Update on cannabis legalisation: German Federal Government to prohibit telemedical prescriptions of medical cannabis

In July 2025, the German Federal Ministry of Health (Bundesgesundheits­ministerium, “BMG”) presented a draft bill for an Act amending the German Medical Cannabis Act (Medizinal-Cannabisgesetz, “Med-CanG”). The draft, which had not yet undergone the mandatory evaluation process when presented, was adopted in revised form by the German Federal Cabinet (Bundeskabinett) on 8 October 2025. Now scheduled for debate in the Health Committee of the German Federal Parliament (Bundestag) on 5 November 2025, the bill seeks to significantly limit the MedCanG, marking a return to fully analogue care. Whereas proponents argue that the proposed curbs enhance patient safety, critics are con-cerned about gaps in care.

The first interim report from the research project “Evaluation of the Act on the Handling of Cannabis for Non-Medical Use” (“EKOCAN”), published on 29 September 2025, examined the impact of the par-tial legalisation of cannabis on child and adolescent protection, health and crime and found no imme-diate need for action in the areas assessed. The report estimates medical cannabis to have account-ed for around 12 to 14% of total cannabis demand in 2024 but was unable to reliably quantify how much of this was consumed recreationally rather than for medical reasons.

Given the legislative developments, this article revisits the key provisions of Germany’s 2024 Cannabis Act (Cannabisgesetz, “CanG”), with a particular focus on the proposed curtailments to its second part, the MedCanG. The two most important changes in 2024 were:

• The introduction of a purely authorisation-based procedure for the cultivation and distribution of medical cannabis in place of the previous award-based procedure. This ended the days of centralised purchasing by Germany’s Cannabis Agency.
• The removal of medical cannabis from the Narcotics Act (Betäubungsmittel­gesetz). This reduced bureaucratic requirements and enabled pharmacies to process (telemedical) prescriptions for medical cannabis.

These changes presented producers, doctors, pharmacies and patients – and not least digital platforms – with a number of new opportunities and challenges. However, the proposed tightening of the MedCanG could now reverse the remote prescription and dispatch options.

Existing law: prescription of medical cannabis via online platforms and dispatch by pharmacies

The liberalisation associated with the current MedCanG has focused attention on the prescription of medical cannabis through online platforms. Increasingly in demand, these new market players offer telemedical consultations to patients and often cooperate with one or more mail-order pharmacies in cases where a prescription is issued. The rules governing telemedical prescriptions of medical cannabis by doctors and the subsequent mailing of cannabis products by pharmacies are currently the same as for conventional medicines. Compliance with the general provisions governing pharmacies, drugs and their advertising is sufficient. Key rules here include sections 9 and 10 Health Products and Services Advertising Act (Heilmittelwerbe­gesetz), which ban advertisements for telemedical treatment and for prescription drugs respectively. The courts have already restricted the activities of some platforms on this basis.

Reform plans: prescription and mail-order ban

The proposed stricter MedCanG will fundamentally call into question the current prescription and mail-order services provided by online platforms and targets telemedicine providers in particular. The bill provides for a ban on the remote prescription and mail-order sale of medical cannabis.

• Under the proposed legislation, medical cannabis may only be prescribed following in-person contact between a doctor and the patient at the prescribing doctor’s surgery. Follow-up prescriptions may be issued without another in-person consultation only if the prescribing doctor has seen the patient in person and prescribed the medical cannabis within the last four quarters.
• The bill explicitly excludes treatment provided exclusively via video consultation.
• The proposed legislation also aims to prohibit the mail-order sale of medical cannabis. For patients with limited mobility, the only option would be delivery through the pharmacy’s courier service, to be carried out by the pharmacy’s own staff if necessary. 

While the government cites the need to ensure patient safety as justification for these measures, it does not assume that they will get in the way of supplying patients with medical products. In the government’s view, the special status of medical cannabis as a drug with addictive potential and other health risks requires comprehensive information and advice, which should be provided through in-person consultation at the pharmacy.

Nevertheless, the planned ban on remote cannabis prescriptions and mail-order cannabis sale can certainly be viewed critically, even when taking into account the reasonable objectives. This is because the rationale for the ban appears inconsistent with the fact that (medical) cannabis is no longer classified as a narcotic and may be lawfully consumed for recreational purposes without further conditions. To achieve the desired objectives, less restrictive alternatives could be considered – for instance, requiring video medical consultations prior to issuing prescriptions and obliging mail-order pharmacies to provide video pharmaceutical consultations by qualified pharmacy staff.

Conclusion

Political discussions about reversing or reforming the partial legalisation of cannabis have regained momentum in light of the current bill to amend the MedCanG. Under the stricter regulations proposed, medical cannabis would once again be subject to more specific regulatory requirements than other prescription drugs. It remains to be seen whether and to what extent the bill will be amended during the consultations in the German Bundestag. The fact that the SPD (Social Democratic Party) parliamentary group’s rapporteur recently stated that the draft still requires adjustment indicates that further amendments may yet be forthcoming. He emphasised that patients who rely on medical cannabis must continue to have easy and barrier-free access, regardless of whether they live in urban or rural areas.

If the ban on remote prescriptions and mail-order sale is implemented in its current form, it will likely have significant implications not only for patients but especially for digital platforms – even though alternative regulatory approaches to achieving the law’s objectives could also be considered.