Since medical marijuana was legalized in Germany in March last year, an increasing number of patients are being prescribed the drug. But the healthcare industry has been less enthusiastic about the boom and many questions have gone unanswered.
Demand for cannabis has shot up since it was legalized about a year ago. Around 44,000 units of the plant covered by health insurance were distributed to patients in 2017, according to figures from the pharmacy association ABDA which were recently shown to the German Press Agency (DPA).
“The trend has been increasing from quarter to quarter, both for prescriptions and dispenser units,” said Andreas Kiefer, president of the federal pharmacy chamber. Medical cannabis is now also easier to access and much cheaper, according to Kiefer.
At the same time, health insurance companies have been receiving a large number of applications for the reimbursement of medical marijuana costs. Allgemeine Ortskrankenkasse (AOK), Barmer and Techniker Krankenkasse (TK) report that since the drug’s medical legalization on March 10th 2017, a total of over 15,700 applications have been submitted.
The number of applications has “skyrocketed,” according to DAK-Gesundheit (DAK) another large German health insurance provider. Prior to legalization, only about 1,000 people in Germany had permission to use the drug for special medical purposes.
So far, AOK, Barmer, TK and DAK have rejected around one third of the applications they’ve received. According to these health insurance companies, there have been teething problems since the new law was introduced, such as dealing with incorrect or incomplete information from patients.
It’s not only insurance companies which have been feeling the effects of the boom.
Bavarian drug manufacturer Bionorica has also benefited from increased demand for the drug; sales of the company’s cannabis remedy Dronabinol more than doubled in 2017. Bionorica is also expanding production as the company’s patients have almost tripled – with numbers constantly on the rise.
Doctors on the other hand are under pressure as they need to give precise reasons for prescribing cannabis. Some doctors fear for their reputation as marijuana can evoke associations with “druggies” or habitual users of drugs. Its medical efficacy is also partly controversial.
“We still know far too little about whether and how cannabis-based medicinal products work,” said Josef Mischo from the German Medical Association.
Studies have to be carried out “very carefully” to determine whether cannabis is an alternative to conventional therapies, Mischo said.
The German Hemp Association on Thursday said in a statement that even after one year, doctors continue to be reluctant to prescribe the drug, adding that this is due to two things: obtaining approval from health insurance providers as well as the lack of continuing education opportunities for physicians.
Cannabis use was legalized in Germany for medical purposes for people with serious diseases like certain cancers and multiple sclerosis. Patients suffering from epilepsy or chronic nausea due to chemotherapy can also be prescribed the drug.
Up to now, the import of medical cannabis has come mainly from countries like Canada and the Netherlands. But in the near future the federal government aims for cultivation of the drug at home.
A cannabis agency under the Federal Institute for Drugs and Medical Devices (BfArM) has been advertising contracts to companies concerning the licences for 6,600 kilograms of medical cannabis – to be cultivated over a period of four years.
More than 100 companies have since applied and about ten of them have made it to the final round; a decision is set to be made soon. The first marijuana plants grown in Germany under state supervision are planned to be available by 2019.
credit:420intel.com