At present, Germany is experiencing massive delays in the delivery of medical cannabis. The supply at most pharmacies is limited to three or four of the 16 available medical strains. More than 10 of Germany’s medically-approved strains originate from the Canadian medical cannabis program, but currently, only smaller stocks of Pedanios’ 18/1 are available — the other five Pedanios Strains are sold out. None of the five strains produced by Tweed are available in German pharmacies.
Due to the lengthy import and export process, Canadian cannabis could return to the German market in September, at the earliest. Shortages from Canada are not the only problem, Dutch producer Bedrocan has not been able to deliver all of its six available medical strains.
On July 17th, medical patients in Germany reported that all wholesalers are currently sold out, posting on self-help network Cannabis as Medicine (SCM) and the German Hemp Federation’s (DHV) forums. Only a few pharmacies that pre-stocked the sought-after medicine can still provide for patients. Patients must, therefore, call their pharmacy before visiting the doctor, ask which of the few strains are available, and then request to have their medicine placed on hold. If a pharmacy can not fill the order of a prescribed strain, the patient’s prescription is effectively invalid. The patient then must revisit the doctor to obtain a valid prescription for an available strain.
The current law for cannabis as medicine has been in existence for four months. In that time, the number of medical cannabis users has risen unpredictably fast. In the case of two of the largest health insurance companies, by mid-July, more than 3,100 patients had applied for reimbursement of medical cannabis prescribed by their doctor. The insurance company Techniker Krankenkasse (TK) published the only concrete figures on these applications.
According to the TK’s reports, 863 applications for reimbursement had been received by July 7, 522 of which were approved and 341 were rejected. Germany’s largest health insurance fund, the AOK, received roughly 2,300 applications by the same date but did not publish figures on approved or rejected applications.
The number of individuals who have applied for reimbursement from the two other large and numerous small insurance companies is not yet known. In view of the total number of insured persons in Germany, experts estimate there are several thousand unreported cases of pending reimbursement applications. In addition, there are no statistics available on patients who have received a cannabis prescription without applying for reimbursement. Maximilian Plenert, a member of the board of directors of the Federal Association for Accepting Drugs and Human Drug Policy (akzept.e.V.), was invited as an expert on medical cannabis to several German Bundestag hearings. On request from Marijuana.com, Plenert said he estimates that on the basis of the numbers and feedback received, about 10,000 patients have obtained medicinal cannabis flowers from pharmacies since the introduction of the law in March.
Due to these unforeseen developments, many cannabis patients are currently confronted with a shortage of supply. The German Hemp Association (DHV) has received numerous reports of affected patients who are currently waiting for their medicine. After all, those affected simply do not need “Cannabis Flos,” but one or more strain varieties, each with a specific active ingredient profile.
Currently, German patients are completely dependent on imported cannabis. They only receive what is not needed by the Dutch and Canadian cannabis programs. The imminent legalization in Canada will only exacerbate this problem, as bottlenecks are already expected in Canada by July 2018. In addition, it is far easier and less bureaucratic for Canadian producers to use the domestic recreational market instead of struggling with lengthy export- and import-licensing procedures.
While many health insurance companies continue to oppose cannabis for reasons beyond the exorbitant costs, pharmacists appear to be enjoying their new role. As the Deutsche Apotheker Zeitung reported recently, the majority of German pharmacies welcome the new law. Three out of ten pharmacists said the new law had a positive impact on the demand. However, the additional examination of the medicine represented a considerable effort, and 98 percent of pharmacists surveyed complained. This is probably why they charge almost 10 Euro per gram for the high effort of checking, repacking, and labeling cannabis medicine. The survey found that 30 percent of pharmacists have no opinion on the new regulations, while one in five oppose it.
The production of medical cannabis in Germany could begin much faster if the licensing of the producers was a less bureaucratic than the current procedure. According to the recently founded Cannabis Agency, the earliest date to supply pharmacies with medicinal cannabis products is mid-2019. Allowing patients to grow cannabis could mitigate the problem of supply bottlenecks. But this solution, much like under ex-Premier Harper in Canada, is not politically viable in Germany. The federal government still carries out numerous trials against patients who have applied for the cultivation of a few plants to meet their medical needs. If the supply remains inadequate through 2019, the German Health Ministry will continue to lose these trials against cannabis patients.
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