Germany: Update – Rate Stabilization Act: End of cannabis flowers as a reimbursable service planned

GKV Contribution Rate Stabilization Act: End of cannabis flowers as a reimbursable service planned
BvCW warns against exclusion of cannabis flowers

2026-04-19 | The draft of the GKV Contribution Rate Stabilization Act provides that cannabis flowers will no longer be covered by statutory health insurance, according to apotheke-adhoc.

Insured patients with serious illnesses would then only be entitled to treatment with extracts of standardized quality as well as medicines containing dronabinol or nabilone. According to the draft, removing the prescribability of flowers would result in savings for statutory health insurance (GKV), increasing from around €130 million in 2027 to up to €180 million in 2030.

The Health Finance Commission had previously proposed the removal to stabilize GKV finances, arguing that the scientific evidence for patient benefit is significantly more robust for finished medicinal products. In addition, the rapid onset of effects when inhaling flowers poses a higher risk of addiction. As natural products, the active ingredient content is also subject to fluctuations. The commission stated: “In a solidarity-based healthcare system, it is fundamentally necessary that services at the expense of the insured community are based on sufficient evidence and ensure a comprehensible therapeutic quality.” Standardization is hardly achievable with flowers compared to extracts.

The German Cannabis Business Association (BvCW) has commented on the draft bill from the Federal Ministry of Health and criticizes the planned removal of cannabis flowers from the benefit catalog. From the association’s perspective, the proposal is neither medically nor legally viable and contradicts existing case law.
According to the BvCW, cannabis flowers are not therapeutically interchangeable with extracts for certain patient groups, for example in cases of acute symptoms requiring rapid onset of action. A blanket exclusion could therefore endanger the care of seriously ill patients and interfere with physicians’ therapeutic autonomy.
Furthermore, the expected savings potential projected by the ministry is considered unrealistic. Many affected individuals would likely switch to other reimbursable medicines or be unable to afford the therapy. This could lead to a shift toward the illicit market and cause additional follow-up costs.