In Germany, the partial legalisation of cannabis has opened up a new telemedicine market. Instead of visiting a doctor in person, patients can now request prescriptions online, with cannabis flowers sent directly to patients via specialist pharmacies.
Critics argue that this system allows ordinary consumers to obtain the plant-based medicine too easily, even if it does bypass the black market and generate tax revenue for the state.
Similarly, health insurers are not burdened with covering the cost of cannabis for patients with serious illnesses who require regular treatment.
Nevertheless, the GKV-Spitzenverband, the central association representing Germany’s statutory health and nursing care insurance funds, has welcomed the newly proposed changes to telemedicine rules.
In its statement on the planned amendment to the Medical Cannabis Act, it supported the proposals but criticised cannabis in flower form as a product without formal pharmaceutical approval.
The health insurers argue that cannabis use has increased, and that prolonged consumption, in particular, is linked to the onset of serious illnesses.
Anxiety disorders, depression, schizophrenia, visual and speech impairments, and tachycardia are among the possible effects on body and mind, prompting concern over rising costs for the health system.
As the GKV-SV told Pharmazeutische Zeitung: “The health-related follow-up costs of these possible consequences of long-term cannabis use are largely borne by the statutory health insurance system.”
They stress that even with cannabis, prescriptions should follow the principle of ‘as much as necessary, as little as possible.’
While welcoming the proposed ban on mail-order cannabis and the requirement for in-person consultations with doctors, as a way to curb excessive and medically unjustified use, the insurers remain sceptical about cannabis flowers altogether.
Unlike standardised extracts or ready-to-use cannabis-based medicines, dried cannabis flowers are not approved under pharmaceutical law. Their efficacy and safety, therefore, cannot be guaranteed due to a lack of formal testing.
The GKV-SV concludes there is no medical necessity for cannabis in dried flower form, meaning the current supply arrangements and reimbursement obligations should be reconsidered. From its perspective, dried flowers should no longer be covered by statutory health insurance.
The association also wants tighter rules for all cannabis-based medicines. It supports banning ‘lay advertising’ for raw materials used in prescriptions or extemporaneous preparations, and favours reintroducing stricter criteria for authorisation.
Such changes would make it harder for patients to exploit frequent changes of prescribing doctor and would encourage regular reviews of treatment effectiveness.
Despite shifting global attitudes towards cannabis and a growing body of scientific research, the GKV-SV remains sceptical, conservative and critical of cannabis-based medicines.
Additional evidence against cannabis use was presented in July by the Kaufmännische Krankenkasse (KKH). It estimated that around 250,500 people in Germany received medical treatment for mental and behavioural disorders linked to cannabis use in 2024.
Since partial legalisation, such diagnoses have reached their highest level in a decade, and their fastest rate of increase, rising by 14.5%.
However, the KKH figures, reported by Welt, do not account for the fact that, under current conditions, most consumers still lack access to legally produced cannabis and are therefore likely using untested black-market products.
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Critics argue that this system allows ordinary consumers to obtain the plant-based medicine too easily, even if it does bypass the black market and generate tax revenue for the state.
Similarly, health insurers are not burdened with covering the cost of cannabis for patients with serious illnesses who require regular treatment.
Nevertheless, the GKV-Spitzenverband, the central association representing Germany’s statutory health and nursing care insurance funds, has welcomed the newly proposed changes to telemedicine rules.
In its statement on the planned amendment to the Medical Cannabis Act, it supported the proposals but criticised cannabis in flower form as a product without formal pharmaceutical approval.
‘Cannabis makes you ill’
The health insurers argue that cannabis use has increased, and that prolonged consumption, in particular, is linked to the onset of serious illnesses.
Anxiety disorders, depression, schizophrenia, visual and speech impairments, and tachycardia are among the possible effects on body and mind, prompting concern over rising costs for the health system.
As the GKV-SV told Pharmazeutische Zeitung: “The health-related follow-up costs of these possible consequences of long-term cannabis use are largely borne by the statutory health insurance system.”
They stress that even with cannabis, prescriptions should follow the principle of ‘as much as necessary, as little as possible.’
No reimbursement for flowers
While welcoming the proposed ban on mail-order cannabis and the requirement for in-person consultations with doctors, as a way to curb excessive and medically unjustified use, the insurers remain sceptical about cannabis flowers altogether.
Unlike standardised extracts or ready-to-use cannabis-based medicines, dried cannabis flowers are not approved under pharmaceutical law. Their efficacy and safety, therefore, cannot be guaranteed due to a lack of formal testing.
The GKV-SV concludes there is no medical necessity for cannabis in dried flower form, meaning the current supply arrangements and reimbursement obligations should be reconsidered. From its perspective, dried flowers should no longer be covered by statutory health insurance.
Calls for stricter requirements
The association also wants tighter rules for all cannabis-based medicines. It supports banning ‘lay advertising’ for raw materials used in prescriptions or extemporaneous preparations, and favours reintroducing stricter criteria for authorisation.
Such changes would make it harder for patients to exploit frequent changes of prescribing doctor and would encourage regular reviews of treatment effectiveness.
Despite shifting global attitudes towards cannabis and a growing body of scientific research, the GKV-SV remains sceptical, conservative and critical of cannabis-based medicines.
More treatments linked to cannabis use
Additional evidence against cannabis use was presented in July by the Kaufmännische Krankenkasse (KKH). It estimated that around 250,500 people in Germany received medical treatment for mental and behavioural disorders linked to cannabis use in 2024.
Since partial legalisation, such diagnoses have reached their highest level in a decade, and their fastest rate of increase, rising by 14.5%.
However, the KKH figures, reported by Welt, do not account for the fact that, under current conditions, most consumers still lack access to legally produced cannabis and are therefore likely using untested black-market products.
The post German Health Insurance Companies No Longer Want to Cover the Costs of Cannabis Flower appeared first on Business of Cannabis.
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