What could change for patients?
As already proposed in the July draft, the core elements of the initiative remain unchanged in the version now approved by the Cabinet. Initial prescriptions of cannabis flower would still be permitted only after a personal consultation – either in a doctor’s office or during a house visit. For repeat prescriptions, at least one such in-person consultation per year would be required. The planned ban on shipping cannabis flower by mail also remains part of the draft. This point had already sparked debate in the earlier draft, particularly regarding access in rural areas and for patients with limited mobility.
Import figures, telemedicine – and a question of interpretation
The Federal Ministry of Health continues to justify its proposal by pointing to a sharp rise in import figures, which it links to growing use of telemedical platforms. But this is exactly where political and public debate begins. After all, the numbers tell more than one story. While cannabis flower imports rose by around 170% in the second half of 2024, the number of prescriptions issued through statutory health insurance (GKV) increased only moderately. This suggests that reclassification of medical cannabis – which is no longer listed as a narcotic – has opened access to therapy for many patients who were previously excluded. These may include those without a qualifying serious diagnosis under insurance regulations. At the same time, feedback from the field shows that patients with chronic illness or mobility issues in particular have benefited from mail-order access – especially in rural areas, where local pharmacies offering cannabis flower are often hard to find.
Legislation in motion: Parliament will have its say
With the cabinet’s approval, the draft bill is now on its way to the Bundestag – and it is widely expected that key aspects of the proposal will be amended in the legislative process. Early voices, including from within the governing coalition, have already indicated that revisions are needed – especially regarding the proposed shipping ban and the requirement for in-person doctor-patient contact. At the same time, a separate review process is underway at the EU level: the notification submitted to the European Commission allows both the Commission and other Member States to raise concerns, particularly around restrictions on telemedical services and potential conflicts with the EU’s freedom to provide cross-border services. While it remains to be seen when and in what form objections will be raised, one thing is clear: this is not the end of the debate.
Now is the time to get involved
This is a crucial time to stay engaged. While the public consultation phase has ended, the parliamentary process still offers opportunities to contribute – through professional associations, policy dialogues, or direct outreach to lawmakers. Those who support a balanced, patient-focused, and legally robust regulatory framework should make their voices heard now. Because once again, this legislative process shows just how narrow the path can be between political steering and the practical realities of care. That’s why it’s so important to help shape it constructively.