Since the entry into force of the Medicinal Cannabis Act (MedCanG) At the beginning of April 2024, access to medical cannabis in Germany was significantly liberalized. Cannabis flowers can no longer be prescribed exclusively with a narcotic prescription, but with regular prescriptions, and online dispensing and delivery by pharmacies also became possible.
Now there is a new Draft bill of the Federal Ministry of Health (BMG) who wants to partially reverse these advances. In this article we show what changes are planned and why many patientsinside and Expertraise the alarm – and what risks and legal problems exist from the point of view of critics.
What does the draft propose?
Here are the main planned changes at a glance:
| Area | Planned change |
|---|---|
| Medical prescription / doctor contact | Prescription of medical cannabis flowers should only be after a personal doctor contact Digital initial prescriptions or exclusive video/telemedicine should no longer be permitted. |
| Shipping by pharmacies | The shipping of medical cannabis flowers by pharmacies should be banned. Pharmacies should be required to dispense cannabis flowers in person and provide advice. |
| Frequency of doctor visits | Patients should visit their doctor in person on a regular basis, e.g., every quarter. |
| Restrictions on telemedicine and online prescriptions | Telemedicine, online prescriptions, and e-prescriptions should be restricted or completely excluded for medical cannabis, especially when it comes to initial prescriptions or mail-order. |
Criticism & Risks
1. Difficult access to care, especially in rural areas
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For patients in regions without nearby doctors or pharmacies, travel times, costs and stress increase – especially for those with chronic illnesses or limited mobility.
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If telemedicine and shipping are prohibited, flexible, digital care channels that are often already used will no longer be available.
2. More bureaucracy & additional costs
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More frequent doctor visits mean additional costs and organizational effort – not only for patients, but also for doctor's offices and pharmacies.
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Personal consultation in pharmacies when dispensing rather than mailing takes time, which can also be reflected in costs and capacity bottlenecks.
3. Danger of a return to the black market
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If legal routes become too cumbersome, expensive, or simply impractical, some patients may, out of frustration, resort to illegal sources without any guarantees of quality or safety.
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Black market products pose risks such as contamination, unclear content, and health hazards.
4. Legal and constitutional concerns
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Professional freedom of doctors: Obligations to exclude certain types of prescriptions could conflict with medical freedom.
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Problems of European law: Requirements such as shipping bans or digital restrictions could violate the free movement of goods and services within the EU.
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Equality & Discrimination Risks: Patients with fewer resources or in structurally weak regions are disadvantaged compared to urban areas.
5. Ideology instead of evidence-based regulation?
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Critics accuse the draft of many regulations not being based on empirical data, but rather being politically motivated restrictions.
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A transparent cost-benefit analysis is often missing: What effects are expected from the restrictions, and are they justified?
Possible alternatives & recommendations
To ensure care without the risk of significant disadvantages, experts suggest:
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Maintain telemedicine and mail-order arrangements at least as an option – especially for initial prescriptions under certain conditions (e.g., by specialized physicians).
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Mandatory information and advice, but with digital or hybrid formats that facilitate access.
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Flexible arrangements for rural areas: telemedicine, home visits, mobile pharmacies, etc.
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Transparency in draft legislation: publication of studies, cost forecasts, impacts on care, legal opinions.
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Embedding quality assurance, safety and patient protection into processes – without unnecessary hurdles.
Frequently Asked Questions (FAQ)
1. What is the Medical Cannabis Act (MedCanG)?
The MedCanG is a German federal law, in force since April 1, 2024, which regulates the medical use of cannabis in Germany.
2. Why is the draft being criticized?
Because some proposals (in-person doctor visits, no mail-order treatment, ban on telemedicine) could undo existing improvements, which would particularly harm patients in more remote regions. There are also legal concerns regarding fundamental rights and EU law.
3. When could changes come into effect?
The draft is still under debate. Whether and how the proposals will be adopted depends on parliamentary votes, possible revisions, and expert opinions. The original draft bill has since been withdrawn, according to reports.
4. How can patients prepare or inform themselves now?
Patients should describe their current healthcare situation to their treating physicians and pharmacists, be alert to potential changes, and contact associations and patient organizations if necessary. They should also utilize information on existing legal regulations, telemedicine services, and online prescriptions.
Conclusion
The current draft reform of the Medical Cannabis Act poses significant risks for patients and the rule of law. Instead of improving medical care, proposed regulatory changes could create barriers to access, additional costs, and adverse health consequences. Data protection, the freedom of healthcare professionals, and equal opportunities for care should be preserved.
