Cansativa Expert Dialogue: An Interview with Melanie Dolfen, Pharmacist and Pioneer in Medicinal Cannabis

You are both a pharmacist and an entrepreneur. What motivates you?

For one thing, I’m often under pressure, yet I try to remain as relaxed as possible. I am somewhat traditional in my view that a pharmacist should act more like a family doctor than a merchant. In the same way as a family doctor, we serve as the local pharmacy for many. We advise and consult; people know and trust us, especially in areas where we have specialized like #kinkgesund and medizinal.com. Meanwhile, I am fully in the startup mindset. We are working to reinvent the pharmacy. As an entrepreneur, I am passionate about personalized medicine, which I hope will emerge soon. Personalized pharmacy fascinates me! In this area, I consider myself an activist, highly critical of Big Pharma and the industrial approach to people’s health. Things need to change.

One of your main focuses is providing medicinal cannabis. What have been the greatest challenges for you as both a pharmacist and entrepreneur in recent years?

Medicinal cannabis still has not fully established itself, which presents daily challenges for me. The greatest difficulties stem from our role as a pharmacy, including resistance from insurance companies, misinformation from associations, and biased Pharma PR. There’s a prevailing belief that only therapies involving finished pharmaceutical products are viable, leading to a subtle distrust towards patients who are supposedly only meant to receive standardized industrial products. This undermines our pharmacological expertise, despite our deep understanding of how these treatments work and their benefits to patients. It appears that the Joint Federal Committee (German: Gemeinsamer Bundesausschuss, G-BA) and the Federal Ministry of Health are undermining our efforts to integrate cannabis flower therapy. Moreover, the lack of research on medicinal cannabis further complicates the situation.

What, in your opinion, is the biggest misconception about medicinal cannabis?

We still face the same old prejudices. A major misconception is that cannabis that can be smoked cannot be medicinal. Many think that prescriptions for cannabis flowers are merely for pleasure. But that’s incorrect. The “failed legalization”, as I see it, is worrying because I fear that insurance companies will eventually succeed, and the funding for the flowers will be cut off. (We managed to prevent this once in 2023). This would be detrimental for patients with severe illnesses who genuinely benefit from it.

What has changed for you since the enactment of the cannabis law?

The chaos in pharmacies has increased. We struggle to distinguish between genuine patients and recreational consumers. The influx of inferior goods and the rise of dubious online platforms (and I don’t want to generalize) complicate our work further. Unfortunately, we missed establishing a clear separation here. It is not the pharmacy’s role to decide whether someone is truly a patient or whether the prescribing doctor is legitimate.

Doctors may find it easier now to address the issue and make prescriptions. However, despite legalization, public perception hasn’t shifted much. The topic has gained societal acceptance, yes, but whether more commitment is seen from already-known doctors or whether new doctors are getting involved is hard to tell.

Why do you consider the legalization to have failed?

The announcement that Germany would legalize cannabis prompted manufacturers to ramp up capacities for a market that doesn’t exist. The second pillar of legalization1, which would address commercialization, is missing. What was supposed to reach cannabis shops is now being pushed into pharmacies. This has resulted in a dubious online infrastructure that declares consumers as patients. The second pillar is clearly lacking. I advocate for medicinal cannabis as a serious medicine, not for serving recreational consumers indirectly. I aim to establish a robust second pillar to then discuss where recreational consumers can purchase their cannabis in the future.

What would you like from the federal government to sustainably strengthen and further develop the provision of medicinal cannabis?

The legalization has pressured medicinal cannabis because the government failed to clearly differentiate it from recreational cannabis. This urgently needs to be addressed! In my opinion, we need more government quality controls and significantly more research. We must work towards establishing binding indications. Additionally, better recognition and funding of patient-specific pharmacy work are essential. We have developed our expertise through self-motivation, given that medicinal cannabis is not covered in our formal education. This subject should undoubtedly be included in the curricula for doctors and pharmacists.

Anything else?

Do you have specific questions or suggestions for the Cannabis Briefing? Then send us an email to briefing@cansativa.de. If you are interested in revolutionising the cannabis industry with us, then stay tuned and follow our briefings!

We wish you a good read!

With legalising greetings,