Medical Cannabis in Germany: THC Prices Vary by a Factor of 12

Source: Working Group on Medical Cannabis (ACM), September 2026. Prices are for informational purposes only and may vary depending on the pharmacy and coverage terms.

The price difference between the most expensive and least expensive products is thus about a factor of twelve. Compared to medical cannabis flowers, the gap is even wider. According to the ACM, the THC provided by Exilby can cost more than twenty times as much as the equivalent amount found in dried flowers.

Why THC Prices Don't Tell the Whole Story

Although these figures reveal significant differences, researchers caution against interpreting them to mean that these products are therapeutically interchangeable.

THC bioavailability, routes of administration, pharmaceutical quality, and approved indications all influence therapeutic outcomes.

For example, inhaled cannabis and orally administered extracts have different absorption profiles, which means that identical amounts of THC do not necessarily produce comparable effects.

The calculation also does not take into account the other active ingredients. The Sativex, for example, contains CBD, the presence of which is not taken into account in a comparison based solely on THC.

The cost per milligram is therefore a useful economic indicator, but it does not provide a comprehensive assessment of therapeutic value.

Germany's cannabis reimbursement policy in the spotlight

This comparison is particularly important for the German health insurance system. Recent Rules require patients who are starting certain cannabis-based treatments to first try an approved pharmaceutical product before they can receive reimbursement for alternative preparations, subject to the relevant medical indications.

On October 15, German lawmakers tightened the restriction on this priority to authorized indications.

However, the ACM's findings reveal a potential contradiction: the cannabis-based medicines (Sativex, Epidyolex, Exilby, etc.) can be significantly more expensive per milligram than alternatives prepared at a pharmacy.

For example, preparations made from dronabinol cost about one-sixth as much per milligram as Exilby.

The German federal government also acknowledged, in response to parliamentary questions posed by the Greens, that prioritizing pharmaceutical drugs was unlikely to yield significant savings.

A Debate Beyond the Price of THC

Supporters of approved medications argue that their prices reflect regulatory requirements, standardized manufacturing, proven efficacy, and consistent dosages. These considerations remain essential when evaluating medical cannabis treatments, particularly for patients who require predictable pharmaceutical formulations.

Nevertheless, the ACM’s analysis introduces a measurable economic dimension to the debate. And these figures highlight a major challenge that France will also have to address: balancing clinical data, patient access, and pharmaceutical costs, particularly when approved drugs may be significantly more expensive than cannabis-based preparations.