Prescriptions increase and patient care improves
The first year after the “Cannabis Act” that came into force on March 10, 2017 is coming to an end. Doctors have been able to prescribe cannabis flowers as a prescription medicine for almost a year. According to the Federal Association of German Pharmacists' Associations (ABDA), around 44,000 units of cannabis were covered by statutory health insurance in 2017 - with a steadily rising trend.
"The tendency was increasing from quarter to quarter, both for recipes and dispensing units," summarizes Dr. Andreas Kiefer, President of the Federal Chamber of Pharmacies in a press release from ABDA. The German Medicinal Products Institute (DAPI) has evaluated the health insurance data. Accordingly, there were 4615 prescriptions with 10,055 dispensing units in the second quarter of 2017, which rose to 12,717 prescriptions with 18,828 dispensing units by the fourth quarter. Private recipes were not recorded here.
The supply improves
"A lot has improved since then, especially for patients who previously obtained cannabis through a special permit," says Kiefer. Patients would no longer be left alone with dosage and use. The pharmacists have defined uniform quality criteria for cannabis flowers in the German Medicines Code.
Prices for patients are falling
According to Kiefer, cannabis has become significantly cheaper for many patients. With the approval of the health insurance, only the additional payment is due, which is limited to a maximum of 10 euros per medication. Patients can now redeem their cannabis prescriptions at any pharmacy nationwide.
How many patients receive cannabis?
Before March 2017, medical cannabis was still a niche product. About 1,000 patients had a special permit. "For data protection reasons, the DAPI does not determine how many patients have received cannabis flowers," explains Kiefer. Based on the number of prescriptions available, however, he suspects that there are now significantly more than the expected 1000 patients. Cannabis recipes have thus at least partially arrived in everyday care.
Not only patients benefit
Professor Dr. Michael A. Popp, owner and CEO of Bionorica SE, welcomes the positive development in the prescription of the active ingredient dronabinol, better known as tetrahydrocannabinol (THC), the active ingredient from the cannabinoid group that occurs in hemp. According to Popp, 11,000 patients were treated with dronabinol in 2017. That is almost three times more people than in 2016. The global sales figures for dronabinol are also developing accordingly. At around EUR 13.6 million, sales in 2017 were more than double the previous year.
Approval rate is around 60 percent
"Thanks to the law amendment, we can help more seriously ill people with dronabinol and improve the therapy situation," emphasizes Popp. According to Popp's forecasts, a further increase is expected in 2018. "According to media reports, the current approval rate on the part of the statutory health insurance companies is around 60 percent," reports Popp. He hopes that the approval situation will continue to develop positively. "This would significantly improve the quality of life of many patients who depend on it," said Popp.
Cannabis - a new billion dollar market?
So far, the required cannabis has been imported from the Netherlands and Canada. The Federal Institute for Drugs and Medical Devices (BfArM) has now set up a cannabis agency to control the cultivation of cannabis for medical purposes in Germany. Many companies sense high margins because cannabis can be produced cheaply. However, experience in cultivation is a prerequisite for state cultivation, because the BfArM requires a certain quality standard that the cannabis agency has set.
Cannabis cultivation in Germany
The first German cannabis harvest is due to be brought in in 2019. The cultivated cannabis may only be used for medicinal purposes. The German cultivation is intended to ensure the availability of cannabis for medical purposes in reproducible quality in accordance with pharmaceutical legislation.
How expensive is medical cannabis?
The BfArM cannabis agency will set a manufacturer selling price. At this price, the cannabis is then sold to pharmaceutical manufacturers, wholesalers or pharmacies. The cannabis agency itself will not generate any profits or surpluses, but will only cover the personnel and material costs incurred. The cannabis agency is not responsible for the actual retail price in the pharmacy. (vb)