Legal problems: German marketing of medical cannabis

The German market for medical cannabis is one of the largest in the world. In fact, as of 2021, it will not only be the largest market in Europe, but also responsible for implementing growing plans in many sunnier and cheaper areas. This applies to countries in the European Union (EU) as well as other controversial places, all of which are hoping to export cannabis to a country that has previously been unable to source the medicinal cannabis consumed in the country domestically.

All well and good – but that’s the good news.

In fact, the pharmaceutical infrastructure medical cannabis companies face is neither clear nor easy to navigate. Here’s why.

Cannabis is legally defined as a controlled narcotic

The first problem that all traders in the German market face is that cannabis is legally defined as a narcotic at the federal level. To this day, despite a decision at the European level last autumn, this also includes hemp with a low THC content – which has recently led to a number of lawsuits and embarrassing misunderstandings on a non-medical, commercial level.

In addition, cannabis as a medicine is now clearly present in the system – but the mere import and / or registration of varieties and brands (regardless of who makes them or where such flowers or products come from) is nowhere near enough to generate sales .

Unlike in the USA, for example, drugs may not be advertised directly to potential consumers (also known as patients).

As a result, cannabis specialists, like general pharmaceutical distributors, have to go through a strange, highly inefficient, and expensive three-step process to obtain prescriptions that begins but by no means ends with what is euphemistically referred to as “medical education.”

Step by painful step

For all budding distributors who are not in the business and want to get into the cannabis specialty business directly, the first step is actually still quite difficult. Before they can get their final licenses and permits, they need to identify a qualified supplier. Since there is only one dealer in the country who deals with domestically grown cannabis, it means everyone has to find other companies who want to work with them.

Five years ago that meant one of two things. Find a Canadian company looking to expand into Europe and Germany or go to Bedrocan, the Dutch breeder across the border. As a result of the early onslaught, Bedrocan also began doing this to limit both the amount of cannabis it was willing to sell per distributor and the number of distributors it wanted to work with.

The Difficulties and Dichotomies of German Cannabis Prescriptions

Once a distributor has signed at least one off-take agreement with a certified company and has all of their licenses and approvals, the real battle begins. In order to sell your cannabis strain or brand in German pharmacies, retailers have to do several (expensive and time-consuming) things that go beyond obtaining the necessary licenses and sourcing the product. They need to educate doctors about their strain or product and find patients who will stand up for their brand when they encounter a doctor prescribing cannabis.

For those with private health insurance, the search for a doctor is no longer a big issue, especially in the larger cities. “Pain centers” (pain clinics) are staffed by doctors who are generally sympathetic to patients with a demonstrable, previously diagnosed disease. If you are privately insured, a referral from a family doctor is not necessary. However, both the doctor’s visit and the cannabis must be paid for out of pocket and in advance by the patient.

For those with statutory or “public” insurance, the struggle is even tougher, starting with the search for willing doctors. However, once found, the doctor has to work with the patient at this point to fill out forms and wait for approval from the regional approvers (not even individual health insurers). Once approved, patients can ask for the brand of cannabis they want. Provided the doctor is compassionate and does so, he must himself take this prescription with the specific mark on the paper to a specialist pharmacy. Nowadays, such pharmacies can order overnight.

Anyway, none of this is easy. To date, distributors have relied on a variety of methods (including the free press, hiring pharmaceutical agents, and sponsoring events) to reach both the public and prescribers. In addition, the availability of doctors and their willingness to prescribe vary depending on the federal state.

The Frankfurt city authority responsible for training new cannabis doctors, for example, does not publish the names of the doctors they have trained. As High Times admitted, they also know that most doctors who work with statutory health insurance in Hessen refuse to admit more than two cannabis patients per practice.

The future of generic extracts

Given all of these issues, not to mention the markup available, liquid dronabinol, the global generic with 96 percent THC extract, is very popular in the German market these days. The reason? It’s easier to market to both doctors and patients, not to mention getting approved by health insurers (because of the “generic” name).

However, most patients do not want to take this extract and prefer other medications or treatments.

Contact with patients remains critical, but difficult

Every distributor in Germany maintains online patient contacts. In fact, Facebook and other social media groups are fairly widespread for patients. However, this is not a panacea. As committed as patients may be to certain brands, they are most anxious to find a regular supply and source of their medication.

Unfortunately, this remains by far the most difficult hurdle to overcome in a country where cannabis is at least legally insured, but where it took until the end of last year for the first patient to receive a guaranteed one-year prescription.

Until one of these dynamics changes – through legal challenge or major legislative reform – commercializing any type of cannabis and from any source, traditional or not, is a difficult challenge.