Medicinal Cannabis in Germany: supply can’t meet demand

Cannabis has been available on prescription in Germany for two years. But there are two problems: Pharmacies report supply bottlenecks – and many patients have to pay out of pocket. Companies like World High Life (NEX: LIFE) are stepping up to solve the problem.

“With cannabis, I can participate much better in social life”, explains Sebastian Hurth. The young man suffers from Tics, a symptom of Tourette’s syndrome – a neurological disease. He makes uncontrolled movements and shouts provocative things and constantly runs the risk of hurting himself.

Other medications have ceased to work and thus he received special permission to smoke cannabis. Since then his symptoms have improved. Sebastian is one of the lucky ones as his health insurance now covers medical cannabis, for many that is not the case.

Problems for patients

The law, which is only two years old and allows pain patients in particular to use the drug, does not exactly make it easy for those who need cannabis to buy it. Health insurance companies usually do not have enough prescriptions from doctors to cover the costs. Even if they promise to pay, it is far from certain that pharmacies will be able to supply the right type of cannabis.

Sebastian Hurth recently had to wait three months for his prescription. Then he has to switch to one of the other twenty or so cannabis strains and never knows beforehand whether and how it will affect him or how he will have to dose it.

Still too little cannabis

One of the reasons for the shortage of medical care is that medical cannabis has only been allowed to be cultivated in Germany since this year. Currently, pharmacies only sell cannabis from Canada and the Netherlands. This year, the Federal Institute for Drugs and Medical Devices invited tenders for the cultivation of 10.4 tonnes of medical cannabis for companies. The first harvest is expected at the end of 2020.

Sandra Grußbach of cannabis importer Cannamedical Pharma doubts that this quantity will be able to meet the demand. “The quantity tendered by the Cannabis Agency will not significantly improve the situation in Germany”.

At the same time, demand is increasing rapidly. It is estimated that about 15,000 patients will receive cannabinoid drugs this year. If something isn’t done soon Germany’s problems will only continue to spiral.

Especially for pain patients

The physician Franz Josef Grotenhermen, a proponent of hemp as a drug, is convinced that one million patients in Germany could be successfully treated with cannabis. He sees the main problem not in the provision of larger quantities, but in the assumption of costs by the health insurance companies. “These are mainly responsible for pain patients.”

“Patients with neurological or psychological illnesses are almost all rejected and have to pay their own doses,” says the doctor. Chronically ill people in particular often do not have sufficient financial means, they remain without therapy or would have to cultivate cannabis themselves illegally or obtain it illegally on the black market.

Lack of scientific studies

Despite obvious problems the umbrella organization of statutory health insurers believes that there is not enough evidence to justify costs: “The SHI system has been obliged by law to bear the costs without there being sufficient information on the efficacy of cannabinoids,” says Claudia Widmaier of the association. “The legislator has set itself the goal that it will become clear from the care whether (…) cannabis is effective as a treatment or not.

Grotenhermen agrees that there are too few studies. If studies were to substantiate the positive effect of cannabis, health insurance companies would find it difficult to reject therapies. However, the pharmaceutical industry has no reason to carry out such long-term studies for a lot of money, as cannabis flowers are not patentable.

For Grotenhermen one thing is certain: the various cannabis strains can do more than alleviate the suffering of pain patients. He has also treated ADHD, post-trauma, Tourette, obsessive-compulsive disorder and cluster headaches with cannabis and achieved good results. But the affected patients all had to pay for their therapy themselves.

Doctors under pressure?

The psychologist and psychiatrist Peter Hess sees a great deal of uncertainty and ignorance among general practitioners. Some of his colleagues do not treat with cannabinoids because they have a bad reputation in society.

Because he’s open to cannabis therapies, people run him down. It doesn’t pay off for him either, because he has to write elaborate expert opinions for each individual to cover the costs of the health insurance, which in many cases would then be rejected anyway. The answering machine in his practice explains to callers that Hess can no longer accept new patients.

Because cannabis is so expensive, 25 euros per gram, health insurance physicians would also run the risk of overrunning their prescription budgets and receiving recourse claims or provoking an audit.

Reservations against cannabis as a medicine

The outgoing Federal Drug Commissioner, Marlene Mortler, spoke out clearly against the greater spread of cannabis as medicine. The demand, she said recently, has not only medical reasons. Lobbyists would persuade patients that cannabis is the best medicine for them.

This, however, is prevented by the narcotics law. It prohibits the prescription of cannabis as long as other drugs are effective.

The private sector plugs the gaps

While the German government and insurers argue about whether cannabis is effective or not North American companies have already started to make a killing. Now that Germany and other European countries are opening up to cannabis these companies have turned their eyes to Europe.

World High Life (NEX: LIFE) is a British company that leverages knowledge from some of North America’s top cannabis minds. The company seeks to take what worked in North America and apply it to the European market. LIFE has started their journey with the acquisition of Love Hemp in a transaction worth $11.23 million. Love Hemp represents Britain’s top CBD producer, and World High Life plans to help the British company enter the wider European market.

World High Life also has plans to enter into the medicinal cannabis market, of which Germany is likely to become a key player over the next few years. It is companies like WHL, who have a clear interest in cannabis, who will spearhead the efforts to ensure that patients, doctors, and insurers are shown the real benefits associated with cannabis as a treatment option.

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