Briefing

How France Is Preparing for Permanent Access

New rules for the reimbursement of medical cannabis have applied in Germany since 30 July 2026. Cannabis flower is no longer covered by statutory health insurance, including for patients already receiving treatment. Before receiving a new prescription for extracts or other compounded preparations, patients must first undergo a six-month trial with a licensed cannabis-based medicinal product, provided one is available for their condition. Existing treatments with extracts or compounded preparations can continue unchanged. (KBV, 6. August 2026)

France, by contrast, is now working towards moving medical cannabis from a pilot programme into routine care. In March 2021, the country launched a tightly controlled pilot involving around 3,000 patients. Its main purpose was to determine whether a safe and practical medical cannabis supply system could be established. The French medicines agency ANSM gave an overall positive assessment of the programme’s organisation, safety and observed treatment outcomes.

These findings are now intended to inform a permanent system. The legal basis was established through France’s 2024 social security reform. What is still missing is a decree governing the assessment and reimbursement of products. This was submitted to the Conseil d’État for legal review on 2 July 2026.

Under the current timetable, the decree could be published when the autumn parliamentary session begins on 1 October. Whether this schedule will hold remains uncertain. Only after publication can the French health authority HAS complete its reimbursement assessment. Regular prescribing is therefore unlikely to begin before 2027. (Légifrance 26.12.2023, Business of Cannabis 03.07.2026)

Access Will Be Strictly Limited

Like Germany, France is taking a tightly restricted approach to reimbursement. Medical cannabis would only be available when other treatments have failed. Access is planned for five areas:

• refractory neuropathic pain
• certain drug-resistant forms of epilepsy in adults and children
• painful spasticity associated with multiple sclerosis or other central nervous system disorders
• difficult-to-treat symptoms caused by cancer or cancer treatment
• advanced palliative care

Treatment would have to be initiated in a hospital. Prescribing doctors and dispensing pharmacists would also need to complete specific training. Access would therefore be limited to clearly defined patient groups and remain under close medical supervision. (HAS 29.07.2025)

France Is Focusing on Extracts, Not Cannabis Flower

France is also placing tight restrictions on the products that could become available. The focus is on oral and sublingual medicines, particularly standardised cannabis extracts in oil form. The proposed range includes THC-dominant, balanced THC/CBD and CBD-dominant formulations. Cannabis flower of the kind dispensed by German pharmacies would not be allowed. Inhaled products would only be considered in sealed, non-refillable single-dose systems designed for use with a medical vaporiser. From the outset, France is building a market around highly standardised products. Traditional cannabis flower is unlikely to have a place in it.

A Narrow Path That Could Change Europe

France’s plan to give medical cannabis a permanent place in its healthcare system is a positive development. When it comes to reimbursement, the French approach is less different from the German model than it may initially appear. In Germany, access through statutory health insurance is also tightly restricted and subject to specific eligibility rules, including requirements to try other treatments first.

The main difference lies outside statutory reimbursement. Germany also has a private prescription market that is not subject to statutory health insurance rules and where cannabis flower remains available. France is not planning a comparable self-pay market and excludes cannabis flower entirely. The French path therefore remains narrow. But as they say in cannabis care: “Start low, go slow.” New healthcare systems also tend to develop from cautious beginnings that then prove themselves in practice.

Following Germany, France is now the second major EU economy to prepare permanent, reimbursed access to medical cannabis. Other countries will be watching closely to see whether the model succeeds. How broad the French approach eventually becomes will therefore be determined not by the decree itself, but by how it works in practice over the coming years. That will also help determine how quickly the rest of Europe follows.

Any other questions?

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

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Best wishes from both of us,

Medical cannabis: legal, but still a limited market

Medical cannabis has been easier to access in Switzerland since August 2022. Physicians can prescribe cannabis-based medicines without requiring exceptional authorisation from the Federal Office of Public Health. This removed an important regulatory barrier. (Federal Office of Public Health) In practice, however, access remains limited: cannabis-based medicines are only reimbursed by mandatory health insurance in exceptional cases. There is still no broad reimbursement pathway.

In Germany, reimbursement has also become significantly more restrictive: under the GKV Contribution Rate Stabilisation Act, cannabis flower has been removed from statutory health insurance coverage (Cannabis Briefing 16.07.2026). Even so, the German market continues to differ from Switzerland. Since 2024, medical cannabis in Germany is no longer classified as a narcotic, which has made prescribing easier. The market also grew much more strongly over many years, as statutory reimbursement had been an important driver since 2017.

As a result, Switzerland’s medical cannabis market remains comparatively small and more case-by-case. The greater regulatory momentum is currently not in the medical sector, but in the question of how Switzerland intends to regulate non-medical cannabis use in the future.

Pilot projects as the basis for regulation

Since May 2021, Switzerland’s Narcotics Act has allowed local, time-limited pilot projects for the controlled distribution of cannabis. Their purpose is to generate evidence for future legislation. (Federal Office of Public Health) These projects are not legalisation in the conventional sense. They are research projects with clear rules: participants are registered, products are dispensed under controlled conditions, and consumption patterns are scientifically monitored. At the same time, different access models are being tested, including pharmacies, non-profit points of sale and social clubs. In Germany, Federal Drug Commissioner Hendrik Streeck recently signalled openness to similar scientifically monitored pilot projects. So far, however, no such projects have been approved in Germany. (DAZ)

This is what makes the Swiss approach so relevant for Germany. While Germany is still debating model projects, Switzerland is already gathering real-world evidence on how controlled access, youth protection, product control and scientific monitoring can work together.

The Cannabis Products Act: controlled access, not a free market

Building on these pilot projects, Switzerland is now working on a new Cannabis Products Act. Last late summer, the National Council’s Committee for Social Security and Health presented a draft proposal that would allow adults legal access to cannabis (Cannabis Briefing 11.07.2025). The consultation process has now been completed and the results show that while there is still political momentum behind regulation, the path forward remains complex.

Cannabis would continue to be classified as a narcotic. The draft includes maximum possession and distribution limits, a ban on sales to minors, a comprehensive advertising ban, neutral packaging, clear product labelling and a separation between production and retail. Limited home cultivation would also be permitted. (Swiss Parliament)

Sales would be organised on a non-profit basis. Cantons would be able to license points of sale, with any profits earmarked for prevention, harm reduction and addiction services. Online sales remain controversial: the federal government would be able to grant a single online licence, but only under strict registration and youth protection requirements.

Consultation process: support, but many unresolved questions

The responses to the Cannabis Products Act were mixed. Parts of the expert community, municipalities and organisations working in addiction prevention broadly support the regulated approach. Politically, there is also support for the proposal’s focus on public health, youth protection and prevention.

At the same time, the consultation exposed clear points of tension. Many cantons criticised the expected administrative and enforcement burden, as well as what they see as insufficient financing. The high level of regulation, the role of online sales and the timing of the proposal were also questioned. Some stakeholders want to wait for more results from the ongoing pilot projects; others consider the model too restrictive or reject legalisation altogether.

Financing remains one of the most sensitive issues. The draft provides for a steering levy based on THC content and the health risk of each product. The revenue would help finance enforcement, prevention and harm reduction. Several cantons, however, are calling for a more robust financing model, such as an excise or steering tax. Such a tax could require a constitutional amendment and therefore a popular vote. (Swiss Parliament)

Outlook: revision, not a halt

In early May, the responsible committee of the National Council decided to continue work on the proposal. It referred the draft back to the subcommittee for revision, with a particular focus on youth protection, regulatory density, enforcement, financing and the role of the cantons. (Swiss Parliament)

A rapid implementation is therefore unlikely. After the revision, the proposal will return to committee deliberations before moving through the National Council and the Council of States. The final law could also be subject to an optional referendum.

For Germany, Switzerland remains an important reference case. Germany has already implemented partial legalisation, while pilot projects have yet to materialise. Switzerland is taking the opposite approach: first testing controlled access models under scientific supervision, then using those findings to shape a national legal framework. This evidence-led process is what makes the Swiss debate relevant far beyond Switzerland itself.

Any other questions?

Do you have specific questions or suggestions for the Cannabis Briefing? Then send us an email to briefing@www.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!

Best wishes from both of us,

A broad cost-cutting package with many points of contention

Without additional measures, the German government expects the statutory health insurance system, known as the GKV, to face a funding gap of more than €15 billion in 2027. The legislation is therefore designed to reduce expenditure through a broad package of measures.

These include higher patient co-payments, limits on increases in healthcare remuneration, an additional manufacturer rebate for patent-protected medicines, and the removal of homeopathic and anthroposophic medicines and treatments from the services that health insurers may reimburse. (German Bundestag 08.07.2026)

Political debate consequently focused on the largest financial questions: how the federal government, pharmaceutical companies, hospitals, physicians and insured patients would contribute to stabilising the system. Medical cannabis remained largely a side issue, partly because the number of patients directly affected is comparatively small.

For those patients, however, the consequences are far from minor. Under German law, patients are only eligible for reimbursed medical cannabis once it has been established that standard treatment options are unavailable, unsuitable or have failed. As Manuel Kralik also described in an earlier Cannabis Briefing interview, applications for reimbursement often follow long and difficult treatment journeys.

What will change?

The reform introduces two main changes.: First, dried cannabis flower will be removed entirely from the statutory health insurance benefit entitlement. It will remain legally prescribable and available through pharmacies, but will generally no longer be reimbursed by statutory health insurers.

Second, access to the cannabis medicines that remain eligible for reimbursement will become more restrictive. These include standardised cannabis extracts and medicines containing dronabinol or nabilone, which are prepared by pharmacies as compounded medicines. (German Bundestag 08.07.2026)

Authorised cannabis-based finished medicinal products already had priority under the existing rules. Before prescribing cannabis flower or extracts, physicians had to assess whether a suitable authorised finished medicine was available. (Federal Joint Committee 16.03.2026)

The new element is a mandatory treatment period. Under the reform, patients receiving statutory outpatient care must first undergo a six-month treatment trial with an authorised cannabis-based finished medicinal product. Only after this trial may the remaining eligible compounded preparations be prescribed at the expense of the GKV.

The prior-authorisation requirement for a patient’s first prescription will remain in place. As before, prescriptions issued by certain specialist groups and physicians with qualifications designated by the Federal Joint Committee will be exempt from this requirement.

How does the law take effect in Germany?

The Bundestag passed the law on 10 July 2026. On the same day, the Bundesrat approved it without requesting any further changes. This completed the parliamentary process. At the editorial deadline, however, the law had not yet been published in the Federal Law Gazette and had therefore not yet entered into force. The following assessment is based on the version adopted by the Bundestag (German Bundesrat 10.07.2026)

According to that text, the changes affecting medical cannabis will not wait until 1 January 2027. Instead, they will enter into force on the day after publication in the Federal Law Gazette. The exact date is therefore not yet known.

Open questions for patients already receiving treatment

The adopted text does not contain an explicit transition period or grandfathering provision.

For patients with an existing approval for reimbursed cannabis flower, this suggests that continued reimbursement may no longer be possible once the new rules enter into force. Prescriptions issued before that date may also become difficult to dispense under the GKV if the pharmacy supplies the medicine only after the law has taken effect. The final reimbursement and billing practice has not yet been conclusively clarified.

It is also unclear how the new six-month treatment trial will be applied to patients who are already receiving cannabis extracts or compounded preparations containing dronabinol or nabilone. As the law does not expressly provide transitional arrangements for these patients either, implementation will depend on how statutory insurers, physicians and pharmacies apply the new rules in practice.

Not back to square one

For the patients affected, the reform is nevertheless a step backwards. One dosage form will be removed from collectively funded healthcare, while access to other cannabis medicines will face an additional hurdle.

At the same time, the treatment infrastructure developed since 2017 will remain in place. Physicians, pharmacies and pharmaceutical wholesalers have built expertise, supply chains and professional standards over the past nine years. These structures provide a foundation for finding workable treatment pathways even under the new reimbursement conditions.

Anything else?

Do you have specific questions or suggestions for the Cannabis Briefing? Then send us an email to briefing@www.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!

Best wishes from both of us,

Mary Jane as a mirror of a changing industry

Mary Jane has always been more than a conventional trade fair. It shows how widely cannabis is now being discussed across society, business and regulation. Between the conference programme, product innovations, community spaces, festival elements and business meetings, it becomes clear just how varied expectations of the market have become.

That is precisely where the real value of Mary Jane lies in 2026. After years of political momentum, partial legalisation and strong growth in the medical market, visibility alone is no longer enough. The central question now is: how professional, resilient and responsible has the cannabis market become?

From momentum to a test of maturity

The past few years have shown how dynamically the cannabis market can develop when regulatory frameworks allow movement. At the same time, greater visibility also raises expectations. Quality, product safety, reliable supply chains, clear standards and responsible communication are no longer side issues. They are prerequisites for trust.

At a trade fair such as Mary Jane, it becomes particularly clear that cannabis can no longer be viewed from just one perspective. For some, the focus is on consumer culture, homegrow and social normalisation. For others, the key issues are medical care, pharmaceutical quality, pharmacy practice, reimbursement and regulation. The challenge is not to blur these areas, but to distinguish them clearly.

B2B, medical cannabis and supply: the professional segment is gaining importance

The fact that Mary Jane once again opened with a dedicated trade visitor day shows its ambition to treat cannabis as a serious economic and healthcare topic. This is particularly relevant for the medical segment. Here, the discussion is not about lifestyle or trends, but about patient care, product quality, pharmaceutical standards and security of supply.

Germany is now one of the most important medical cannabis markets in Europe. With that role come growing demands on all market participants. Supply chains must be stable, quality processes must be transparent, regulatory requirements must be clear, and cooperation with doctors, pharmacies and wholesalers must be professionally organised. Mary Jane provides an important forum for this exchange because it brings together different perspectives: manufacturers, importers, distributors, pharmacies, service providers, policymakers and patients. For the medical market, one point remains essential: growth must not be confused with arbitrariness. Trust is built where quality, standards and responsibility come together.

Adult-use cannabis after partial legalisation: normalisation needs monitoring

The situation around adult-use cannabis has also changed noticeably since partial legalisation came into force. After the initial political and public debate, many things have begun to settle. Adult consumers now operate within a clearer legal framework, homegrow has become part of the new reality, and cannabis social clubs are gradually developing as another component of a regulated approach to cannabis.

This means that key objectives of partial legalisation are becoming visible in everyday life: adult consumers are being decriminalised, cannabis is being discussed more openly and objectively, and the focus is shifting more strongly towards health protection, prevention, education and controlled structures. At the same time, this process is not complete. Especially when it comes to youth protection, prevention and reducing the illicit market, developments must continue to be closely monitored and adjusted where necessary.

Mary Jane makes this new phase tangible. It shows that cannabis has entered mainstream society, but also that normalisation does not replace regulation. A responsible market needs clear rules, reputable providers, transparent information and continuous political oversight.

Between festival and professional dialogue

Mary Jane’s distinctive mix remains both its strength and its challenge. On one side, there is the festival, community, culture and consumption. On the other, there is professional dialogue, business, medicine, regulation and healthcare. It is precisely this balancing act that makes the trade fair relevant: it reflects the full breadth of the cannabis debate.

For the industry, this is an opportunity. Where different groups engage with one another, barriers can be reduced and misunderstandings addressed. At the same time, the fair also highlights how important clear distinctions remain. Medical cannabis, adult-use cannabis and industrial products each follow different logics and must be assessed accordingly.

Anything else?

Do you have specific questions or suggestions for the Cannabis Briefing? Then send us an email to briefing@www.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!

Best wishes from both of us,

A Market Driven Largely by Private Care

Access through the NHS remains limited and difficult for many patients. As a result, private clinics have become the main driver of patient access. According to recent market data, the UK medical cannabis market is now almost entirely private: more than 99 percent of prescriptions are issued outside the NHS, primarily through private clinics and specialist care providers. One analysis estimates that more than 40 private clinics should be active in the market, including around 20 to 25 specialist medical cannabis providers with regular prescribing activity. By the end of 2025, around 80,000 patients are expected to have received treatment through the private system (groweriq 02.05.2026).

Imports are rising sharply as well: in 2025, around 30 tonnes of medical cannabis flower were imported into the UK, more than twice as much as in the previous year (BoC 20.05.2026). This makes the UK one of Europe’s most dynamic medical cannabis markets, even though access still depends heavily on private care.

Private Care in Response to Limited Access

This development shows that patient demand is real. Patients are looking for additional treatment options, doctors are gaining experience, and private providers are building care pathways where the public system remains constrained by high barriers and limited resources. Germany is facing a related debate: the reimbursement of medical cannabis flower by statutory health insurance is currently under discussion as part of the GKV Contribution Rate Stabilisation Act. Against the backdrop of a financially strained NHS, private healthcare has become an important route into medical cannabis treatment in the UK. It can improve access, support patient education, and help medical cannabis become more widely recognised as a legitimate treatment option.

Germany as a European Reference Market

This is where there is a clear opportunity for Europe. Markets such as the UK can draw on the experience of countries that have already integrated medical cannabis more deeply into regular care. In Germany, medical cannabis has been prescribable and reimbursable by statutory health insurance since 2017. Since April 2024, medical cannabis has no longer been classified as a narcotic. Instead, it is regulated under the Medical Cannabis Act, which has significantly reduced bureaucracy for prescribing and dispensing.

This regulatory shift has had a noticeable impact on the German market. Prescriptions, imports, and market volumes have all increased significantly. Market analyses now identify Germany as Europe’s largest medical cannabis market and an important hub for imports and distribution. With its pharmaceutical infrastructure, pharmacy expertise, regulatory experience, and established quality processes, Germany is becoming a central reference point for medical cannabis in Europe.

An Opportunity for European Cooperation

The UK market is no longer at the beginning of its legal opening. It has entered a new phase. The key question now is how a fast-growing private market can combine patient access, medical quality, and long-term trust. Germany can play an important role here as a partner, reference market, and supply chain hub. This applies not only to products, but also to expertise in pharmaceutical quality, pharmacy-based care, import processes, documentation, and everyday medical practice.

The relevance of these questions was also clear at Cannabis Europa, which took place in London on 26 and 27 May 2026. The UK medical cannabis market is growing quickly, but it also faces the challenge of bringing private care, regulatory clarity, and reliable quality standards closer together. For Germany, this creates a clear European opportunity: the experience built here can help other markets integrate medical cannabis into care in a more professional, reliable, and patient-centred way.

Anything else?

Do you have specific questions or suggestions for the Cannabis Briefing? Then send us an email to briefing@www.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!

Best wishes from both of us,

How did you first come to use medical cannabis? 

I was diagnosed with multiple sclerosis in 2012. At first, I went through conventional treatment: disease-modifying therapy, pain medication, and other prescriptions. I experienced severe side effects, including breast infections that required several surgeries. At the same time, my pain medication kept being increased. In 2014, I brought up cannabis with my neurologist because I had read that it could help with MS. He was open to the idea, but he did not want to handle the application process. So I learned what was required and prepared the application myself. At the time, patients still needed a special authorization from BfArM (The Federal Institute for Drugs and Medical Devices) to access medical cannabis. After a few follow-up questions between the authority and my doctor, the authorization was granted. The next hurdle was finding a pharmacy willing to order cannabis at all.  

What changed for you once you started the therapy? 

I have been using medical cannabis continuously since 2014. Since then, I have stopped taking my MS medication entirely. I have not had any relapses since 2014, and I have not had any further breast infections. My physical condition is much more stable than it was before. For me, it is not about treating one isolated symptom. It is about maintaining balance. The therapy helps me better manage pain, cramps, concentration issues, and other symptoms. It has allowed me to take part in everyday life more reliably again. 

Why is this therapy not simply interchangeable for you? 

Cannabis is a highly individualized therapy. Many components of the plant work together, which is why different strains can have different effect profiles. That makes it possible to tailor treatment more closely to the individual patient.  For me, cannabis flower and extracts serve different purposes. An oral extract can provide a kind of baseline because its effects last longer, helping to reduce and smooth out pain peaks during the day. Inhaled cannabis flower, by contrast, works much faster. When pain, spasticity, or cramps occur acutely, I need a therapy option with a rapid onset of action. From my perspective, there is currently no equivalent alternative. 

What barriers do patients still face today, and what has improved since 2017? 

In patient counseling, I still see a lot of prejudice. Especially in rural areas and in Bavaria, the topic remains highly politicized. Many patients not only have to find a doctor; they also have to deal with skepticism in their families, workplaces, and social circles. On the positive side, more pharmacies and physicians have become open to medical cannabis since 2017. The reforms introduced in 2024 have reinforced that trend. I also see that the patient population has become older and more diverse. More women and more older patients are seeking support. At the same time, access remains difficult. Specific strains are not always available, and switching a patient’s prescribed strain without consultation can disrupt treatment. Reimbursement is still complex as well. Documentation requirements and concerns about financial recourse mean that some patients still struggle to access treatment, even when there is a clear medical need. 

What would it mean if cannabis flower were removed from statutory reimbursement? 

I see this as a serious issue for patient safety and treatment reliability. Flower is not simply replaceable. Especially with acute pain peaks, cramps, or spasticity, fast onset matters. Patients who rely on that effect cannot simply be switched to extracts. Extracts can provide an important baseline, but they do not replace the rapid onset of inhaled therapy in every situation. Many seriously ill patients cannot afford to pay for cannabis flower out of pocket on an ongoing basis. If flower were removed from reimbursement, it would create another barrier for those patients. There is also the risk that, without reimbursement, some patients may turn to unsafe sources. That cannot be in the interest of responsible healthcare. 

You have two wishes. What would you like to see from policymakers? 

I would like to see less polarization around cannabis. We need an open, fact-based approach so that medical cannabis can be understood as a normal treatment option. Many debates are still shaped by recreational use or public-order concerns. For patients, however, this is about access to care, participation in daily life, and treatment reliability. 

And what would you like to see from the industry? 

From the industry, I would like to see more factual education and less marketing-driven communication. We need information that truly helps patients, physicians, and pharmacies. That also includes prevention and a responsible approach to cannabis more broadly. If we can reduce fear and help people understand medical cannabis as a normal medical option, everyone benefits: patients, healthcare providers, and the broader public debate. 

 We sincerely thank Manuel Kralik for this open conversation and for sharing such important insights from the patient perspective. 

Anything else?

Do you have specific questions or suggestions for the Cannabis Briefing? Then send us an email to briefing@www.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!

Best wishes from both of us,

How did you first come to use medical cannabis? 

I was diagnosed with multiple sclerosis in 2012. At first, I went through conventional treatment: disease-modifying therapy, pain medication, and other prescriptions. I experienced severe side effects, including breast infections that required several surgeries. At the same time, my pain medication kept being increased. In 2014, I brought up cannabis with my neurologist because I had read that it could help with MS. He was open to the idea, but he did not want to handle the application process. So I learned what was required and prepared the application myself. At the time, patients still needed a special authorization from BfArM (The Federal Institute for Drugs and Medical Devices) to access medical cannabis. After a few follow-up questions between the authority and my doctor, the authorization was granted. The next hurdle was finding a pharmacy willing to order cannabis at all.  

What changed for you once you started the therapy? 

I have been using medical cannabis continuously since 2014. Since then, I have stopped taking my MS medication entirely. I have not had any relapses since 2014, and I have not had any further breast infections. My physical condition is much more stable than it was before. For me, it is not about treating one isolated symptom. It is about maintaining balance. The therapy helps me better manage pain, cramps, concentration issues, and other symptoms. It has allowed me to take part in everyday life more reliably again. 

Why is this therapy not simply interchangeable for you? 

Cannabis is a highly individualized therapy. Many components of the plant work together, which is why different strains can have different effect profiles. That makes it possible to tailor treatment more closely to the individual patient.  For me, cannabis flower and extracts serve different purposes. An oral extract can provide a kind of baseline because its effects last longer, helping to reduce and smooth out pain peaks during the day. Inhaled cannabis flower, by contrast, works much faster. When pain, spasticity, or cramps occur acutely, I need a therapy option with a rapid onset of action. From my perspective, there is currently no equivalent alternative. 

What barriers do patients still face today, and what has improved since 2017? 

In patient counseling, I still see a lot of prejudice. Especially in rural areas and in Bavaria, the topic remains highly politicized. Many patients not only have to find a doctor; they also have to deal with skepticism in their families, workplaces, and social circles. On the positive side, more pharmacies and physicians have become open to medical cannabis since 2017. The reforms introduced in 2024 have reinforced that trend. I also see that the patient population has become older and more diverse. More women and more older patients are seeking support. At the same time, access remains difficult. Specific strains are not always available, and switching a patient’s prescribed strain without consultation can disrupt treatment. Reimbursement is still complex as well. Documentation requirements and concerns about financial recourse mean that some patients still struggle to access treatment, even when there is a clear medical need. 

What would it mean if cannabis flower were removed from statutory reimbursement? 

I see this as a serious issue for patient safety and treatment reliability. Flower is not simply replaceable. Especially with acute pain peaks, cramps, or spasticity, fast onset matters. Patients who rely on that effect cannot simply be switched to extracts. Extracts can provide an important baseline, but they do not replace the rapid onset of inhaled therapy in every situation. Many seriously ill patients cannot afford to pay for cannabis flower out of pocket on an ongoing basis. If flower were removed from reimbursement, it would create another barrier for those patients. There is also the risk that, without reimbursement, some patients may turn to unsafe sources. That cannot be in the interest of responsible healthcare. 

You have two wishes. What would you like to see from policymakers? 

I would like to see less polarization around cannabis. We need an open, fact-based approach so that medical cannabis can be understood as a normal treatment option. Many debates are still shaped by recreational use or public-order concerns. For patients, however, this is about access to care, participation in daily life, and treatment reliability. 

And what would you like to see from the industry? 

From the industry, I would like to see more factual education and less marketing-driven communication. We need information that truly helps patients, physicians, and pharmacies. That also includes prevention and a responsible approach to cannabis more broadly. If we can reduce fear and help people understand medical cannabis as a normal medical option, everyone benefits: patients, healthcare providers, and the broader public debate. 

 We sincerely thank Manuel Kralik for this open conversation and for sharing such important insights from the patient perspective. 

Anything else?

Do you have specific questions or suggestions for the Cannabis Briefing? Then send us an email to briefing@www.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!

Best wishes from both of us,