Patients are experiencing a rapid surge in the price of medical cannabis, as well as a shortage of supply in pharmacies, since a recent amendment of Germany’s cannabis legislation.

Until the beginning of 2017, around 1,000 patients in Germany had been given special authorisation by the state to buy medical cannabis from pharmacies, at the cost of €15 (£13.50) per gram. To get such authorisation was difficult and time consuming, and applications had to be examined and approved by various medical practitioners. New legislation changed that.

In January, members of the German Parliament voted unanimously to legalise the prescribing of medical cannabis; a law which was implemented in March. According to Health Minister Hermann Groehe, the country’s public health system will now fund cannabis prescriptions for patients, but only “if they cannot effectively be helped any other way” – essentially limiting state coverage of medical cannabis to seriously ill patients.

While this reform has gained widespread praise as a progressive step, some serious problems have arisen. As the Cannabis Industry Journal has reported, “a real crisis is brewing” for both patients in cannabis treatment and for cannabis suppliers.

Following the introduction of the new legislation, there has been a sharp rise in demand for cannabis from patients – which suppliers have been unable to cope with. This has resulted in a shortage of supply of many varieties of medical cannabis in pharmacies.

Medical cannabis provided in Germany is imported from Canada and the Netherlands, rather than domestically cultivated. Germany’s dearth of medical-grade cannabis is thus compounded by a lengthy importation process, as well as the current Canadian cannabis shortage. Currently, Canadian supplies of cannabis may not be available in Germany until September at the earliest.

In addition to the shortage of supply, there has been a surge in the costs related to acquiring medical cannabis in Germany. Since the introduction of the new legislation, medical cannabis prices have risen by over 66 per cent to €25 (£22.50) per gram. Pharmacies have also been adding a preparation fee to medical cannabis to cover the costs of packaging, labelling and dosing.

To further complicate matters, some doctors have been reluctant to hand out medical cannabis insurance prescriptions, whereby a patient’s insurance company – rather than the state – covers the cost of the drug. If a doctor makes such a prescription, but the insurance company fails to pay out, the doctor would be liable for the cost of the cannabis. Therefore, some doctors have opted to only provide private prescriptions for medical cannabis – meaning patients must pay out of their own pocket, undermining the new legislation.

Due to the price rises and shortage of supply, some German patients are opting to buy from the illegal market, or engaging in home cultivation, to acquire cannabis. This was a situation the government was hoping to avoid when it introduced the legislation.

It is evident that a lot of work needs to be done to meet the promises of the new legislation and ensure that all eligible medical cannabis patients are receiving the cost-effective treatment that they need. Nonetheless, it has only been five months since the legislation took effect, so it may take a while for the government to work through initial challenges.

The government is currently in the process of selecting a company to cultivate cannabis on German soil. Patients hope that the problems of the current situation will be alleviated once the first domestic crops are ready.