Your latest cannabis business info from Europe

Your latest cannabis business info from Europe


Pharmacies in Germany – medical cannabis reimbursement issues 

Pharmacies in Germany and cannabis reimbursement issues 

The disturbing trend of reimbursement nullifications that is currently affecting pharmacies with medical cannabis throughout Germany is worrisome. If vital facts like dosage instructions are not present, health insurance providers are persistently cutting payouts to zero for everything from antibiotics and fever syrups to expensive pharmaceuticals. Pharmacists who are experiencing financial losses are frustrated and confused by this circumstance. The owner of Rochus-Apotheke in Wangen, Dr. Jenny Hsieh-Ehrhardt, expressed her surprise at receiving a nullification for a cannabis prescription owing to the absence of the word “buds.”

The medical cannabis prescription incident

A prescription (BtM) for cannabis buds occured at the pharmacy in Allgäu in September of the previous year. Following a thorough examination, the pharmacist methodically filled up the prescription. The specialist made sure to include all the necessary details that were listed in the tariff. This included the precise product name, the accompanying pharmaceutical central number (PZN), the cost, the designation of the particular strain, and the dosage.

Thus, the pharmacy followed all the procedures for distributing a prohibited substance prescription. However, Barmer, one of Germany’s health insurance carriers, nullified the prescription. According to the nullification, the term “buds” was absent, which resulted in a loss of €395.65. This nullification seemed unbelievable to Dr. Hsieh-Ehrhardt, who refused to accept it. She contested the ruling and took the matter to the Baden-Württemberg State Association of Pharmacists (LAV). Unfortunately, the appeal was denied, which made her more angry.

A wider concern in Germany

The need in the rejection letter that the pharmacist submit an excerpt from the controlled substance file that specifically indicates the cannabis bud strain prescribed to the insured patient added to the difficulty of the matter. The PZN in the prescription, however, had already clearly identified the strain. Dr. Hsieh-Ehrhardt, determined to correct the situation, filed a second appeal with the LAV, this time enclosing a section from their controlled substance dossier. The result of this appeal is still up in the air.

Pharmacists across Germany raise the concerns on the issue of reimbursement nullifications, which goes beyond prescriptions for cannabis to expensive pharmaceuticals. Even when prescriptions are correct, pharmacists suffer large revenue losses due to the past or actual absence of crucial words or dose information. To address the issue, pharmacists are contesting these nullifications and requesting assistance from professional bodies. Whether these cases are unique or a part of a larger trend affecting reimbursement processes will depend on the results of these appeals.

German pharmacies dealing with reimbursement cancellations have had trouble filling prescriptions for expensive drugs and cannabis. Despite successfully filing prescriptions, missing phrases or allegedly missing dose information has cost pharmacies money. To correct the situation, pharmacists are actively contesting these nullifications and requesting support from professional organisations. Whether these cases are one-off occurrences or point to a wider trend in reimbursement methods is still up for debate


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