Berlin, 2026-07-10: With today’s adoption of the GKV Contribution Rate Stabilization Act (BStabG) by the German Bundestag, access to individualized cannabis therapies will become significantly more restrictive. Under the revised Section 31(6) of the German Social Code (SGB V), medical cannabis extracts and isolates, including dronabinol, are now treated as secondary treatment options. Statutory health insurance reimbursement for cannabis extracts will only be available after patients have completed a six-month treatment trial with an approved cannabis-based pharmaceutical.

Michael Greif, Managing Director of the German Cannabis Business Association (BvCW), strongly criticized the decision: „The new regulation completely fails to achieve its stated objective. Rather than reducing costs for statutory health insurers, it is likely to increase them, as individualized cannabis preparations are often more cost-effective than expensive pharmaceutical products. At the same time, physicians‘ therapeutic freedom in medical cannabis treatment is being severely restricted.“

Kathrin Konyen, Coordinator of the BvCW Medical Cannabis Division, added that lawmakers failed to introduce either transitional arrangements or grandfathering provisions for patients already undergoing treatment: „A blanket priority for pharmaceutical products forces physicians into rigid treatment pathways, creates unnecessary bureaucracy, and jeopardizes successful therapies. Treatment decisions must be based on individual medical needs—not on generalized legal requirements. Prioritizing pharmaceuticals would only be medically justified if an approved, available product exists for the specific indication and no medical objections apply.“

Compared with the projected €40 billion funding gap in Germany’s statutory health insurance system by 2030, annual spending on medical cannabis—approximately €205 million for flowers and extracts in 2025—represents only a negligible share of total healthcare expenditure. According to the association, expectations of meaningful cost savings ignore significant secondary costs. Many chronically ill patients will be unable to afford self-funded treatment, potentially resulting in increased spending on pharmaceutical products and extracts, greater reliance on the illicit market, home cultivation exceeding the legal 50-gram limit, or a return to opioid therapy with its substantially higher addiction risks and long-term healthcare costs.

The BvCW therefore calls on Germany’s federal states to advocate amendments during the Bundesrat legislative process. The association offers its expertise to both the Bundesrat and the Federal Ministry of Health and proposes the following key changes:

• Preserve physicians‘ therapeutic freedom: The mandatory six-month trial period should be abolished or at least substantially shortened. Decisions on whether pharmaceutical products or individualized cannabis preparations (including flowers and extracts) are medically appropriate must remain solely with the treating physician. Moreover, determining whether a pharmaceutical product is effective generally requires far less than six months. Forcing patients to remain on an ineffective therapy for such a prolonged period is medically unacceptable.
• Introduce statutory exemption clauses: If the trial period remains in place, explicit exceptions should apply in cases of intolerance, contraindications, insufficient therapeutic response, or unsuitable dosage forms—for example, where rapid inhalation is medically necessary to manage breakthrough pain.
• Guarantee legal protection for existing patients: Transitional provisions should ensure that patients currently receiving medical cannabis are not forced to discontinue successful therapies, thereby preventing serious and medically unjustifiable treatment interruptions.