German Cannabis Business Assoc Newsletter reports
© KBV / GKV-Spitzenverband
The National Association of Statutory Health Insurance Physicians (KBV) has surprisingly revised its legal interpretation regarding the prescription of medical cannabis, reports Apotheke Adhoc. While the association had jointly maintained with the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) at the beginning of August that the six-month treatment trial with an approved finished pharmaceutical product stipulated in the GKV Contribution Rate Stabilisation Act was only mandatory where there was a suitable indication, it has now performed a U-turn. According to the body’s current view, a finished pharmaceutical product must take priority in all cases for initial prescriptions – regardless of whether the product is approved for the specific medical condition or would have to be used off-label.
This new legal assessment has led to an open disagreement with the health insurance funds. The National Association of Statutory Health Insurance Physicians states that there is currently no longer a shared interpretation with the GKV-Spitzenverband regarding this issue and is calling for clarification from the Federal Ministry of Health. Under the new KBV position, a cannabis-containing finished pharmaceutical product must primarily be prescribed for initial treatment attempts. However, this requirement does not apply to existing patients who had already received treatment with cannabis flowers or extracts before the cut-off date. If a patient does not tolerate the finished pharmaceutical product or if the treatment proves ineffective, continued prescription would be inappropriate: physicians may then switch directly to an extract or another cannabis-containing medicinal product without having to test a second finished pharmaceutical product. Due to the existing legal uncertainty, the KBV recommends that prescribing practices voluntarily obtain approval from the health insurance fund before issuing a prescription for the time being.
For medical practices, pharmacies, and patients, this change of course creates renewed uncertainty in everyday care until a decision by the Federal Ministry of Health is available.
The Federal Association of Pharmaceutical Cannabinoid Companies (BPC) sharply criticises the current situation in a LinkedIn post.
The current reporting is largely based on information provided by Apotheke Adhoc. The original announcement regarding the joint interpretation with the GKV-Spitzenverband from August has been removed from the KBV website.
For patients seeking legal support, the BvCW has compiled a list of specialist lawyers in the fields of social law, health insurance law, and social security law.
