markets significantly restricted.
Germany’s Ministry of Health has now published a long-feared draft amendment to its Medical Cannabis Act (MedCanG), threatening a crackdown which will be a major cause for concern for hundreds of cannabis businesses, both in and outside of German borders.
In parallel, the thriving Australian market is also enduring a widespread crackdown after the Australian Health Practitioner Regulation Agency (AHPRA) issued new guidance, specifically targeting ‘direct-to-consumer, single-issue telehealth models’.
Prohibition Partners Lead Analyst, Alex Khourdaji, said: “The political push-back on telemedicine is becoming a contentious issue throughout the global medical cannabis industry.
“Although it is clear that telemedicine services ease patient access tremendously, bad actors seeking profits over patient well-being put the entire industry in jeopardy. It is important that other markets with a telemedicine structure, such as the UK, learn the lessons from other markets and self-regulate efficiently in order to hinder malpractice and avoid bans on telemedicine services. At the end of the day the people that lose the most are the patients”
Germany
Back in May new figures showed that German medical cannabis imports have continued their meteoric rise, growing a further 15% on Q4, 2024 in the first quarter of 2025, totalling 37,223 kg.
In the wake of these dizzying growth statistics, the newly sworn in Federal Minister of Health, Nina Warken (CDU) seized the initiative and told Frankfurter Allgemeine Zeitung (FAZ) that she wants to ‘restrict the easily accessible online prescriptions’.
While this has long been a talking point of the anti-cannabis CDU party, their recent election success, seeing them become the largest party in the Bundestag (though not large enough to form a government alone), signalled that this rhetoric could soon become real-world policy.
This week, the German Federal Ministry of Health confirmed these fears, publishing a draft amendment targeting the loosely regulated telemedicine market in Germany.
The full draft is available here: https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/Gesetze_und_Verordnungen/GuV/C/RefE_AEndG_MedCanG.pdf
According to the Ministry, imports of medical cannabis flowers rose by 170% between the first and second halves of 2024, while (statutory health insurance) GKV-covered prescriptions increased by just 9%.
This, they say, suggests that a significant share of products are reaching patients via private prescriptions, often facilitated by online platforms with no in-person medical evaluation. The Ministry argued that this trend undermines patient safety, given that cannabis flowers are unlicensed medicines with addiction potential and cognitive health risks.
As such, it proposes the following changes to the MedCanG law:
In-person consultations now mandatory
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Initial prescriptions for cannabis flowers must follow a face-to-face consultation (in practice or via a home visit)
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Follow-up prescriptions online will still be allowed, but only if a personal consultation occurred in the past 12 months (4 quarters)
Ban on Mail-Order Dispensing
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Shipping of cannabis flowers directly to patients will no longer be allowed
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During the in-person consultation, patients must provide detailed medical history, alongside a physical examination and explicit consent to be treated with medical cannabis flower
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Prescriptions must now be collected in person at a pharmacy
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This is designed to ensure proper pharmaceutical counselling on use, side effects, and storage
Legal Sanctions for Non-Compliance
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Violations of these new rules would incur legal sanctions under MedCanG
The bill must now be approved by the Federal Cabinet, led by Chancellor Friedrich Merz and including ministers from the CDU/CSU–SPD coalition.
Given that the SPD were the original architects of the bill, it is unclear whether they will vote to approve the draft as it stands.
Australia
According to Prohibition Partners’ Global Cannabis Report: 5th Edition, Australia’s medical cannabis revenues are expected to grow from around US$600m in 2024 to more than US$1.2bn by 2028.
For comparison, this is over half of the projected value of all medical cannabis sales in Europe by 2028 (US$2.2 billion by 2028), with Germany’s sales accounting for US$1.2bn alone.
With growth rates fast catching up to the more mature German market, similarly driven by the explosion of telehealth services, Australian authorities have also raised concerns about the lack of oversight and potential for abuse of this model.
In September 2024, the Australian Health Practitioner Regulation Agency (AHPRA) established a new Rapid Regulatory Response Unit (RRRU), tasked with investigating rapidly evolving healthcare models, including online prescriptions for medical cannabis.
This marked a stark shift in its strategy, moving from targeting individual practitioners to investigating systemic issues in its current framework.
Earlier this month, new prescribing data gathered by the regulator uncovered what it called concerning prescribing patterns, raising ‘red flags’ and showing that ‘some practitioners are not meeting their professional obligations’.
This included findings that just eight practitioners had issued more than 10,000 prescriptions over a six-month period, including a single prescriber who issued over 17,000 by themselves.
In response, AHPRA has published new guidance for the medical cannabis sector, warning operators that it will not hesitate to prosecute those who violate these new rules.
AHPRA has already taken action against 57 healthcare practitioners, and is investigating a further 60.
The new AHPRA guidelines require clinics to:
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Treat medicinal cannabis like any drug of dependence (e.g. opioids)
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Prescribe only when clinically appropriate and not as first-line treatment
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Conduct a thorough patient assessment, a treatment plan, and an exit strategy
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Reflect clinical need, not patient demand
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Models built around single-medicine prescribing are now under review
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Future restrictions on direct prescribing by product sponsors are likely
- Unacceptable practices include:
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No legitimate indication
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Inadequate mental health checks
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Ultra-short consults
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Conflicts of interest (e.g. prescribing & dispensing)
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