German sales of insurance-covered medical cannabis continue upward trend

Sales of insurance-covered medical cannabis continued to increase during the first quarter of 2019 in Germany, the largest market outside North America.

In the first three months of the year, sales of reimbursed cannabis products totaled 24.5 million euros ($27.5 million), an increase of 7% from the fourth quarter of 2018, according to government data.

The increase over the first quarter of 2018 was of 78%.

The German National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) provided the sales numbers through March 2019.

The association’s figures shed light on the health of one of the world’s largest medical cannabis markets.

In particular, the data shows that sales of reimbursed:

  • “Unprocessed flower” increased 10% in the first quarter versus the previous quarter.
  • Preparations increased 7%.
  • Finished pharmaceutical products rose 2%, despite signs that regulators and medical associations would prefer more sales of products with clinical trials and less of flower and preparations that lack proven efficacy.

Germany medical cannabis, German sales of insurance-covered medical cannabis continue upward trend

Data about the coverage of medical cannabis products in Germany is presented under three broad categories:

  • Unprocessed cannabis flower, all of which has been imported from the Netherlands and Canada. Germany has granted its first domestic cultivation permits, and industry officials expect the first harvests by the end of 2020.
  • Cannabis preparations – including ground imported flower, when prescribed by a doctor – dronabinol preparations, and full-spectrum extracts from Canadian firms Tilray and Aurora Cannabis. While no exact numbers are provided for each product, local sources consulted by Marijuana Business Daily are confident that “almost all” of the sales within this category are of dronabinol preparations. Recently, Canopy Growth of Canada acquired the cannabinoid-division of Bionorica, which is believed to be the only producer and supplier of dronabinol in Germany.
  • Finished pharmaceutical products, including Sativex and Canemes, which have marketing authorization in Germany, and other finished medicines without registration such as Marinol. Sales for each product in this category are provided in the chart above. Sativex represented at least 93% within the category every single month during the past year.

The sales data is based on the retail price at pharmacies, the only authorized points of sale to patients. For all products not included in the “finished pharmaceutical preparations,” pharmacies do a markup of up to about 100%.

Assuming an average retail price of 20 euros per gram of “unprocessed flower,” 579 kilograms (1,276 pounds) were covered by the statutory health insurance in the first quarter. This does not include flower that has been processed – when the doctor prescribes it grounded – which is included in the cannabis preparations category.

The estimated 579 kilograms figure also doesn’t include flower sold via private prescriptions. That’s because the GKV-Spitzenverband data includes only sales that were covered by statutory health insurance.

Germany imported 765 kilograms of flower for pharmacy dispensing in the first quarter. In all of 2018, about 3,000 kilograms were imported, more than double the 1,200 kilograms of 2017.

Alfredo Pascual can be reached at