Latest updates on German medical cannabis health insurance inc decisions from social courts or Bayreuth & Frankfurt

Further news

Medical Cannabis

Discrimination against cannabis magistral preparations draws criticism; BvCW asks Federal Ministry of Health for clarification
2026-08-25 | According to a  report by Business of Cannabis, the legislator is scaling back reimbursement by statutory health insurers (GKV) for dried cannabis flowers under the new BStabG regulations while giving preference to approved finished medicinal products. In future, reimbursement of magistral preparations would require a mandatory six-month trial period with finished medicinal products. The only THC-containing finished medicinal products currently available are Sativex (indication: spasticity associated with multiple sclerosis) by Almirall Hermal and – soon to be launched – Exilby (indication: back pain) by Vertanical.

Michael Greif, Managing Director of the German Cannabis Business Association (BvCW), sharply criticized this statutory prioritization. The assumption that it would generate cost savings was economically flawed, as finished medicinal products were systematically in a significantly higher price range than magistral preparations or cannabis flowers. While established products could incur monthly treatment costs of between 350 and more than 1,000 US dollars, individualized preparations were often more cost-effective in the long term. Patients who depended on the rapid effects of inhaled cannabis flowers also faced the risk of gaps in treatment. Lacking the financial means to pay for private prescriptions, affected patients could be pushed toward the illicit market or home cultivation.

After the Federal Association of Statutory Health Insurance Physicians (KBV) unilaterally terminated the agreement previously reached with the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband), considerable uncertainty has arisen among physicians and patients regarding the prescription of finished medicinal products and magistral preparations. According to Parliamentary State Secretary Dr. Georg Kippels (CDU), there is no grandfathering for patients who received cannabis flowers at the expense of statutory health insurance before July 30, 2026, as reported by  apotheke-adhoc. The exclusion from reimbursement also applies to ongoing treatments. The  BvCW has therefore contacted the Federal Ministry of Health (BMG) directly, requesting clarification on key issues including indication restrictions, treatment duration and grandfathering.

SPD member of the Bundestag Carmen Wegge has acknowledged in a personal statement that she continues to consider the exclusion of cannabis flowers from reimbursement under the GKV Contribution Rate Stabilization Act to be wrong, according to the initiative  Legalisierung aus Vernunft on X. Wegge argued that the exclusion ignored the fact that cannabis flowers were medically the most effective treatment for many seriously ill patients. She also warned of additional costs resulting from treatment discontinuation.

Neurologist Kirsten Müller-Vahl (Hannover Medical School and member of the  Scientific Advisory Board of the BvCW) pointed out that inhalation using a vaporizer enabled precise and effective treatment, as reported by  ZDFheute. Cannabis-based alternative medicines were in some cases more expensive and only approved for limited indications, which cast doubt on potential savings. Since home cultivation was hardly a viable option for patients for quality and quantity reasons, affected patients had already announced lawsuits before the social courts. In the “ÄrzteTag”–podcast, Dr. Konrad F. Cimander analyzed the consequences of the statutory exclusion of cannabis flowers from reimbursement. Despite unclear requirements regarding dosage forms, he emphasized that solutions were needed for patients requiring rapid onset of active ingredients.

Social Court of Frankfurt rejects application for interim reimbursement of cannabis flowers
2026-08-26 | The Social Court of Frankfurt has rejected the first lawsuit challenging the exclusion of cannabis flowers from statutory health insurance coverage, as reported by  apotheke-adhoc. A patient with a severe neurological disorder sought to have her three-year cannabis flower treatment continued through court proceedings. The court found that, since July 30, the Contribution Rate Stabilization Act had provided neither a legal basis for reimbursement nor transitional provisions. The exclusion did not violate constitutional rights, as the legislature was permitted to restrict the statutory health insurance benefits catalogue for reasons of cost as well as concerns regarding addiction risks and fluctuations in active ingredient concentrations in cannabis flowers. As the patient’s condition was not life-threatening, she was referred to another trial of treatment with finished medicinal products.

Social Court of Bayreuth rejects claim for coverage of cannabis treatment costs for ADHD
The Social Court of Bayreuth rejected an ADHD patient’s claim for reimbursement of cannabis flowers. According to the ruling (Social Court of Bayreuth,  S 6 KR 613/21), a degree of disability of 30 did not constitute a serious illness that substantially impaired quality of life. The court also found that the medical justification was incomplete because it did not sufficiently address alternative standard treatments or the claimant’s previous drug use. Since there was also insufficient scientific evidence supporting the use of cannabis for ADHD, the health insurer’s decision was deemed lawful.