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Tag: Germany

A Focus On German Patients: What Do They Still Face?

At an undisclosed location, somewhere in Bavaria, a group of activists met on the first weekend of November. They were drawn there by their friendships and their long-time struggles to gain access to medical cannabis.

All of them were sick. But for all the disabilities, across a range and spectrum of chronic conditions, there was also a very serious commitment at the gathering too.
These were all German cannabis patients, frustrated with the many issues still in the room since the market began to reform and change in 2016.

Most have not been able to find regular doctors. All of them have struggled with insurers and finding regular supplies at their local pharmacies (including in big cities like Berlin), and a lot of them are starting to cultivate cannabis again if they ever stopped.

For all of the “reform” in the room, namely that cannabis is now available by prescription in German pharmacies, there is still a long way to go. What is on the market is too expensive not only for patients, but also insurers, to cover in increasingly large numbers. Changing the compensation that pharmacies must charge (as is now in the offing) is just one small piece of the conundrum.

In Germany currently, legal medical cannabis that patients can buy in pharmacies costs more than twice as much as what can be found on the unregulated market, and on the grey market prices can frequently go as low as 5 euros a gram, if not “free” for those who grow at home illicitly.

Some of the more business and cost-minded patients are estimating their costs too. Even the fairly novice growers understand that they are looking at the same costs per gram as growing say, tomatoes. Unless of course, they get caught.

Many patients now carry their cannabis in the pre-packaged containers that all the big companies provide flower in for the German market. The joke of course, if not the reality in every medical cannabis market in Europe right now, is that it is not what is actually in those plastic jars.

The patients at the deep end of both sick and tired are defending themselves in the only way that they can. As more than one of the meeting attendees said, “What are they going to do? Arrest me? They already have.”

Everyone knows at this point though, that at least a part of the battle has indeed been won. Germans at least know that really sick people can in fact legally obtain and use cannabis. The particulars, at least so far, however, have not moved the needle anywhere fast enough.

For those whose mobility and/or budgets are limited by their condition, the only way to respond in both protest (if not effective challenge) is very simple – grow their own, or be part of a cooperative that includes them for free or for a minimal charge in a circle of people who know this is the only drug that helps them manage their condition so effectively.

To leave them out of the circle of care, would be, at its core, a very un-German thing to do. It is not a message that the “industry” wants to hear, but it is in the room and as a steady drumbeat that will not go away.

Which Conditions Are Receiving The Most Medical Cannabis Reimbursements In Germany?

The cannabis plant is one of the most versatile plants on earth. It has the power to feed, the power to clothe, and the power to heal. A growing number of suffering patients are turning to the cannabis plant to help treat their condition, including in Germany.

Since 2017, doctors in Germany have had to report medical cannabis information to the German government. It’s a requirement whenever German doctors prescribe medical cannabis that’s covered by statutory health insurance and thus is eligible for reimbursement.

The requirement to provide data makes it very easy for the German government to publish statistical data since the data is readily available. Germany recently disclosed the health conditions that have received the most reimbursements as of September, a summary of which can be found below along with what percentage the condition represents from the data set:

  • Pain (70.9%)
  • Spasticity (10.8%)
  • Anorexia (6.9%)
  • Epilepsy (1.6%)
  • ADHD (1.5%)
  • Tourette Syndrome (1.0%)

The remaining 7.3% is comprised of ‘other’ non-specified conditions. As you can see from the data, pain is the most likely condition to receive medical cannabis reimbursements in Germany by far, although that doesn’t mean that it’s necessarily the only condition that those patients suffer from.

It could be that using cannabis for pain management is really popular in Germany, but it could also be that pain is an easier condition to qualify for and that pain is a symptom of a number of other health conditions.

Many patients in Germany could very well suffer from multiple health conditions yet chose to only qualify for medical cannabis for pain management reasons. Rather than go into great detail with their doctors and be subjected to a number of tests, they can simply establish that they are suffering from pain and that cannabis helps.

This survey data that was released by BfArM involved 6,538 patients, although that’s not to say that there are only that many medical cannabis patients in Germany. German doctors are required to report the data only after the patient has received reimbursements for a full year or ‘as soon as treatment is interrupted.’

The number of patients involved in the study will increase over time. The requirement to participate in the data survey will continue until March 2022.

The German Cannabis Market Is Projected To Reach $16B By 2028

Germany is home to the largest legal cannabis market in Europe, which is not surprising given the fact that Germany has the fourth-largest economy on the planet. Germany’s population is more than twice that of the state of California.

In addition to Germany’s medical cannabis industry expanding, lawmakers in Germany are reportedly exploring the idea of legalizing cannabis for adult-use. Obviously, if that happens Germany’s legal cannabis industry will increase in size dramatically.

How big will Germany’s legal cannabis industry get? A new projection has been released by Prohibition Partners in regards to Germany’s cannabis industry, and it involves an eye-popping figure. Read more about it in our recent article on Cannabis & Tech Today.

Germany Is Exploring Cannabis Legalization Reform

Uruguay was the first country to legalize cannabis for adult-use, followed by Canada. A Supreme Court ruling in Mexico declared cannabis prohibition unconstitutional in that country, which makes Mexico essentially the third country to legalize cannabis for adult use.

Many political observers have speculated that the European nation of Luxembourg will be the next to legalize cannabis, however, Luxembourg may not be the first to legalize on the European continent. A report recently surfaced stating that German lawmakers (Chancellor of Germany Angela Merkel’s political party) are giving strong consideration to legalization. Per DW:

Germany’s center-right Christian Democratic Union (CDU) is openly considering a momentous u-turn in the party’s attitude to the legalization of cannabis.

“Cannabis could be freed for personal use, of course with controlled production and distribution,” CDU interior policy spokesman Marian Wendt told the RND network on Friday. “The resources freed in the police and judiciary should be used to fight the illegal trade.”

The implementation process of cannabis legalization in Uruguay and Canada has had its ups and downs, but for the most part, it has been successful. Whether that would prove to be the case in Germany would largely depend on the legalization model it adopts.

The unregulated cannabis market will likely always exist in Germany, just as it will likely exist in other countries that move to legalize cannabis for adult use. However, that’s not to say that legalization won’t be worth it in Germany and that the continued existence of an unregulated cannabis market (or not) should be the only measure of success.

Freeing up law enforcement to investigate and prosecute real crime in Germany is in itself worth it to legalize cannabis for adult use, as is refraining from ruining people’s lives because they were in possession of a plant that is safer than alcohol. A thriving regulated cannabis industry is another huge benefit.

Prohibition Partners recently released a projection for Germany’s cannabis industry putting the size of Germany’s legal cannabis industry at over $16 billion by 2028. That projection was based in part on the assumption that Germany would legalize cannabis for adult use between now and 2028. It’s quite possible that legalization could come sooner rather than later to Germany.

German Cannabis Pharmacy Association Debuts At Dusseldorf’s ExpoPharm 2019

International Cannabis Business Conference veterans are showing up at all sorts of interesting conferences and expos these days auf Deutschland. Most notably last week Tobias Loder of Luxe 99 Apotheke joined Markus Fischer (also a pharmacist and the titular head of the new German Cannabis Pharmacy Association VCA) plus a host of familiar faces at a first of its kind expo.

Expopharm is not new of course. It is one of the largest pharmacy conferences in Europe, if not the largest. However, this year in Dusseldorf cannabis was featured for the first time as medicine.

The big firms showed up (of course), but what was notable, beyond the VCA, were the indie specialist distributors out in force.

Cannabis as medicine is now accepted in Germany, regardless of the fights that still remain on the ground. On the ground, those who are dealing with “last mile” issues that include everything from finding a doctor and a suitable pharmacist to approvals are in the room.

Beyond activists and patients in other words, the business community is coming together to face its own cannabis future.

Big Changes and Challenges Are Underway For German Pharmacists 

German pharmacists are caught in a dilemma that nobody else is at present when it comes to the cannabis question. There are no chains larger than three (and in some cases four) brick and mortar outlets. Online sales are verboten.

Patients must interact with pharmacists to obtain their medications. Most patients must also obtain preauthorization from their health insurers to be able to afford their meds. On top of this, there is a new defacto fee structure in place – namely health insurers are forcing pharmacists to lower their mark-up costs. That pressure used to come 100% from distributors.

That is now changing, and so are other rules and norms.

As Peter Homberg of Denton’s law firm explained in Berlin last week at his firm’s medical cannabis conference, patients can now obtain a full three-month prescription for 100 grams of flower from their doctors. That means that pharmacies will be handling higher bulks, larger orders, and greater logistical challenges on getting the product on a regular basis.

Also, against all of this, the market is now opening for new products to enter the country.

What Makes This Cool

Producers who want to enter the German market with properly certified product are beginning to find that the market is opening up in an interesting way. Personal relationships and guaranteed delivery, as well as pricing,  are the name of the game.

German pharmacists themselves are in the middle of a changing regulatory landscape that will continue to prove interesting for years to come.

Don’t forget to mark your calendars now for the fourth International Cannabis Business Conference in Berlin April 1-3, 2020!

The German Cannabis Market Continues To Open For Imports

The shifting laws of national sovereignties along with new global treaties and a rather old global one are allowing new winds of cannatrade to enter Germany.

It’s not just Portugal, in other words, that is now on the map to import cannabis into Germany. Spain, Denmark, Malta, Greece, Australia, and South Africa are all birthing producers who are clearly putting Germany in the middle of their bullseye, if not European plans.

What does this mean in general for the average producer?

You have to have your paperwork in order, be prepared to prove cert, and plan, as of now, to spend your conference days at the next International Cannabis Business Conference in Berlin networking your tail off!

Who To Look For?

When planning your Berlin trip to the International Cannabis Business Conference, here are a few things to put on your packing list of to do’s.

Top of the list? A distributor with the right papers on the ground. There are currently 19 of them – with more coming into the market. Their good relationships with pharmacies are essential. And there are thousands of them. All of them are small businesses – owning no more than three or four brick and mortar outlets. All of them are looking for reliable, clean, tested, and certified products.

If that is you, with a plan for insuring a steady supply, you will be popular in every room you show up in.

You Do Not Need The Big Guys…But It Can Sometimes Help

The biggest names in the industry are now in the German market – with one of them already set up to cultivate certified product and two hot on their heels. On top of that larger firms have already established distribution relationships in the German market that allow them to say that they have market penetration in the bag.

However, that is not the whole story – as the indies are finding out. The right relationships with the right strategic partners make all the difference. The market needs certified product – and if that is you – your future is looking very bright in Germany (and beyond) that right now.

The doors may not be fully open, but they are opening more and more with every passing month. For the right entrepreneurial canna firms, there are lucrative opportunities to be had.

German Pharmacists Support Medical Cannabis, See Market Growth

The German cannabis patient community has grown by leaps and bounds since the program was approved a few years ago and the International Cannabis Business Conference is so pleased to have witness the growth firsthand, holding our first annual conference in Berlin just after medical legislation was approved. Despite a lot of bureaucratic red tape (that has loosened over time), there are now about 50,000 cannabis patients and that number could easily increase to hundreds of thousands in the coming years as cannabis goes more mainstream and prices drop.

The robust growth of Germany’s medical cannabis program isn’t only evident by the increase in the number of patients, but in clear signs that the future growth of the program is very bright. First, the increase in exports has surged dramatically as the European Union powerhouse has imported nearly as much cannabis from Canada and the Netherlands in the first six months of 2019 as it did in all of 2018. Also, very tellingly, licensed German pharmacists, those actually dispensing the medicine, not only support medicinal cannabis, but three-fourths see the market growing, as reported by Marijuana Business Daily:

According to the paid report, the majority of pharmacists in Germany generally favor medical cannabis – as long as they’re the ones responsible for dispensing it.

Three-quarters believe the German medical cannabis market will continue to grow, and among that group, 15% said growth will be strong.

***

About half the pharmacists believe they are well informed about medical cannabis, but fewer than 5% responded they are “very well” informed. The rest said they were poorly or very poorly informed.

With cultivation companies in Germany now getting licensed, with homegrown cannabis expected to be on pharmacy shelves in 2020, prices will come down, variety will increase, and local lobbying efforts will strengthen. With the industry growing, as German pharmacists and virtually everyone expects, advocates will become more influential with policy makers, and the bureaucratic hurdles slowing the medical program will start to be removed. Eventually, the lobbying effort and public support will garner enough votes to legalize cannabis for all adults. When they do, will German pharmacists still be the sole dispensers, or will the market open up to more retail outlets? Only time will tell.

The International Cannabis Business Conference is THE industry event to learn the latest and to network with top investors and entrepreneurs. Next up: Vancouver, British Columbia, Canada, this September 15-16. Purchase discounted early bird tickets by August 21st to save.  

Patients Are Powering the European Cannabis Industry

It is a truism in the room that the cannabis industry, globally, and in each region of the world it springs forth in, is driven first by the medical side of the business. No matter how much excitement about CBD first strategies, it is the places where fully leaded, THC included, and regulated whole plant medication are authorized that are able to drive real change, if not nascent markets forward.

This has been true of the United States and Canada and it’s the truth in Europe as well.

In Germany, despite the fact that patients gained access just as they lost the right to cultivate small amounts themselves (at least until recreational reform hits), so far, patients have only gained wider spread access by submitting themselves to the complicated approval process required by insurers. There are now about 50,000 patients in Germany and these patients are helping move cannabis more and more mainstream in their homeland and across europe, as the EU powerhouse’s influence ripples beyond its borders.

in the UK, the entire discussion is taking another twist. Namely, desperate parents of sick children began importing medicine from Holland and Canada and dared the authorities to shut them down.

That strategy worked, but only to a limited degree, unfortunately. Despite the fact that it was announced last fall that cannabis would be covered as a Schedule II prescription, covered under the NHS, so far there are, by best estimates fewer than 100 patients in the UK, but patients have not given up. In some cases, they have even partnered with large industry players from Canada and other countries to put pressure on the government to open the market.

The situation is so obviously dire in the U.K. right now, that it will have an effect, and probably far beyond the UK – globally. There is not a patient in the room of any nationality who has not had to deal with intransigent anti cannabis rules, unbending medical infrastructure and paperwork of all kinds.

In the UK, much like the conversation in every other legalizing market, the corner, at least, has been turned. The issue, not to mention those who are suffering, are visible.

Public opinion is shifting. Parliament is apologizing. And the market, no matter its shape post October 31, is clearly opening. And that progress is mostly due to the unrelenting pursuit of greater access by patients and their advocates. A sincere thanks to all sick and disabled patients, and their supporters, for moving our cause of freedom and compassion forward.

The International Cannabis Business Conference is THE industry event to learn the latest and to network with top investors, entrepreneurs, and advocates. Next up: Vancouver, Canada, this September 15-16. Discounted early bird tickets are on sale until August 21st.  

German Cultivation Bids Reverberate Across the Global Cannabis Industry

The day after the third annual International Cannabis Business Conference in Berlin, as the crew packed up and headed on to Zurich, news about the German cultivation bid surfaced in the domestic media. Namely, that three bid finalists (Aurora, Aphria and Demecan, a start-up founded with Wayland) had been selected. This is unofficial “news” as not only does the bid process itself face a pending lawsuit that is headed to court in Germany this week, but insiders on the ground in Germany will also not be surprised to see more legal action challenging this decision. So far, BfArM, the federal agency managing the bid has yet to make an official announcement.

Regardless, even the “unofficial” news is a sign that the German market is starting to gain not only traction but formal shape (starting with established pricing).

In the meantime, International Cannabis Business Conference Berlin saw producers from all over the world descend on a cannabis industry gathering that has already earned its stripes if not its rightful moniker as the “Cannes of Cannabis.” Dealmakers came together in Berlin from Australia, Israel, Canada, many countries in Latin America and several from the African continent to sell to Europe and an opening market. As one Australian producer said “there was more demand here than we could possibly fill.”

In fact, several weeks before the International Cannabis Business Conference, signs were already afoot that the market is opening for international competition from all over the world – not just Canada and Holland, as has been the case up until now. Frankfurt based Farmeko announced a 50 tonne, four-year import deal from Macedonia via Poland in mid March.

The biggest news about the bid, however, is not that it seems to be at least resolving for this first round but that other opportunities are opening in its wake – and not only in Germany but across the continent.

Greece is fully engaging the licensing process, it is very likely that Poland may start down the cultivation path soon and the UK and Ireland are all moving questions at this point.

Switzerland, of course, represents another unique wrinkle in all of this and may prove yet to be the market leader in Europe on the recreational front for several reasons – namely it is not an EU member but part of the economic framework of the region.

The combination, however, clearly of all of these fragmented puzzle pieces moving forward, surrounding the activity around the German bid is absolutely one of the strongest catalysts for the entire conversation. Not to mention a conference now in its third year that brings all the movers and shakers together in one place.

This spring, in other words, is a critical building year for the industry across the continent and the International Cannabis Business Conference is right in the middle of the conversation.

It is not too late to book your tickets for the International Cannabis Business Conference’s first year in Zurich, a megaconference team-up with CannaTrade! Early-bird prices end on April 24th.