Medical cannabis has received increasing attention in recent years as an alternative treatment for various medical conditions. Since the change in the law in March 2017, which allows doctors in Germany to prescribe cannabis for medical purposes, the use of cannabis flowers has increased significantly. These flowers contain natural cannabinoids such as THC (tetrahydrocannabinol) and CBD (cannabidiol), which can have therapeutic effects.

Overview of medicinal cannabis

Medicinal cannabis is extracted from the hemp plant (Cannabis sativa or Cannabis indica) and contains over 100 different cannabinoids. The two best-known and best-researched cannabinoids are THC and CBD. THC is primarily known for its psychoactive effects, but can also relieve pain, reduce nausea and increase appetite. CBD, on the other hand, has no psychoactive effects and is valued for its anti-inflammatory, pain-relieving and anxiety-relieving properties.

The therapeutic use of cannabis is diverse and includes the treatment of chronic pain, multiple sclerosis, epilepsy and various mental illnesses such as anxiety disorders and depression. Doctors prescribe cannabis when conventional therapies are not sufficiently effective or cause too many side effects.

Meaning and use of cannabis flowers

Cannabis flowers are the dried inflorescences of the female hemp plant and contain the highest concentration of cannabinoids. These flowers can be inhaled (smoked or vaporized) or prepared as a tea. Inhalation offers the advantage of a rapid effect, as the active ingredients enter the bloodstream directly via the lungs and take effect within minutes.

The use of cannabis flowers is particularly popular in the treatment of pain and spasticity. Patients with chronic pain conditions often report significant pain relief and an improvement in quality of life. In patients with multiple sclerosis, the flowers can relieve muscle spasms and spasticity, improving mobility and quality of life.

Cannabis flowers are also used to treat certain mental illnesses. Patients with post-traumatic stress disorder (PTSD) and anxiety disorders benefit from the anxiolytic and calming effects of cannabinoids. Cannabis has also been shown to be useful in the treatment of sleep disorders by improving sleep quality and making it easier to fall asleep.

Overall, cannabis flowers have been shown to be a valuable addition to traditional treatments. However, it is important that it is always used under medical supervision to ensure the correct dosage and minimize side effects.

Cannabis flower costs

The cost of cannabis flowers on private prescription can vary greatly depending on various factors. The main factors that influence the cost are explained below.

Factors that influence the cost

Variety of strains

Variety plays a significant role in the cost of cannabis flowers. There are numerous strains that differ in their cannabinoid profile, terpene content and cultivation methods. High-quality strains that have specific therapeutic properties or are grown under strictly controlled conditions can be more expensive. Strains such as "Bedrocan", "Tilray" or "Aurora" have different price ranges, which also depend on the particular dispensary. Some strains may be rarer and therefore more expensive as they are imported or have special cultivation requirements.

THC and CBD content

The THC and CBD content of cannabis flowers is a crucial cost factor. Strains with a high THC content, such as those often used for the treatment of chronic pain and spasticity, are generally more expensive. THC is known for its psychoactive effects as well as its pain-relieving and muscle-relaxing properties. On the other hand, strains with a high CBD content, which are not psychoactive but have anti-inflammatory and anti-anxiety effects, are also often more expensive. The price can therefore vary depending on the specific medical need and the ratio of THC to CBD.

Dosage and consumption

The prescribed dosage and daily consumption largely determine the monthly cost. Patients may require different doses depending on their condition and individual needs. A typical daily dose can range from 1 to 5 grams, which can lead to significant monthly expenses. For example, a daily dose of 1 gram at a price of 20 euros per gram can lead to monthly costs of around 600 euros. Higher doses increase the total cost accordingly. It is therefore important that patients clarify the dosage with their doctor in order to keep the costs within reasonable limits.

Other cost factors

In addition to the factors mentioned above, other aspects can also influence the costs:

Import costs: as much of the medicinal cannabis in Germany is imported, import costs and taxes can increase the final price.
Availability issues: If there are supply shortages, the price can rise as demand exceeds supply.
Forms of processing and distribution: Processed products such as oils or capsules can be more expensive than unprocessed flowers.
Pharmacy surcharges: Pharmacies may charge different prices and surcharges, which can also lead to price differences.

These factors lead to a wide range of prices for cannabis flowers on private prescription. Patients should do their research and possibly compare several pharmacies to find the best and most cost-effective solution. It can also be helpful to find out about possible reimbursement options through private health insurance or tax deductibility of the costs.

Private cannabis prescription

Definition and differences to health insurance prescriptions

A private prescription for cannabis is a medical prescription where the costs for the medication must be borne by the patient themselves, in contrast to a public health insurance prescription where the costs are covered by the health insurance company. On a private prescription, the prescribed cannabis flowers or products are described in the same detail as on a public health insurance prescription, but here the patient is financially responsible. The price can be considerable, as it is not subsidized by the statutory health insurance companies.

The main difference between a private prescription and a public health insurance prescription lies in how the costs are covered. While statutory health insurance companies can cover the costs of medical cannabis under certain conditions, this coverage is only granted after an individual examination and approval. A private prescription, on the other hand, does not require such approval, which can make access to cannabis quicker and easier, albeit at the expense of the patient's budget.

Prescription process by the doctor

The process of prescribing cannabis on private prescription is similar to other prescription drugs, with some additional steps due to the specific regulation of cannabis. The doctor must first conduct a thorough medical history and diagnosis to determine if cannabis is a suitable treatment option.

The need for a doctor's prescription

A doctor's prescription is essential for the legal purchase of cannabis flowers or products. Pharmacies are not allowed to dispense medicinal cannabis without such a prescription. The doctor must specify the exact type, quantity and dosage of cannabis in the prescription. This prescription is issued on a special narcotics prescription (BtM prescription), as cannabis is classified as a narcotic.

Criteria for the prescription

There are strict criteria that doctors must follow before prescribing cannabis. These criteria are designed to ensure that cannabis is only prescribed when it is medically necessary and justified. The criteria include:

Alternative therapy: cannabis is usually only prescribed if other therapy options have not been sufficiently effective or have had severe side effects.
Medical indications: Cannabis may be prescribed for certain conditions, including chronic pain, spasticity in multiple sclerosis, nausea and vomiting in chemotherapy, and certain neurological and psychological disorders.
Patient information: The doctor must fully inform the patient about the use, possible side effects and interactions with other medications.
Regular check-ups: The course of treatment must be regularly monitored and documented to ensure the effectiveness and safety of the therapy.

The decision to prescribe cannabis is at the discretion of the doctor and should always be based on a sound medical assessment. As cannabis is a narcotic, its prescription and dispensing is subject to strict legal regulations to prevent abuse and illegal distribution.

Medical cannabis Germany

Legal framework

In Germany, the legal framework for medicinal cannabis is strictly regulated. Since March 2017, the law has permitted the use of cannabis as a medicinal product if certain conditions are met. The law amending narcotics law and other regulations allows doctors to prescribe cannabis in the form of dried flowers or extracts. The legal provisions are anchored in the Narcotics Act (BtMG), which strictly controls the use of cannabis.

Legalization and regulations

The legalization of medical cannabis in Germany was a significant step towards giving patients access to another treatment option. Since the change in the law, patients suffering from serious illnesses and for whom no alternative therapies are available or effective can obtain medicinal cannabis on prescription. However, this legalization is subject to strict regulations. Doctors must issue a special prescription for narcotics (BtM prescription) and it may only be dispensed in pharmacies.

The prescription and use of medicinal cannabis is strictly regulated in order to prevent abuse. This includes monitoring the prescribed quantity and regular checks on the success of the therapy by the treating doctor. Only licensed pharmacies are allowed to sell medicinal cannabis and they must ensure that the quality of the cannabis meets the legal requirements.

Authorization procedure and exemptions

The authorization procedure for the prescription of medicinal cannabis stipulates that patients must generally obtain authorization from their health insurance company. This authorization is granted if the attending physician confirms the medical necessity and other treatment options have been exhausted. The health insurance company reviews the application and decides whether the costs will be covered. In many cases, a detailed report from the doctor is required, documenting the previous treatments and their results.

However, there are also exceptions. In urgent cases where immediate treatment is required, doctors can prescribe medicinal cannabis without prior authorization. In such cases, patients must initially bear the costs themselves and can subsequently apply for reimbursement from their health insurance company. These exemptions are intended to ensure that patients in acute situations have quick access to the treatment they need.

The strict legal framework and regulations in Germany ensure that medical cannabis is used responsibly in order to guarantee the greatest possible benefit for patients and at the same time prevent abuse.

Cannabis on prescription prices

Average cost per gram

The cost of cannabis flowers available on prescription can vary greatly. On average, prices are around 20 to 25 euros per gram. These prices can vary depending on the pharmacy, strain and THC or CBD content. It is important that patients find out about the prices at their pharmacy in advance, as there is no standardized price regulation.

Price examples of different strains

Prices for different cannabis strains vary depending on their specific cannabinoid profile and cultivation method. Here are some examples of the price range of different strains:

Bedrocan: This strain has a high THC content and costs around 22 euros per gram.
Pedanios 22/1: With a high THC content and low CBD content, this strain costs around 23 euros per gram.
Tilray THC25: This strain contains 25% THC and is priced at around 24 euros per gram.
Aurora 20/1: This strain costs around 20 euros per gram and contains a high THC content with a low CBD content.
Pedanios 8/8: With a balanced ratio of THC and CBD, this strain costs around 21 euros per gram.

Monthly costs based on usual consumption

The monthly cost of cannabis on prescription depends heavily on the prescribed daily dose. Here are some examples of the monthly costs based on typical consumption:

1 gram per day: at an average price of 22 euros per gram, the monthly cost is around 660 euros (30 days x 22 euros).
2 grams per day: At a price of 22 euros per gram, the monthly cost rises to 1320 euros (30 days x 2 grams x 22 euros).
3 grams per day: With a daily consumption of 3 grams, the costs amount to 1980 euros (30 days x 3 grams x 22 euros).
5 grams per day: For a high consumption of 5 grams per day, the monthly costs are around 3300 euros (30 days x 5 grams x 22 euros).

These calculations make it clear that the cost of medicinal cannabis can be considerable, especially at higher doses. Patients should therefore compare prices and, if necessary, discuss with their doctor whether costs can be covered by health insurance or whether there are alternative financing options.

Reimbursement of cannabis flowers

Possibilities of cost coverage by private health insurance companies

Private health insurance companies offer to cover the costs of medicinal cannabis under certain conditions. The exact conditions may vary depending on the insurer, but the following generally applies:

Medical necessity: the treating doctor must confirm the necessity of cannabis flowers for treatment. This is usually done by means of a detailed certificate that includes the diagnosis, the course of treatment to date and the reasons for prescribing cannabis flowers.
Exhaustion of other therapies: It must be proven that other therapies were not sufficiently effective or had unacceptable side effects.
Contractual agreements: Some private health insurers have special contracts or supplementary insurance policies that cover the costs of alternative or complementary therapies, including medicinal cannabis.

Requirements and application

To apply for coverage by private health insurance, patients should follow these steps:

Medical certificate: The attending physician issues a certificate confirming the medical necessity of cannabis flowers. This certificate should contain detailed information about the diagnosis and the course of treatment to date.
Application to the insurance company: The patient submits an application for cost coverage to their private health insurance company. This application should be accompanied by the medical certificate and the prescription for the cannabis flowers.
Review by the insurance company: The private health insurance company reviews the application and decides whether to cover the costs. This process can take some time and the decision often depends on the individual insurance conditions.
Approval and billing: After approval, the insurance company either covers the direct costs or reimburses the patient for the costs incurred. The exact billing arrangements vary depending on the insurer.

Tax deductibility of costs

Under certain conditions, the costs of medical cannabis can be claimed as extraordinary expenses in the tax return:

Medical necessity: there must be a doctor's prescription confirming the necessity of treatment with cannabis flowers.
Personal contribution: The tax deductibility applies to the part of the costs that is not reimbursed by the health insurance. This personal contribution must exceed certain reasonable limits, which depend on income and family situation.
Evidence: The patient must keep all relevant receipts and evidence (prescriptions, invoices, medical certificates) and submit them with the tax return.

Tax recognition of the costs can reduce the financial burden of the patient's own contribution and should therefore be taken into consideration. It is advisable to consult a tax advisor or the relevant tax authority in advance about the exact requirements and procedure.

Cannabis therapy costs

Long-term financial effects

The long-term financial impact of cannabis flower therapy can be significant, especially if high daily doses are required. Patients must bear the cost of cannabis flowers themselves if they receive them on a private prescription and are not reimbursed by their health insurance. With an average price of 20 to 25 euros per gram and a daily requirement of 1 to 5 grams, for example, the monthly costs can amount to 600 to 3750 euros. Over the years, this adds up to considerable amounts that can place a heavy burden on a patient's budget.

Comparison of costs with other therapies

The cost comparison between cannabis therapy and other therapy options depends heavily on the type of illness and the alternative forms of treatment. For chronic pain, for example, conventional medications such as opioids, antidepressants or anticonvulsants can also incur high costs, especially if more expensive branded drugs are prescribed.

Opioid therapy: Long-term opioid therapies can result in high costs, both for the medication itself and for the accompanying therapies required to treat side effects and addiction problems.
Physical therapy and rehabilitation programs: These can also incur significant costs, especially if they are necessary in the long term and are not fully covered by health insurance.
Alternative therapies: Acupuncture, chiropractic treatments or special pain management programs may require high private co-payments.

Compared to these therapies, cannabis therapy may be more effective for some patients and cause fewer side effects, potentially leading to a better quality of life and lower indirect costs (e.g. less time off work).

Efficiency and cost-benefit ratio

The cost-benefit ratio of cannabis therapy depends on the individual effectiveness and the improvement in the patient's quality of life. Several studies have shown that cannabis flowers can be effective in the treatment of chronic pain, spasticity in multiple sclerosis and other conditions.

Efficacy: Patients often report significant symptom relief and improvement in quality of life. For some conditions, such as neuropathic pain, cannabis can be a valuable alternative when other medications fail.
Side effects: Cannabis has a relatively mild side effect profile compared to many conventional medications, which can reduce the risk of long-term damage.
Cost reduction due to lower medication requirements: In some cases, the use of cannabis flowers can reduce the need for other, more expensive medications or medications with more side effects, which can lower the overall cost of therapy.

Overall, it appears that customized cannabis therapy can be both cost-effective and therapeutically beneficial, especially when conventional treatments fail or have undesirable side effects. Nevertheless, any decision to treat with cannabis flowers should be made carefully, taking into account all medical and financial aspects, ideally in close consultation with the treating physician and taking into account the individual medical history and needs.

Cannabis pharmacy price

Differences in pharmacy prices

Prices for cannabis flowers can vary from pharmacy to pharmacy. These price differences result from several factors, including dispensary sources of supply, the amount of cannabis purchased, and individual dispensary pricing strategies. Some pharmacies source their cannabis flowers directly from domestic producers, while others rely on imports from countries such as the Netherlands or Canada. Imported cannabis can be more expensive due to transportation costs and customs duties.

Pricing and quality standards

Pharmacies are required to sell cannabis flowers for medicinal purposes under strict quality standards. These standards include checking for purity, active ingredient content (THC and CBD) and the absence of contaminants such as pesticides and heavy metals. Compliance with these quality standards can influence prices. High-quality strains that are grown and processed under strict conditions are generally more expensive.

Pricing in pharmacies also takes into account the cost of consultation and the additional administrative work associated with the sale of narcotics. Pharmacies that offer comprehensive counseling services can charge higher prices because they offer their customers added value.

Influence of pharmacy choice on costs

The choice of dispensary can have a significant impact on the overall cost of cannabis therapy. Patients should compare different dispensaries to find the best prices. Some dispensaries may offer discounts or special deals for repeat customers.

Online dispensaries may also be an option, although it is important to ensure legality and compliance with quality standards. Patients should also bear in mind that not every pharmacy stocks every strain of cannabis, which can lead to varying availability and prices.

In summary, the choice of dispensary, the quality of the products and the services offered significantly affect the cost of cannabis flowers. Comparing pharmacy prices and considering offers can help you find the best prices for your individual therapy.

Conclusion

Treatment with cannabis flowers on a private prescription offers many patients a valuable therapeutic option, especially when conventional therapies do not work sufficiently or have severe side effects. However, this form of treatment also entails considerable costs, which are influenced by various factors.

The cost of cannabis flowers varies greatly depending on the strain, THC and CBD content, daily dosage and individual consumption. High-quality and specialized strains can be more expensive, and monthly costs can be significant for high daily doses.

Private health insurance companies offer coverage under certain circumstances, with medical necessity and detailed medical documentation required. In addition, the costs of medical cannabis can be deducted from tax as extraordinary expenses, which can provide financial relief.

The legal framework and strict regulations in Germany ensure that medicinal cannabis is prescribed and used responsibly. The approval process and possible exemptions ensure that patients can quickly gain access to cannabis in urgent cases.

Comparing pharmacy prices is essential for patients, as these vary and the choice of pharmacy can affect the overall cost of treatment. Pharmacies that adhere to high quality standards and offer comprehensive counseling services may charge higher prices, but also offer added value.

Overall, it is clear that cannabis therapy needs to be weighed up carefully, both in terms of financial costs and therapeutic efficacy. Patients should be fully informed and work closely with their doctor to find the best and most cost-effective treatment option. The combination of careful planning, pharmacy comparison and possible support from insurance and tax benefits can help keep costs in check while ensuring effective treatment.

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Fachautor und Biochemier Niklas Bergmann

Niklas Bergmann, Fachautor

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