Why the German Bundesrat wants to overhaul the medical cannabis market

German regulations on medical marijuana continues to be the subject of intense scrutiny.

In anticipation of the Bundesrat vote on November 21, the health commission published a series of recommendations aimed at strengthening the framework created by the Medizinisches Cannabisgesetz (MedCanG). The proposals, set out in detail in an official Bundesrat working document, indicate a desire to strengthen control over prescriptions, prices, distribution and monitoring mechanisms.

Foreign ordinances in question

One of the most important measures under consideration is the end of recognition of foreign prescriptions. Under current rules, prescriptions issued in other EU and EEA countries, and even in Switzerland, are treated in the same way as those issued by German doctors. In the commission's view, this approach is incompatible with the new MedCanG requirement for personal consultation between doctor and patient before issuing a prescription.

According to the recommendation, the German authorities cannot check whether such face-to-face consultations have taken place abroad. The commission therefore proposes that a clear exception be added to the law: foreign prescriptions should no longer be accepted for the medical marijuana.

This change would mark a break with the broader European principle of mutual recognition of prescriptions, and is already causing concern among patients who rely on cross-border medical consultations.

Applying AMPreisV to restore price consistency

Another key recommendation is the explicit application of the’Arzneimittelpreisverordnung (AMPreisV), Germany's drug pricing regulations, at the medical marijuana.

Since this substance was withdrawn from the narcotics law (BtMG) and placed under the MedCanG regime, pharmacies have adopted widely divergent pricing practices. Some argue that cannabis is not covered by AMPreisV because its distribution is governed by MedCanG rather than the classic pharmaceutical framework provided by the’Arzneimittelgesetz (AMG).

The Health Commission rejects this interpretation. It explains that medical cannabis, as a prescription-only product, should not be subject to market-driven price competition. By reaffirming the application of AMPreisV, the Bundesrat aims to reintroduce uniform pricing and avoid excessive differences between pharmacies.

Ban on advertising outside professional circles

Recommendations also target online platforms which have built up their business by promoting «quick orders» of cannabis-based treatments. The commission proposes to extend article 10 of the Heilmittelwerbegesetz (HWG) medical cannabis, with a strict ban on advertising aimed at a non-professional audience.

This is not just a question of commercial ethics. The document highlights concerns about targeting young audiences and the potential consequences for public health, highlighting in particular risks related to addiction and neurodevelopment.

As a result, advertising medical cannabis outside professional circles would be banned outright.

End of cannabis flower shipment

The Bundesrat also supports the transformation of the government's planned ban on shipping cannabis flowers into an enforceable law. The proposal would classify any violation, such as sending cannabis flowers directly to patients, as an administrative offence. The commission draws a parallel with the strict rules surrounding T-prescriptions (German secure prescriptions), arguing that the same level of security and traceability should apply.

This would have a significant impact on telemedicine platforms and pharmacies that rely on nationwide shipments, forcing them to revert to in-person collection or other controlled distribution methods.

Call for a new monitoring mechanism

Finally, the Health Committee addresses what is perhaps the most delicate issue: enforcing the obligation of personal consultation between doctor and patient without compromising patient confidentiality. The supervisory authorities currently have no legal means of verifying compliance in the event of suspicion.

The Bundesrat is therefore asking the Federal Ministry of Health (BMG) to devise a «legally sound mechanism» to enable independent verification while preserving the protection of medical records.

Without such a system, the commission believes, the new consultation rule cannot be effectively controlled.

An uncertain political outcome

It is not yet certain whether the plenary of the Bundesrat will adopt some or all of these recommendations. The legislative process surrounding the medical cannabis reform in Germany has already prompted strong reactions from the industry, which warns that excessive regulation could undermine patient access.

For now, the Health Commission's proposals pave the way for another decisive political debate on a market that is still adapting to its new liberalized foundations.