Reimbursed Sales of Medical Cannabis in Germany Grew by 34% in 2020

The National Association of Statutory Health Insurance Funds (GKV), whose members insure 90% of the German population, have released data on reimbursed medical cannabis usage covering the entirety of 2020. The new data reveals that reimbursed sales of medical cannabis were worth €165 million in 2020.

The GKV have released data showing that the market for medical cannabis in Germany continued to grow in 2020, increasing by 34% compared to 2019 (excluding the newly added product Epidiolex). Sales reached a new record in Q4 albeit by a slim margin, totalling €43 million. This does not include the sales of cannabis which were paid for privately.

As previously noted by Prohibition Partners, raw flowers and flowers in preparation are the most important category of medicines in terms of sales, but also have the fastest declining market share in these data. Sales of raw and prepared flowers combined declined by 14% from Q1 to Q4. Epidiolex sales were the fastest growing in the market, increasing 72% from Q1 to Q4 and totalling €16 million for 2020. This mirrors events in Denmark, where the rollout of Epidiolex saw rapid growth in sales to the detriment of some prescription CBD medicines.

It appears that a portion of sales shifted from extracts produced by pharmacies over to finished products and unauthorised pharmaceuticals including Dronabinol. Sales of finished products such as the oils produced by Cannamedical and Tilray were the second fastest growing segment, increasing by 72% from Q1 to Q2, though the category remains at just 6% of total sales.

Overall, Flowers lost ~8% of market share from the beginning to the end of 2020, while extracts and pharmaceuticals gained 4% each. Extracts include here: full spectrum extracts, finished products, and unauthorised pharmaceuticals including Dronabinol. Pharmaceuticals include Epidiolex, Canemes and Sativex.

Note that sales of cannabis medications not covered by the GKV are omitted from this data, and most of these sales are likely of cannabis flowers, which affects overall market share.

As detailed in the recently released European Cannabis Report, we estimate Germany had 128,000 active patients at the end of 2020. Cannabis is now supplied to Germany from a wide range of countries including Canada, Netherlands, Uruguay, Portugal, Israel, Spain and Australia. Domestically produced cannabis should be sent from producers to the BfArM within the first half of the year and be sold to patients before the end of 2021.

The practices of insurance companies are likely to be holding back further expansion of patient access in Germany. Statutory health insurance companies reject 38% of the applications for reimbursement from patients, limiting doctors ability to prescribe to their patients. This could be solved in the future by making the legislation around insurance of medical cannabis less ambiguous and making insurance of prescribed cannabis mandatory for statutory insurers.

Prohibition Partners dive more deeply into this and other topics in their recently released European Cannabis Report: 6th Edition which looks at social, economic, regulatory and health trends including:

⦁ The progress of medical cannabis access in Europe
⦁ The progress of adult-use initiatives
⦁ The opening of European capital markets to cannabis
⦁ The impact of COVID-19 on patient access and the industry at large
⦁ The patients in Europe and the products they are using
⦁ The trends in product formulation towards extracts and isolates
⦁ The diversification of the supply chain in Europe

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