G-BA Decision on Medical Cannabis – A Win for Patients

Background of the decision

For those who might not recall: In July 2023, the German Bundestag passed the Engpassgesetz (ALBVVG1), which, among other things, defined that certain specialist doctors should be excempted from the so-called Genehmigungsvorbehalt. This prior approval requirement meant that health insurance companies had to approve the prescription for reimbursement beforehand. The G-BA was tasked with defining specialist groups and the necessary medical qualifications , that would no longer require prior approval (Genehmigungsvorbehalt) from health insurance for prescribing medical cannabis.

In November, the G-BA published a draft and consulted various stakeholders for feedback. Several associations called for completely abolishing the Genehmigungsvorbehalt or at least including general practitioners, who are the second largest group of prescribers. They play a crucial role in the current patient care landscape with cannabis medicines, especially in rural areas, and considering the growing shortage of specialists.

Implementation and Impact

While the Committee took their time, the decision was more positive than originally anticipated. Doctors from 16 specialties, including general medicine, anesthesiology, internal medicine, neurology, and psychiatry, can now prescribe medical cannabis without prior health insurance approval at GKV expenses. Five additional qualifications, such as geriatrics, palliative medicine, and specialized pain therapy, are also included. The G-BA ensured that the feedback from the consultation period was considered and selected those specialists who can best assess the requirements for a cannabis prescription.

This change empowers a large number of German medical practitioners to prescribe medical cannabis more freely and less bureaucratic. The decision eliminates the cumbersome approval process from health insurance companies, significantly reducing the administrative workload for doctors. As a result, patients can expect faster access to necessary treatments.

Documentation and Compliance Remain the Same.

It is important to note that while the process for doctors to prescribe medical cannabis at the expenses of the GKV has been simplified, the requirements for a cannabis prescription to be reimbursed by health insurance have not changed. Patients in Germany have a statutory right to medical cannabis if they have a life-threatening illness or a serious condition that significantly impairs their quality of life. Additionally, a series of conditions must be met. Therefore, doctors must still carefully document the prescription of medical cannabis, including the indication, treatment course, and achieved therapy results.

Patient Advocacy Pays Off

This decision is thanks to the long-standing efforts of stakeholders who have highlighted the issues faced by severely ill patients waiting for health insurance approval. Their persistent advocacy has been instrumental in driving this change. The decision marks a significant shift towards the normalization of medical cannabis in the healthcare system, potentially increasing its acceptance and integration into standard medical practice.

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We wish you a good read!

With legalising greetings,