Germany: Bundestag adopts GKV Contribution Rate Stabilization Act

German Cannabis Business Assoc has written the following

65,000 publicly insured patients lose reimbursement for medical cannabis

2026-07-10 | The German Bundestag has passed the controversial GKV Contribution Rate Stabilization Act, triggering sharply divided reactions across the healthcare sector, according to Deutsche Apotheker Zeitung. While statutory health insurers welcomed the cost-saving package as a means of stabilizing contributions for employers and insured persons, physicians, pharmacists, and the pharmaceutical industry voiced strong criticism. The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) and the Association of Substitute Health Insurance Funds (vdek) praised the coalition’s ability to act politically but stressed that the government still fails to adequately finance non-insurance-related public services. Pharmaceutical associations, by contrast, described the legislation as a “law destabilizing Germany as a business location,” warning that international companies could halt investments, cut jobs, and withhold innovative therapies from the German market.

Concerns have also been raised within outpatient care. The National Association of Statutory Health Insurance Physicians (KBV) criticized serious drafting flaws, including the removal of the appropriateness review in psychotherapy, which it argues places a disproportionate share of the financial burden on the outpatient sector. For pharmacies, ABDA President Thomas Preis warned that the permanent increase in mandatory statutory discounts would accelerate pharmacy closures.

The legislation has also met fierce resistance from the cannabis industry. Michael Greif (German Cannabis Business Association – BvCWcriticized the exclusion of medical cannabis flowers from statutory reimbursement, arguing that forcing patients toward more expensive pharmaceutical products will ultimately increase healthcare costs. According to Melanie Dolfen (Berliner BezirksApotheke), approximately 65,000 statutory health insurance patients are expected to lose reimbursement for their medical cannabis therapy, as reported by Pharmazeutische Zeitung. The German Association of Pharmaceutical Cannabinoid Companies (BPC) likewise criticized the mandatory priority given to cannabis-based pharmaceuticals, arguing that it forces physicians to prescribe more expensive and frequently less suitable medicines.

GKV Contribution Rate Stabilization Act: Cannabis industry warns of worsening care for seriously ill patients and rising healthcare costs

Medical cannabis flowers are being replaced by more expensive pharmaceutical products, forcing seriously ill patients to discontinue established therapies

2026-07-10 | With today’s adoption of the GKV Contribution Rate Stabilization Act (BStabG) by the German Bundestag, access to individualized cannabis therapies will become significantly more restrictive. Under the revised Section 31(6) of the German Social Code (SGB V), medical cannabis extracts and isolates, including dronabinol, are now treated as secondary treatment options. Statutory health insurance reimbursement for cannabis extracts will only be available after patients have completed a six-month treatment trial with an approved cannabis-based pharmaceutical.Michael Greif, Managing Director of the German Cannabis Business Association (BvCW), strongly criticized the decision: “The new regulation completely fails to achieve its stated objective. Rather than reducing costs for statutory health insurers, it is likely to increase them, as individualized cannabis preparations are often more cost-effective than expensive pharmaceutical products. At the same time, physicians’ therapeutic freedom in medical cannabis treatment is being severely restricted.”

Kathrin Konyen, Coordinator of the BvCW Medical Cannabis Division, added that lawmakers failed to introduce either transitional arrangements or grandfathering provisions for patients already undergoing treatment: “A blanket priority for pharmaceutical products forces physicians into rigid treatment pathways, creates unnecessary bureaucracy, and jeopardizes successful therapies. Treatment decisions must be based on individual medical needs—not on generalized legal requirements. Prioritizing pharmaceuticals would only be medically justified if an approved, available product exists for the specific indication and no medical objections apply.”

Compared with the projected €40 billion funding gap in Germany’s statutory health insurance system by 2030, annual spending on medical cannabis—approximately €205 million for flowers and extracts in 2025—represents only a negligible share of total healthcare expenditure. According to the association, expectations of meaningful cost savings ignore significant secondary costs. Many chronically ill patients will be unable to afford self-funded treatment, potentially resulting in increased spending on pharmaceutical products and extracts, greater reliance on the illicit market, home cultivation exceeding the legal 50-gram limit, or a return to opioid therapy with its substantially higher addiction risks and long-term healthcare costs.

The BvCW therefore calls on Germany’s federal states to advocate amendments during the Bundesrat legislative process. The association offers its expertise to both the Bundesrat and the Federal Ministry of Health and proposes the following key changes:

  • Preserve physicians’ therapeutic freedom: The mandatory six-month trial period should be abolished or at least substantially shortened. Decisions on whether pharmaceutical products or individualized cannabis preparations (including flowers and extracts) are medically appropriate must remain solely with the treating physician. Moreover, determining whether a pharmaceutical product is effective generally requires far less than six months. Forcing patients to remain on an ineffective therapy for such a prolonged period is medically unacceptable.
  • Introduce statutory exemption clauses: If the trial period remains in place, explicit exceptions should apply in cases of intolerance, contraindications, insufficient therapeutic response, or unsuitable dosage forms—for example, where rapid inhalation is medically necessary to manage breakthrough pain.
  • Guarantee legal protection for existing patients: Transitional provisions should ensure that patients currently receiving medical cannabis are not forced to discontinue successful therapies, thereby preventing serious and medically unjustifiable treatment interruptions.

 

Newsletter of the German Cannabis Business Association

Topic overview:

News of the week

Bundestag adopts highly controversial GKV Contribution Rate Stabilization Act

65,000 publicly insured patients lose reimbursement for medical cannabis

2026-07-10 | The German Bundestag has passed the controversial GKV Contribution Rate Stabilization Act, triggering sharply divided reactions across the healthcare sector, according to Deutsche Apotheker Zeitung. While statutory health insurers welcomed the cost-saving package as a means of stabilizing contributions for employers and insured persons, physicians, pharmacists, and the pharmaceutical industry voiced strong criticism. The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) and the Association of Substitute Health Insurance Funds (vdek) praised the coalition’s ability to act politically but stressed that the government still fails to adequately finance non-insurance-related public services. Pharmaceutical associations, by contrast, described the legislation as a “law destabilizing Germany as a business location,” warning that international companies could halt investments, cut jobs, and withhold innovative therapies from the German market.

Concerns have also been raised within outpatient care. The National Association of Statutory Health Insurance Physicians (KBV) criticized serious drafting flaws, including the removal of the appropriateness review in psychotherapy, which it argues places a disproportionate share of the financial burden on the outpatient sector. For pharmacies, ABDA President Thomas Preis warned that the permanent increase in mandatory statutory discounts would accelerate pharmacy closures.

The legislation has also met fierce resistance from the cannabis industry. Michael Greif (German Cannabis Business Association – BvCWcriticized the exclusion of medical cannabis flowers from statutory reimbursement, arguing that forcing patients toward more expensive pharmaceutical products will ultimately increase healthcare costs. According to Melanie Dolfen (Berliner BezirksApotheke), approximately 65,000 statutory health insurance patients are expected to lose reimbursement for their medical cannabis therapy, as reported by Pharmazeutische Zeitung. The German Association of Pharmaceutical Cannabinoid Companies (BPC) likewise criticized the mandatory priority given to cannabis-based pharmaceuticals, arguing that it forces physicians to prescribe more expensive and frequently less suitable medicines.

GKV Contribution Rate Stabilization Act: Cannabis industry warns of worsening care for seriously ill patients and rising healthcare costs

Medical cannabis flowers are being replaced by more expensive pharmaceutical products, forcing seriously ill patients to discontinue established therapies

2026-07-10 | With today’s adoption of the GKV Contribution Rate Stabilization Act (BStabG) by the German Bundestag, access to individualized cannabis therapies will become significantly more restrictive. Under the revised Section 31(6) of the German Social Code (SGB V), medical cannabis extracts and isolates, including dronabinol, are now treated as secondary treatment options. Statutory health insurance reimbursement for cannabis extracts will only be available after patients have completed a six-month treatment trial with an approved cannabis-based pharmaceutical.Michael Greif, Managing Director of the German Cannabis Business Association (BvCW), strongly criticized the decision: “The new regulation completely fails to achieve its stated objective. Rather than reducing costs for statutory health insurers, it is likely to increase them, as individualized cannabis preparations are often more cost-effective than expensive pharmaceutical products. At the same time, physicians’ therapeutic freedom in medical cannabis treatment is being severely restricted.”

Kathrin Konyen, Coordinator of the BvCW Medical Cannabis Division, added that lawmakers failed to introduce either transitional arrangements or grandfathering provisions for patients already undergoing treatment: “A blanket priority for pharmaceutical products forces physicians into rigid treatment pathways, creates unnecessary bureaucracy, and jeopardizes successful therapies. Treatment decisions must be based on individual medical needs—not on generalized legal requirements. Prioritizing pharmaceuticals would only be medically justified if an approved, available product exists for the specific indication and no medical objections apply.”

Compared with the projected €40 billion funding gap in Germany’s statutory health insurance system by 2030, annual spending on medical cannabis—approximately €205 million for flowers and extracts in 2025—represents only a negligible share of total healthcare expenditure. According to the association, expectations of meaningful cost savings ignore significant secondary costs. Many chronically ill patients will be unable to afford self-funded treatment, potentially resulting in increased spending on pharmaceutical products and extracts, greater reliance on the illicit market, home cultivation exceeding the legal 50-gram limit, or a return to opioid therapy with its substantially higher addiction risks and long-term healthcare costs.

The BvCW therefore calls on Germany’s federal states to advocate amendments during the Bundesrat legislative process. The association offers its expertise to both the Bundesrat and the Federal Ministry of Health and proposes the following key changes:

  • Preserve physicians’ therapeutic freedom: The mandatory six-month trial period should be abolished or at least substantially shortened. Decisions on whether pharmaceutical products or individualized cannabis preparations (including flowers and extracts) are medically appropriate must remain solely with the treating physician. Moreover, determining whether a pharmaceutical product is effective generally requires far less than six months. Forcing patients to remain on an ineffective therapy for such a prolonged period is medically unacceptable.
  • Introduce statutory exemption clauses: If the trial period remains in place, explicit exceptions should apply in cases of intolerance, contraindications, insufficient therapeutic response, or unsuitable dosage forms—for example, where rapid inhalation is medically necessary to manage breakthrough pain.
  • Guarantee legal protection for existing patients: Transitional provisions should ensure that patients currently receiving medical cannabis are not forced to discontinue successful therapies, thereby preventing serious and medically unjustifiable treatment interruptions.
Correction
In our newsletter’s lead story published on 2026-07-08, we reported that medical cannabis flowers would remain reimbursable as a secondary treatment option following a six-month trial with cannabis-based pharmaceuticals. The underlying media report has since proven to be incorrect. Under the legislation adopted by the Bundestag, medical cannabis flowers have been completely removed from statutory health insurance reimbursement. Consequently, reimbursement by statutory health insurers will not be available even after completion of the mandatory six-month pharmaceutical treatment period.

Quote of the week

Georg Wurth: Half a million euros for a monopoly

“It certainly looks as though someone has purchased a monopoly for their product with half a million euros in political donations—at the expense of insured patients. In my 24 years as chairman of the German Hemp Association, I have never witnessed anything like this.”Georg Wurth, Chairman of the German Hemp Association (DHV), commenting on the GKV decision in a press statement.

Number of the week

Clemens Fischer explains €560,000 in political donations

2026-03-18 | Pharmaceutical entrepreneur Clemens Fischer (Futrue GmbHPharmaSGP Vertanical) has publicly explained the motivation behind his major political donations ahead of Germany’s federal election, according to Business Insider. Fischer stated that he donated a total of €560,000 to the CSUFDPSPD, and CDU in order to strengthen Germany’s political center and help overcome the country’s reform backlog.According to Fischer, he expects the next federal government to adopt a more business-oriented approach by reducing bureaucracy and accelerating regulatory approval procedures. He argued that Germany has the potential to reclaim its historic role as the “pharmacy of the world” and become a leading global pharmaceutical hub. Fischer also advocated a fundamental shift toward preventive medicine, suggesting that many chronic diseases could be avoided through earlier intervention.

Following the recent approval of the cannabis-based pharmaceutical Exilby, Vertanical is expected to benefit substantially from the abolition of statutory reimbursement for medical cannabis flowers. At present, Sativex remains the only THC-containing cannabis-based pharmaceutical currently available on the German market.

Company of the week

Aurora Cannabis recognized among Canada’s Best Companies

2026-07-09 | Global medical cannabis producer Aurora Cannabis Inc. has been included in TIME’s “Canada’s Best Companies 2026” ranking, according to a company press release. Aurora stated that it is the first and currently only cannabis company ever to receive this distinction.The ranking, compiled jointly by TIME magazine and data analytics firm Statista, evaluates Canadian companies using a multi-stage assessment process. Eligible companies were required to generate at least US$100 million in annual revenue in either 2024 or 2025 while also demonstrating positive revenue growth over a three-year period. Only 125 companies ultimately qualified for the final list.

The evaluation considered employee satisfaction, three-year revenue growth, and corporate sustainability transparency. Aurora CEO Miguel Martin emphasized that the recognition strengthens the company’s international credibility and reflects the success of its employee-focused corporate culture.

Study of the week

Broad acceptance: U.S. study finds strong physician support for medical cannabis

2026-07-07 | Medical cannabis enjoys overwhelming support among U.S. healthcare professionals, according to a report by NORML citing a survey published in the Journal of Cannabis Research. Among 879 healthcare professionals surveyed, more than 85% acknowledged legitimate therapeutic applications for medical cannabis. Ninety-five percent supported legal patient access, while nearly three-quarters stated they would personally recommend or prescribe medical cannabis.

However, the study also highlighted a significant educational gap: fewer than one-third of respondents reported having received formal clinical training on medical cannabis.

Publication of the week

New scientific reference book summarizes current research on THC and precision medicine

Dr. Stefan Meyer, Member of the Executive Board of the German Cannabis Business Association (BvCW) and Head of its Industrial Hemp Division, has published a new scientific reference work entitled THC – From Molecule to Medicine.

The book presents THC as a neuropharmacological system modulator, deliberately distancing itself from both trivializing and stigmatizing perspectives. It provides a detailed explanation of THC’s interaction with the endocannabinoid system and its influence on complex biological networks.

While the clinical evidence supporting THC use in chronic pain, multiple sclerosis, and palliative care is considered robust, the author notes that evidence for many other indications remains limited. Dr. Meyer therefore advocates a precision cannabinoid medicine approach that integrates genetic factors and individual patient risks into personalized treatment strategies.

In addition to toxicological considerations and the entourage effect involving CBD, the book also examines the growing importance of EU-GMP quality standards within the medical cannabis sector.

Further news

Medical Cannabis

Insurance Reimbursement Facing the Axe: Patients’ Association Warns of Dramatic Consequences of the GKV Savings Act

In a special episode of the podcast “Das Hanfgespräch” (YoutubeSpotify), Daniela Joachim and Marc Ziemann from the Association of German Cannabis Patients (BDCan) warn of existential threats to seriously ill people.

The reason is the GKV Contribution Stabilization Act, which includes the removal of medical cannabis flowers from the service catalog of statutory health insurance companies. In future, patients will have to bear the costs themselves, which is financially impossible for most, while growing their own is rejected as unsuitable for clinical therapy. In addition, in the future, individual formulations such as extracts may only be prescribed after a six-month trial therapy with approved finished medicinal products.

However, since existing finished preparations often show severe side effects or cover too narrow indications, there is a risk of significant supply gaps and an increase in hospital admissions. Because the law was also introduced in Parliament without sufficient lead time, the Greens had (unsuccessfully) appealed to the Federal Constitutional Court. The association is demanding strict protection of existing status for ongoing therapies and is currently preparing lawsuits.

Get Connected

Karma Koala Podcast

Top Marijuana Blog