A doctor who issues an “insurance-prescription” without the commitment for reimbursement risks financial liability for the prescribed medicine and all other therapy costs. With this potential financial burden at play, doctors frequently hand out private prescriptions for cannabis but rarely consider issuing a coveted “insurance-prescription” if the health insurance had not already approved the patient’s reimbursement application.

Since the introduction of Germany’s new law, cannabis prices have risen over 66% from 15 to 25 Euro per gram. The pharmacies justify this with the complicated fee schedule in the German healthcare system. Since March 2017, medical cannabis is legally considered a “recipe substance,” meaning the raw material had to be repacked, labeled, and dosed (ground) according to German pharmaceutical standards before being handed over to patients. If the physician notes “not crushed” on the prescription, the pharmacies will dispense whole flower as opposed to ground herbs, but the fee remains the same.

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