Inside Germany’s New Medical Marijuana Law

On January 19, the German Parliament unanimously voted to legalize medical cannabis. “Critically ill people must be cared for in the best possible way,” federal health minister Hermann Gröhe said at the time. “The costs of using cannabis for medicinal purposes will be met by the health insurance companies if the critically ill, if no other form of treatment is effective.”

The law went into effect in March. Patients are now able to receive up to five ounces per month at a cost of $12 per ounce under public health insurance (which covers 90% of Germans). They can take their doctor’s prescription to any licensed apotheke, or pharmacy, to get it filled. Reimbursement will happen via a special fund set up by the government, with an eye to public health insurers then picking up the slack (probably after the five-year trial also mandated by the new law).

More than 1,000 patients have registered with the program. That number is expected to grow to between 5,000 and 10,000 per year for the next several years, depending on how doctors respond to government education efforts and patient demand.

There’s no list of qualifying illnesses. All patients need to do is get a doctor to write them a prescription. Therein lies the temporary catch. Even the government realizes that finding doctors willing to write such prescriptions is going to be problematic. However, a growing “cannabis doctors” community is eager to put the law into greater practice. Last summer, even before the law passed, legal sales of cannabis in pharmacies doubled—but pharmacies were charging $2,000 an ounce, paid for fully by the patient.

Fourteen cannabis strains are now legally available, all imported and supplied by the Netherlands’ Bedrocan and Canada’s MedCann GmbH. Allowing home growing has been put on a back burner.

As mandated by a United Nations drug treaty, the Cannabis Agency has been established. By May, it had begun to recruit staff members. They will go about implementing the day-to-day details, including vetting the responses to Germany’s first applications for domestically grown medical cannabis.

Ten grow licenses are up for grabs. There are already indications that leading international cannabis firms will have a clear advantage. All they need is an office in Germany and proof they can deliver 200 kilograms of medical-grade cannabis per year by 2019. If domestic crops in the first grow trials fail, it’s possible that imports will be used to back them up.

The Canadian firm Tilray, which began to export cannabis extracts to Croatia last year will likely receive one of the licenses. The U.S. company CW Hemp, maker of the “Charlotte’s Web” strain, which already exports to Argentina, might nab another. In addition, a licensed producer from Israel might partner with a German processor.

The German government wants a steady and expandable supply of cheaper and domestically produced cannabis, probably in the form of extracts, for the majority of patients. That said, cannabis flowers will be available for patients if doctors recommend that.

The biggest uncertainty right now domestically is what the winning combination of producers will look like. With a deadline for proposals to the Cannabis Agency coming in early summer, it’s likely that Germany won’t see its first domestically grown crops harvested until 2019 or 2020. The agency will presumably take until late this year or early in 2018 to screen, test and vet applicants.

While some failures in the early testing process can be expected, deadlines are deadlines. Indoor cannabis, in particular, can be grown with a precision that comes naturally to a nation where the trains usually arrive and depart on time.

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