In October 2025, the German Federal Government introduced groundbreaking amendments to the Medicinal Cannabis Act (MedCanG). The new regulations aim to regulate the rapidly growing market for medical cannabis while simultaneously enhancing patient safety. What does this mean for patients, physicians, and professional cultivators? A comprehensive overview of current developments.
The Cannabis Boom: Numbers That Make You Take Notice
The development of the medicinal cannabis market in Germany shows impressive growth figures. According to the Federal Institute for Drugs and Medical Devices, imports of cannabis flowers for medical purposes increased by an astonishing 170 percent from the first to the second half of 2024. In the first half of 2025, imports even achieved a growth of over 400 percent – from approximately 19 to around 80 tons.
However, these figures stand in stark contrast to prescriptions through statutory health insurance, which only increased by nine percent during the same period. This discrepancy raises concerns: The majority of growth appears to be attributed to self-payers with private prescriptions who obtain cannabis through telemedicine platforms.
“Medicinal cannabis is a prescription drug and not a product for purely recreational purposes,” emphasizes Federal Health Minister Nina Warken (CDU). This clear positioning underscores the necessity of the new regulations.
The New Regulations in Detail: What Specifically Changes?
Personal Physician Contact Becomes Mandatory
One of the central changes concerns prescription practices. In the future, cannabis flowers for medical purposes may only be prescribed after personal contact between physician and patient. This can take place in the practice or during a house call. Pure video consultations are no longer sufficient for initial prescriptions.
Stricter requirements also apply to follow-up prescriptions: Within four quarters, at least one personal on-site contact or house visit must occur. Within this period, follow-up prescriptions can then continue to be issued via video consultation. This regulation is intended to ensure that physicians can carefully and regularly review their patients’ health situation, possible risks, and drug interactions.
Shipping Ban: Cannabis Only Available at Pharmacies
Another significant change concerns the distribution channel. Mail-order trade of medicinal cannabis through online pharmacies will be completely prohibited. Patients must come to the pharmacy in person in the future to receive their cannabis medication. There, they will receive comprehensive advice on application, side effects, interactions, and safe storage.
However, there is an important exception: Pharmacy delivery service remains permitted. This is particularly important for patients with limited mobility. In these cases, pharmaceutical staff can deliver the medications directly to the home and provide necessary consultation on-site.
Background of the Legislative Amendment: Why Now?
With these measures, the Federal Government is responding to a concerning development in the market. Numerous internet platforms had developed a business model where consumers could receive a prescription without direct medical consultation, merely through a questionnaire check. Subsequently, they could choose their desired cannabis strain and have it sent directly to their home.
This practice raised several issues:
- Lack of medical indication: Without personal physician contact, the actual medical necessity often could not be adequately assessed
- Insufficient patient safety: Important aspects such as pre-existing conditions, interactions with other medications, or individual risk factors could only be inadequately considered
- Potential for abuse: Low-threshold availability possibly facilitated non-medical consumption
- Quality control: The lack of personal consultation in the pharmacy prevented appropriate education about dosage and application
Impact on the Industry: Opportunities for Professional Cultivators
The new regulations have far-reaching consequences for the entire cannabis industry in Germany. While online platforms must fundamentally reconsider their business model, new perspectives arise for other market participants.
Professional Indoor Cultivators at an Advantage
The stricter quality and control standards could benefit professional indoor cultivators. With increased regulation, requirements for product quality, purity, and standardization of medicinal cannabis also rise. Modern indoor facilities have a clear advantage here, as they can ensure optimal and consistent conditions.
For professional cultivation operations, this means:
- Higher demand for high-quality, standardized medicinal cannabis
- Increased importance of GMP-certified production facilities
- Growing requirements for documentation and traceability
- Need for technically sophisticated climate control and monitoring systems
What Does This Mean for Patients?
For patients who depend on medicinal cannabis, the new regulations bring both challenges and advantages:
Advantages of the New Regulation
- Improved medical care: Through mandatory personal physician contact, better individual therapy adaptation is possible
- Increased safety: Personal consultation at the pharmacy minimizes application errors and risks
- Quality control: Stricter monitoring can lead to better product quality
- Holistic treatment: Regular physician visits enable better progress monitoring
Challenges for Patients
- Increased effort: Personal physician and pharmacy visits require more time and mobility
- Access barriers: Access could be particularly difficult in rural regions
- Waiting times: Possibly longer waiting times for appointments
- Loss of discretion: Personal pharmacy visits are less anonymous than mail order
The Role of Pharmacies: New Responsibility
Pharmacies take a central position in the new regulation. They become the only legal source for medicinal cannabis and thus bear great responsibility. Every pharmacy can continue to obtain the required cannabis flowers through wholesalers or direct suppliers.
Pharmacies must prepare for the following requirements:
- Comprehensive staff training in medicinal cannabis
- Ensuring availability of various cannabis strains
- Building consultation competencies for this special patient group
- Organizing delivery services for immobile patients
- Adapting storage capacities and security measures
Technical Requirements for Modern Cultivation Facilities
With tightened regulations, requirements for the production quality of medicinal cannabis also increase. Modern indoor cultivation facilities must meet the highest standards to ensure pharmaceutical quality.
Climate Control and Air Management as Key Factors
Precise control of environmental conditions is essential for the production of high-quality medicinal cannabis. The following technical aspects are of particular importance:
- Temperature control: Constant temperatures between 20-26°C in the growth phase and 18-24°C in the flowering phase
- Humidity management: Precise control of relative humidity (40-70% depending on growth phase)
- CO₂ enrichment: Controlled CO₂ supply for yield increase (1000-1500 ppm)
- Air circulation: Even air distribution to avoid microclimates
- Odor control: Effective filtration to prevent emissions
Hygiene and Contamination: Zero Tolerance Policy
Medicinal cannabis is subject to strict microbiological limits. Preventing contamination by mold, bacteria, or pesticides has top priority. Technical solutions for this include:
- HEPA filtration of supply air to prevent spore entry
- Overpressure in critical areas
- Regular air exchange rates (15-30 times per hour)
- Separate air circuits for different production areas
- Continuous monitoring of air quality
The Market in Transition: Forecasts and Perspectives
The legislative amendment marks a turning point in the development of the German cannabis market. Experts expect the following developments:
Short-term Effects (6-12 months)
- Decline in prescription numbers due to higher barriers
- Market consolidation of online platforms
- Increased demand for medical staff training
- Adjustment of logistics chains
Medium-term Perspectives (1-3 years)
- Market consolidation to reputable providers
- Quality improvement of available products
- Development of specialized cannabis competence centers
- Increased research into medical applications
Long-term Development (3-5 years)
- Establishment of Germany as leading market for medical cannabis in Europe
- Development of new pharmaceutical cannabis preparations
- Integration into standard care for certain indications
- Possible relaxations for proven therapy forms
International Perspective: Germany in Comparison
In international comparison, Germany positions itself with the new regulations in the middle range between very liberal markets like Canada and restrictive systems as in many Asian countries. The German approach is characterized by the following features:
- Medical focus: Clear separation between medical and recreational use
- Quality orientation: High standards for production and distribution
- Patient protection: Emphasis on medical responsibility
- Controlled liberalization: Gradual opening with safety mechanisms
This balanced approach could make Germany a model for other European countries considering similar regulations.
Practical Tips for Affected Stakeholders
For Patients
- Find a cannabis-specialized physician in your area early
- Carefully document your symptoms and therapy progress
- Inform yourself about pharmacies with cannabis expertise in your region
- Clarify cost coverage with your health insurance
- Use pharmacy delivery service if you have mobility limitations
For Cultivators and Producers
- Invest in GMP-compliant production facilities
- Implement seamless quality control systems
- Build partnerships with pharmacies and wholesalers
- Focus on standardized, pharmaceutical quality
- Plan long-term and sustainably
A Necessary Step Toward Professionalization?
The amendment to the Medicinal Cannabis Act marks a milestone in the development of the German cannabis market. While the new regulations may initially be perceived as restrictions, they could serve to establish a serious, patient-oriented medicinal cannabis market in the long term.
The Federal Government pursues a clear goal with these measures: “We must prevent an uncontrolled market from developing from medical exceptional cases,” says Health Minister Nina Warken. At the same time, it should be ensured that people with serious illnesses continue to receive the treatment they need.
For professional cultivators and producers, the tightened regulations offer the opportunity to position themselves as quality providers. Investment in high-quality production facilities and quality assurance systems will pay off in the long term. The market is developing away from an unregulated boom toward a sustainable, quality-oriented economic sector.
The coming months will show how the market adapts to the new conditions. One thing is certain: The German medicinal cannabis market faces a phase of consolidation and professionalization that will ultimately benefit all stakeholders – patients, physicians, pharmacies, and reputable producers.
Outlook: What Comes Next?
The draft law still has to go through the parliamentary process. The readings in the Bundestag are still pending, as is the involvement of the Bundesrat. Experts expect the law to come into force in the first quarter of 2026.
In parallel, various professional associations are working on guidelines and standards for practical implementation. The coming months will be crucial for shaping the details and preparing all stakeholders for the new requirements.
One thing is certain: The German cannabis industry faces profound changes. Those who prepare early and invest in quality will benefit from the professionalization of the market.
