Could the Medical Cannabis Reform Become a Cost Trap?

Stricter Requirements: Patients Would Need to Return to In-Person Consultations 

The current draft stipulates that prescriptions for medical cannabis would require an in-person doctor–patient consultation. Telemedical prescriptions – currently a low-threshold option for many patients with milder complaints such as sleep disorders, headaches, or stress-related symptoms – could be discontinued. Since these patients generally do not qualify for statutory health insurance reimbursement and usually pay out of pocket, eliminating telemedicine would create  a tangible barrier: more travel, higher costs, longer waiting times. Physicians willing to prescribe medical cannabis are already in the minority, especially outside urban centers. A a situation that could intensify. 

Restricted Supply: No More Shipping from German Pharmacies 

The draft also states that mail-order dispensing of medical cannabis from German pharmacies would no longer be permitted. This would create significant challenges for patients who are not mobile or who live in regions with sparse pharmacy coverage and limited cannabis expertise. Many pharmacies do not stock medical cannabis or only order it on demand, often with delays. The result could be a structural worsening of access, particularly in rural areas, affecting not only self-pay patients but also those relying on statutory health insurance who depend on consistent medication supply. 

How Significant Could the Cost Risks Be for the Healthcare System? 

One aspect that has received little attention so far is the question of which additional costs might arise if more patients in the future had to attend in-person appointments. A recent study suggests that increasing mandatory doctor visits could lead to substantial additional expenditures, both for statutory health insurance and for medical practices. More required appointments, more documentation, and more administrative workload would inevitably consume more resources. 

It is also possible that the statutory health insurance system is currently benefiting from a degree of implicit cost relief: many patients do not submit applications for reimbursement — whether because they struggle to find a prescribing physician, doctors remain cautious due to potential clawbacks, or patients rely on telemedical services and pay out of pocket. If access were to shift more toward in-person care, more patients might formally test or claim their entitlement to reimbursement, potentially resulting in direct or indirect financial burdens for the statutory health insurance. 

Supply Gaps and a Possible Shift Back to the Illicit Market 

It is also likely that certain patient groups, particularly those with milder complaints currently treated via telemedicine, might increasingly turn back to the illicit market. Home cultivation and Cannabis Clubs would not be able to replace medical care: they neither provide the required product quality nor the necessary supply capacity. The fact that no pilot projects, such as those introduced in Switzerland, have been approved so far could further widen this structural supply gap. 

As early as October, EKOCAN stated – as part of the first evaluation stage of the CanG – that “consumers have too little legal cannabis available” and that the market as a whole suffers from a major supply deficit. 

Reform Requiring Further Refinement 

The need to reform the medical cannabis framework is undisputed. While the draft might introduce additional regulation, it would not necessarily increase supply security. Instead, it could risk creating new barriers without delivering clear benefits. The upcoming committee hearings and parliamentary deliberations will show whether lawmakers will be willing to address these issues and make the necessary adjustments. 

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