What changed in April 2024
The Cannabisgesetz (in force 1 April 2024) reclassified medical cannabis flower off the Betäubungsmittelgesetz (BtMG) narcotics list. Prescriptions moved to a standard private prescription (Privatrezept) rather than the controlled narcotic prescription form. Telemedicine clinics scaled quickly and prescription volumes roughly doubled by the end of 2024, with the total medical cannabis market reaching around €2 billion in 2025.
What changed in October 2025
An amendment effective October 2025 reintroduced a requirement for in-person consultation before a first prescription for cannabis flower, and prohibited home delivery of prescribed medical cannabis to patients. Telemedicine-only models that had built the post-2024 growth had to add physical consultation steps or partnerships with bricks-and-mortar clinics. Pharmacies that had built shipping logistics had to pivot to counter pickup.
How prescriptions work in 2026
- Prescriber — Any licensed physician may prescribe, though many GPs decline; specialist clinics for pain, oncology, and neurology remain the most common route.
- Consultation — First prescription requires in-person consultation. Follow-ups may use telemedicine.
- Pharmacy — Dispensing is via licensed pharmacies; home delivery of the prescribed medication is prohibited; patients collect in person.
- Coverage — Statutory insurance covers cannabis prescriptions only with prior approval and for narrow indications (severe pain, chemotherapy nausea, MS spasticity, terminal palliative care). Most patients pay privately.
What it means for clinics and pharmacies
Telemedicine-only clinics have either folded, merged with physical practices, or established mixed-model offices. Pharmacy-side, shipping-led specialists have shifted to counter dispensing with longer opening hours or partnered with regional pickup points. The market remains large but is more concentrated around providers that can offer in-person access — a structural advantage to clinics in larger cities and to pharmacies with multiple locations.
Sources
- Cannabis Act — Wikipedia
- Prohibition Partners — Germany 2025
- Business of Cannabis — LU medical rollback (regional context)
This article is general information, not medical or legal advice. Patients should consult a licensed physician for treatment decisions.
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