The internationally recognized cannabinoid specialist and Chairman of the International Association for Cannabinoid Medicines (IACM) Dr. Franjo Grotenhermen has been on a hunger strike since May 12th.
Grotenhermen’s main motive for the non-violent protest is the price of cannabis medicine which has increased from 15 to 22.10 Euro/gram since the new law was implemented. Observers fear an additional price hike up to 40 Euro/gram.
The law on the use of medical cannabis in Germany, which was passed only in January and went into effect in March, does not guarantee the care of patients so far. Grotenhermen played a key role in the drafting of the law and is recognized as one of the leading cannabinoids specialists worldwide.
The drastic price increase of nearly 50% is due to the legal status of herbal cannabis. Cannabis is not considered a ready-made drug, but has been defined as a “recipe substance drug” since its registration in the pharmacy system. The pharmacist cannot simply sell it to prescription holding patients, but must “make it ready” for consumption. For this, the flowers are grinded in the pharmacy’s backroom, a process that is valued at 7.62 Euro/gram.
As the chairman of the International Association for Cannabinoid Medicines, Grotenhermen declared his intentions for a limited hunger strike of 7-14 days in a Youtube video last week. The seriously ill doctor decided on a two-week protest because he does not know how his body will react to food deprivation. Additionally, he did not want to blackmail anybody with his health, and instead wants to draw attention to the problematic pricing situation.
Apart from the price increase, there is also the fact that the health insurance reimbursement policy has been sluggish at best. The health insurance companies are currently refusing to pay for palliative patients as well as for many patients who already had a state exemption prior to the new law.
Many of the 1,000 patients who have already passed the high medical and bureaucratic hurdles between 2009 and 2016, and were thoroughly tested and accepted by physicians of the federal health ministry, now have to pay thousands per month for medical cannabis or have to sue their health insurance company in order to achieve the guaranteed right to receive medical cannabis.
(As the author of this article, I have already been accepted as one of the exemption cases by the physicians of the federal health ministry to receive medical cannabis from a Berlin pharmacy since 2015. Today, I had to sue my insurance company for reimbursement for my medical expenses.)
Since the price increase to 22.10 Euro/gram, a patient can hardly afford a legal treatment with a prescription not being reimbursed, and many have been turning to illegal sources ever since. If patients can grow or purchase medical cannabis based on a medical recommendation for five to fifteen Euro like in Canada, the majority of German patients probably would do well without reimbursement. But at a price of 22.10 Euros and no chance to grow their own, very few patients can afford to forgo the support of the health insurance.
Potsdam-based pain therapist Dr. Knud Gastmeier criticized the present situation just as sharply as Grotenhermen, and supported the doctor’s hunger strike with an open letter to the Federal Minister of Health Hermann Gröhe and Brandenburg’s Minister President Dietmar Woidke.
Dear Ladies and Gentlemen,
The chairman of the International Association for Cannabinoid Medicines, Dr. Franjo Grothenhermen, due to the the new medical cannabis law’s unpredictable effects on patients and doctors, decided to start a warning hunger strike. The background is the drastic increase of cannabis flowers of approximately 75 € each 5g to 110 € and, if it not prevented, a further increase to over 200 € per 5g is expected. […].
In Brandenburg, a 77-year-old female patient with a rapidly advancing pancreas tumor was refused the reimbursement of the cannabis drops, although she was a palliative patient. Despite personal intervention by the insurance’s chairman, only one further palliative patient, who had also been rejected medical cannabis before, gets his medicine reimbursed since last Friday. The Cancer patient mentioned above does not yet. […]. Therefore I address the following to the responsible politicians:
- Make sure that the hunger strike of the not quite healthy colleague is being ended as quickly as possible and solutions for the problems described by him are found.
- Ask the health insurance companies about reasons for the numerous rejections and how that can be in compliance with the (new) legal status of medical cannabis. […].
- Clarify the legal situation for doctors when it comes to legal threats like regress (for reimbursement), the doctor’s budget for prescribed medicine or an audit for doctors prescribing medical cannabis. […].
- Physicians prescribing a cannabis therapy must not be sanctioned during the five year phases as their numbers are used for trace-studies. […]. It is a new and so far not comparable therapy situation for all involved for which the doctors are neither to be sanctioned legally nor economically.
- Establish studies for cannabinoid therapy and guidelines for physicians as well as for patients.
- Stop the incomprehensible usury and ensure that patients with a medical indication can legally obtain cannabis at an affordable price in the pharmacy, also if the costs are not reimbursed by the health insurance or if there is no doctor for the indicated cannabis therapy available.
Thank you very much for your interest
Dr. med. Knud Gastmeier
Anesthesiology, Special Pain Therapy and Palliative-Medicine
Karl-Marx Str. 42,