Medical cannabis distributed via European Healthcare systems can be expensive. The result of these high costs is that many patients either grow their own or procure from the black market. Thankfully, in some European countries, the attitudes towards covering the cost of medical cannabis is changing. Due to increased investment, research, education and regulatory cooperation, analysts expect the European medical market to become one of the largest in the world.
Here’s the situation in a few European countries that have medical cannabis programmes.
Medical cannabis has been available in Czechia (formally the Czech Republic) since 2013. The Ministry of Health announced that patients will be refunded 90% of costs of up to 30 grams per month via health insurance companies. This will come into effect in January 2020. Medical cannabis is capped at around 7 euros per gram. According to research from ICCI, in June 2019, there were officially 670 medical cannabis patients and over 100 doctors with a licence to prescribe. Only those suffering chronic pain are able to access medical cannabis Czechia.
Germany legalised medical cannabis in March 2017. Since then, prescriptions have been rising rapidly: from March to December 2017, 27,000 prescriptions were processed. In 2018, this number jumped to 95,000. Medical cannabis in Germany is expensive compared to some other European countries (€20-€24 per gram). According to research by Prohibition Partners the approval rate of the top three insurers (AOK, TK, and Barmer) is around 60% for medical cannabis patient applications. For patients without health insurance cover, medical cannabis in Germany can cost up to €2,400 per month, at the legally prescribed maximum quantity of 100 grams.
Italian doctors have been able to prescribe medical cannabis since 1990. It was not until 2007 that imports of cannabis products from the Netherlands began. In 2014, the Italian Ministry of Defence started domestic cultivation. The country has more than 20,000 estimated medical patients. The price is capped at €9/gram, +10% VAT, plus the cost of the respective pharmacy to prepare.
The Dutch have had a medical cannabis programme since 2003. More than 2,000 pharmacies nationwide are legally required to stock medical cannabis. Estimates suggest that there are more than 50,000 medical cannabis patients in the Netherlands.
Recent changes to insurance policies have meant medical cannabis is now more difficult for patients to acquire. This came on the back of a review by the National Health Institute (Zorginstituut Nederland) in 2017, the body that officially advises insurers on the impact and financial feasibility of different medications. They concluded that there are no conditions for which medical cannabis can be considered a suitable treatment, due to a lack of clinical data. A number of health insurance companies have withdrawn cannabis from their policies, subsequently leaving patients without affordable access .
Due to the price of medical cannabis, many patients choose to go to coffeeshops to obtain their supply or grow their own, leaving them without a reliable and standardised product.
The UK legalised medical cannabis in November 2018. Right now, there is still resistance within the NHS to integrate medical cannabis into the healthcare system. Nearly a year after medical cannabis was introduced only around 20 patients have prescriptions through the NHS. If you want medical cannabis in the UK, you must go through private medical care and it can cost thousands of pounds per month. It will not be covered on your medical insurance.
The implications for foreign firms:
Although the situation is mixed across European states that have functioning medical cannabis programmes there seems to be a general move towards, except in the Netherlands, cannabis being covered on health insurance or the country’s health service. This is seen as a crucial step to ensuring that those who derive therapeutic relief from cannabis based products do so legitimately. As the medical cannabis will be procured and distributed through European health care systems, rather than via the open market in dispensaries as per the US model, reducing costs for patients is essential.
Even in the Netherlands and the UK where medical cannabis is not covered, the reason is explicitly stated to be due to a lack of clinical evidence. As more research demonstrating the efficacy of cannabis based products in treating various conditions becomes available, these arguments grow weaker. In addition to this, as the countries show over time the potential savings of covering costs for cannabis as opposed to more expensive medicines (along with the treatment of undesirable side effects), it is unlikely this trend will reverse. The benefits to companies that are supplying cannabis within markets where costs are covered will ensure more product is sold through legitimate channels. Pricing patients out of medical cannabis programmes will only result in exposing those who find cannabis to be the only medicine that works for them to unnecessary risks.
Looking to learn more about the opportunity in the European medical cannabis industry?
For investors and financiers looking to expand into the European market, join us at The Leaders Summit in New York, November 5th: https://www.cannabis-europa.com/old_cannabis/events/new-york-2019/ For Canadian based companies who are looking to connect with the most influential politicians, ministers, and partners in the Canadian and European markets, join us at The Transatlantic Forum, November 5th: https://www.cannabis-europa.com/old_cannabis/events/toronto-2019/