Regulation
Germany Clarifies Cannabis Prescribing Rule, Sparing Existing Patients a Switch
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Germany’s statutory health insurance system will not force existing medical cannabis patients off their current treatment, the two bodies that run the system’s prescribing rules clarified on August 6, 2026 — and Berlin-based producer Cantourage Group SE welcomed the move the following day, saying it gives physicians and patients legal certainty after a savings law tightened the rules on July 30, 2026.
The National Association of Statutory Health Insurance Physicians (KBV) and the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) published a joint interpretation of the cannabis provisions in the GKV-Beitragssatzstabilisierungsgesetz, the health-insurance savings law that took effect on July 30, 2026. The statute stripped dried cannabis flower from the insurance catalogue and required that first-time treatment begin with an authorized cannabis-based finished medicine in a six-month therapeutic trial before an extract or compounded formulation may be prescribed. The new rules drew numerous inquiries from physicians, the KBV said.
“The clarification provides legal certainty for physicians and, above all, for patients. Continuity of treatment is an essential component of reliable medical care,” said Philip Schetter, CEO of Cantourage Group SE, in the company’s statement.
What the Clarification Changes for German Patients
Under the joint reading, the six-month trial requirement applies only to indications for which a finished medicine is actually authorized. Patients with severe pain or other indications without an authorized finished medicine can receive an extract or another cannabis-based medicine from the outset, with no trial required. Patients already being treated with cannabis extracts or compounded formulations containing dronabinol or nabilone keep their entitlement, and physicians may issue them follow-on prescriptions without ordering a switch first.
The trial itself is also less rigid than the statute’s wording suggested. The prescribing physician may end it early and move to a different cannabis-based medicine, such as an extract, if the patient does not tolerate the finished medicine or it proves ineffective, and no second authorized product has to be tested for the same indication.
The Rules That Stay in Force
The clarification does not touch cannabis flower, which has not been prescribable at insurance expense since July 30, 2026. Physicians must move flower patients to another cannabis-based medicine, and that switch requires fresh approval from the patient’s health insurance fund unless the prescriber belongs to a specialty exempt from the approval requirement, a group that includes general medicine, neurology, and gynecology. Exempt physicians can still request approval voluntarily, and the KBV advises documenting the reason for the change carefully. The underlying conditions for cannabis treatment eligibility are unchanged, the association said.
What Cantourage Says It Means for Business
Cantourage said the clarification has no material impact on its business development, describing its exposure to the reimbursement rules for compounded cannabis formulations and finished cannabis medicines as limited. The company, which was listed on the Frankfurt Stock Exchange on November 11, 2022, offers pharmaceutical-grade products across dried flower, extracts, dronabinol, and cannabidiol, and last month launched its proprietary medical cannabis brand gramz. in Germany.
The prescribing rules the clarification interprets trace back to the savings law’s passage last month, when the Bundestag moved to end insurance coverage for medical cannabis flower as part of a broader effort to stabilize statutory health insurance contribution rates. Under the system’s prescribing guidance, first-time cannabis prescriptions outside the exempt specialties still require insurer approval, with a two-week processing window and a three-day fast track in general outpatient palliative care. Medical cannabis has been prescribed on Germany’s standard electronic prescription since the Cannabis Act removed it from narcotics scheduling in April 2024; only nabilone still requires a narcotics prescription form.
