Is there THC in medical marijuana

Help for the seriously ill

Doctors are only allowed to prescribe cannabis-based narcotics in the form of dried flowers or extracts and medicinal products with the active ingredients dronabinol or nabilone under certain conditions. These are:

1. There is a serious illness.
2. There is no other promising and recognized treatment option in the individual situation.
3. There is a not entirely remote prospect of a beneficial effect from the drug.

The law does not list any diseases or diagnoses that are generally considered to be serious. The decisive factor is that the disease is life-threatening or that the quality of life is severely impaired in the long term. Whether an attempt at therapy with cannabis is an option is at the discretion of the attending physician.

If your doctor uses a finished medicinal product within the scope of the approved application areas, he or she does not have to consult the health insurance company before prescribing it.

Otherwise, the following applies: When prescribing cannabis medicinal products for the first time, the health insurance company must approve the service. It only covers the costs if the following conditions are met:

  • There is a serious illness.
  • There is no treatment alternative that is generally recognized, meets medical standards and is individually suitable. This means that either no other promising therapeutic option is known or other therapeutic options cannot be used, for example due to severe side effects.
  • There is a chance that the medicine will have a positive effect on the course of the disease or the symptoms.
  • Affected persons must agree that the health insurance company transmits their data anonymously to the Federal Institute for Drugs and Medical Devices (BfArM).

The health insurance company must check the existence of the prerequisites in each individual case with the involvement of the medical service of the health insurance company (MDK). They must obtain the relevant report immediately and inform the insured about it. The health insurance company must make a decision on the application within five weeks. If the health insurance company cannot meet the deadline, it must notify the applicant in writing in good time. This includes a reason why she cannot meet the deadline.

The five-week period begins on the day after the application is received by the responsible health insurance company. It ends with the announcement of the decision.

If the health insurance company does not meet the deadline, the application is considered approved and the patient is entitled to reimbursement of costs (so-called approval fiction). Anyone who has procured the drug themselves after the deadline has expired can request reimbursement of the costs incurred by the health insurance company.

Important to know: For patients who are in specialized outpatient palliative care and cannot wait weeks for a decision, the health insurance company has to make a decision within three days. Palliative care refers to the treatment of people with an incurable, advanced disease with a limited life expectancy.

The health insurance may only refuse cannabis therapy in justified exceptional cases. Once approval has been granted, no new application to the health insurance company is necessary to adjust the dosage or change the flower variety.

Regulation: If the health insurance company has approved the application for reimbursement, the doctor can write a prescription. With the exception of cannabidiol, cannabis medicinal products must be prescribed on a narcotic prescription. Doctors are allowed to prescribe cannabis even if the health insurance does not cover the costs. Then the patient has to pay for the medicine privately.

If the finished medicinal products are used outside of the approved areas of application, this is called off-label use. Special legal regulations apply to off-label use. In these cases, it is necessary to apply to the health insurance company to cover the costs.