German States Seek Stronger Oversight of Medical Cannabis Prescriptions
The federal states in Germany are advocating for greater authority in monitoring the stricter regulations planned for the prescription of medical cannabis. In response to the draft amendment of the Medical Cannabis Act (MedCanG), state representatives have emphasized their intent to maintain primary responsibility for overseeing the distribution and prescription process of medicinal cannabis products.
Currently, the supervision of pharmaceutical distribution in Germany is legislated at the state level, with each federal state responsible for enforcing regulations through its designated authorities. The new legislative proposal, supported by the Federal Ministry of Health, aims to introduce more stringent controls over online prescriptions and the shipping of medical cannabis, requiring a personal consultation between patient and physician before a prescription can be issued.
A key point of contention is the existing provision in the pharmaceutical prescription ordinance, which recognizes prescriptions from other EU member states, countries within the European Economic Area, and Switzerland as equivalent to German prescriptions. The states argue that, for the revised process under MedCanG to function effectively, this equivalency must be excluded for medical cannabis. They propose that prescriptions for medical cannabis should only be valid if issued following a direct, in-person medical consultation within Germany, thus preventing reliance on foreign-issued prescriptions for these products.
Another significant aspect concerns the regulation of pricing for medical cannabis. With the partial decriminalization of cannabis removing it from the scope of the Narcotics Act, pharmacies are no longer bound by uniform pricing regulations for these products. The states are calling for the application of the national pharmaceutical pricing ordinance (AMPreisV) to medicinal cannabis, ensuring price consistency across all pharmacies. They argue that medical cannabis, as a prescription-only medication, should not be subject to market-driven price competition and should adhere to standardized pricing under German law.
The legislative initiative also seeks to address concerns related to advertising. The states recommend that advertising for medical cannabis be restricted exclusively to professional circles, in line with the German Drug Advertising Act. This measure aims to prevent broad public advertising campaigns, particularly those targeting young people or promoting easy online access to medical cannabis, which have been a recent concern with the rise of digital platforms offering such services.
While the proposed regulations include a ban on the online prescription and shipment of medical cannabis, an effort led by representatives from Thuringia to ease the ban--citing potential risks to patient access--did not receive majority support among the states. As a result, the legislative proposal maintains its requirement for in-person physician assessment and prohibits direct-to-consumer shipping of medical cannabis.
It is important to note that although the Federal Council (Bundesrat) can express recommendations and propose amendments, it does not possess a veto right to block this particular law. The federal legislative process allows for the Bundesrat to provide input, but ultimate legislative authority remains with the federal government and parliament.
The ongoing debate reflects the states' desire to ensure patient safety, prevent abuse, and promote a regulated, equitable market for medical cannabis. The proposed changes are expected to bring greater clarity and uniformity to how medical cannabis is prescribed, priced, and advertised in Germany, aligning national practice with evolving legal and medical standards.