On July 30th, 2026, a ban in Germany on reimbursement for cannabis flowers under the Statutory Health Insurance Stabilization Act came into effect. The reimbursement ban was approved despite the best efforts of countless medical cannabis patients, advocates, and organizations to prevent it from passing. The details of the impact that the ban will have on patients, including how many patients will be affected, were provided in a recent LinkedIn post by the Bundesverband pharmazeutischer Cannabinoidunternehmen e. V. (BPC).

Around 65,000 patients will lose the ability to receive statutory health insurance reimbursements for flowers, which creates a “double burden,” according to BPC.

“Medical cannabis flowers are completely excluded from reimbursement by statutory health insurance.” BPC wrote in its post (translated from German to English). “For the remaining reimbursable cannabis medicinal products, a priority regulation will apply in the future, which requires at least six months of therapy trial with an approved finished medicinal product before any prescription.”

“From the BPC’s point of view, the legislator is thus making the situation for seriously ill patients doubly worse: a particularly vulnerable group is deprived of a proven therapy option, while all others are forced to take a six-month detour.” BPC continued.

The organization highlighted some essential points that remain unclear:

• Grandfathering: What applies to people who are already stable? Whether and how an ongoing, effective therapy can be continued is not clear from the regulation.
• Off-label use: Since approved finished medicinal products are only approved for a few indications, the BPC assumes that the mandatory therapy trial could result in use outside the marketing authorisation for the vast majority of those affected. How off-label and follow-up prescriptions will be handled in the future remains to be seen.
• Contraindications and interactions: What happens if a therapy trial is discontinued due to contraindications, intolerances or relevant interactions? An expressly regulated medical exception is not clearly laid down in the law.

“Above all, it remains unclear how health insurance companies, doctors, pharmacies, the Federal Joint Committee (G-BA) and ultimately the courts will interpret the regulations. In addition, there is the question of costs. In a law that is intended to stabilize contribution rates, it is questionable whether the expected savings will actually occur or whether costs and risks will simply be shifted.” BPC wrote.

“The BPC is therefore urgently calling for improvements: the withdrawal of the blanket exclusion of reimbursement of cannabis flowers, priority for finished medicinal products only where an approved and deliverable preparation is actually available, medical deviations in justified cases and grandfathering for patients with stable attitudes.” the organization concluded.

The Working Group on Cannabis as Medicine (ACM) recently announced that it will file a constitutional complaint against the passage of the measure.

“The ACM board has decided to file a constitutional complaint against the statutory health insurance contribution stabilization law passed by the Bundestag and Bundesrat. And our chances are good.” the organization stated in a news release (translated from German to English).

ACM is urging German medical cannabis patients to get involved and recommends two different options for doing so. The first option is to participate in the complaint before the Federal Constitutional Court. Attorney Professor Dr. Oliver Tolmein. Mr. Tolmein is filing the constitutional complaint on behalf of patients. The second option is contacting members of the Bundestag.

“All patients who benefit from such therapy and are disadvantaged by the law are warmly invited to contact their local member of parliament and inform them about the disadvantages of the law. In particular, they can ask members of the governing coalition (SPD, CDU, and CSU) to advocate for patient welfare and, in their specific case, for optimal therapy with cannabis-based medications.” ADM wrote. “Make it clear to the members of parliament that therapy with cannabis-based medications is always an individualized treatment. This also applies to the choice of preparation, as these have different effects.”

“We will do everything in our power to overturn this law. It’s not the first time an ACM legal initiative has been successful, even if it sometimes took years. With your support, we can do it again.” the organization concluded in its news release. “We will soon be setting up a donation account to ensure we have sufficient funds. The DHV (German Hemp Association) has already expressed its fundamental support.”

ACM’s contact information can be found in its news release. In addition to ACM’s planned constitutional complaint, the German Association of Cannabis Patients (BDCan) has asked Federal President Frank-Walter Steinmeier to review the adopted measure from a constitutional perspective before it is enacted.

“Seriously ill people must not lose their established therapy overnight. It’s about ensuring continuity of care and preventing unnecessary interruptions to ongoing treatments.” stated Daniela Joachim, Chairwoman of the Board of the BDCan, in a news release (translated from German to English).