Czech Republic to reimburse 90% for medical cannabis

The medical marijuana has been legal in the Czech Republic since 2013, with no special price or reimbursement conditions.

Patients have to deal with a limited number of doctors authorized to prescribe it, with insufficiently stocked pharmacies and at a high price. Cannabis is either imported from the Netherlands or Canada, via Canopy Growth or Tilray, and sold for between €5.40 and €7.75 a gram, or produced locally by the Elkoplast company and sold for €7 a gram. Czech patients are theoretically entitled to 180g of cannabis per month.

A proposal supported by the government

In January 2019, the Czech Ministry of Health published a bill to cover cannabis treatment in a maximum of 30 grams per month per patient and up to 90% of the price. Last Tuesday, the proposal was adopted by Parliament. Reimbursement will start at the beginning of 2020.

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«We are aware that the current cost of therapeutic cannabis can be a significant burden for certain groups of patients, particularly those who are disabled and on low incomes. This can even lead to the illegal self-cultivation of cannabis of unknown quality, which can have a negative impact on patient health. Therefore, we would like to contribute 90% of the retail price of cannabis in pharmacies via public health insurance. The amount of the supplement will be comparable to the supplement for the treatment of chronic diseases», said Minister of Health, Adam Vojtěch.

A criticized 30g limit

While the Czech Ministry of Health considers 30g a month to be sufficient, patient associations disagree.

«We consider this to be sufficient, as today's average patient consumes up to 10g per month. This was confirmed by a survey of prescribers. However, in exceptional cases, on the proposal of the attending physician and with the agreement of the examining physician, reimbursement above this limit will also be possible», explained the Minister.

«The Ministry proposes to limit the amount of cannabis for medical purposes to a reimbursement of 90% at only 30g per month (the legal limit is 180g). It is based on SAKL statistics [editor's note: the Czech national agency for the regulation of medical cannabisThese figures do not quantify the real needs of patients, but only reflect current consumption, limited by unavailability. Allowing export and using the capacity of a Czech producer would considerably reduce the price for a Czech patient».» explains KOPAC, the main Czech association of patients treating themselves with therapeutic cannabis. «Moreover, a reimbursement to 90% of a limited amount of 30 g of cannabis, far from sufficient for some patients, will not solve their problem.»

By May 2019, only 665 Czech patients had been given access to medical cannabis, while the number of licensed doctors authorized to dispense therapeutic cannabis has barely reached 100. A total of 5 kilos has been prescribed since the start of the year, or 7.5 grams per patient, a paltry and unrealistic amount indeed.

Last year, the consumption and prescription of medical cannabis in the Czech Republic had reached 4.8 kilograms, almost four times more than the previous year. The number of patients legally treated with medical cannabis also tripled in 2018 to almost 450 people.