Here is post COVID-19 fantasy for North Americans. Imagine walking into your average corporate box pharmacy, submitting a prescription for medical cannabis (including flower), written for you by a licensed physician and walking away with a month’s supply of the same for about $12.
Sound like a great, if psychedelic, trip in your local geography? That process is now occurring in Germany, and on an increasingly regular basis—although do not be fooled. Actually, getting a doctor and obtaining a cannabis prescription here is still not for the faint of heart. The process has been evolving since 2017 when the laws changed here. The first cannabis grown in Germany is just coming online this year.
However, it is getting increasingly normal. And that is a victory that is worth celebrating no matter where it happens.
In Germany, the pharmacies are also a critical component of the supply chain in this new reality. German law mandates that a special relationship is maintained between patient and pharmacist, making them in the medical hierarchy, far beyond their “last mile” place in the supply chain, as important as doctors.
This is the best way to understand a bit more viscerally how they work today. If you think of an “old fashioned” small town pharmacy in a Norman Rockwell American past, this is what German pharmacies, in some ways, still function as today. It is against the law for one company to own more than four brick and mortar pharmacies.
For this reason, the pharmacies, and those who work in them, are front line care in a way that is personal. In other words, a form of health care that is almost completely forgotten if not discarded in the U.S. and the UK.
The difference is that in the present, pharmacists are also not only on the front lines of patient care, but must balance operations in a complex, highly bureaucratic environment. German apothekes operate at the crucial meeting point of doctor, patient, distributor, insurance company, and all the additional moving parts.
When it comes to cannabis of the Rx kind, this is a critical distinction.
Cannacurious From the Beginning
Tobias Loder is one of the pharmacists on the leading edge of this absolute revolution now not so quietly taking its place in the German medical system. He first dispensed cannabis to a patient in 2014.
This was of course, not the first step. Loder was also part of the International Association of Cannabinoid Medicines or IACM, which was co-founded by a German doctor, one of the leading cannabinoid medical research conferences in the world at this point, as a student in the 1990’s.
“I have followed the industry since then,” said Loder. “And of course, I was even more interested as legal cannabis started to come to Germany. I love people. And I want to help them. Integrating cannabis into my pharmacy seemed like just a natural thing for me to do. I could see, from the 1990’s, that the medical impact of cannabis was impressive.”
After the drug became legal, Loder decided to support this “new medication.” And as many in North America might enviously agree at this point, as Loder said, “If you do something from the heart it has a better chance of being successful.”
A Family Pharmacy Story on The Edge of Cannabis Reform
Loder is not the first generation of pharmacists in his family. “My mother started the pharmacy in the 70’s, and I took over in 2000.”
These days, he has two brick and mortar store locations near Cologne and a specialized “cannabis pharmacy”—the first of its kind in Germany—that is a mail order location. No visitors allowed. “That location is two times bigger than the other two stores put together by square meter,” Loder says, laughing. Sales, however, are about equal.
It is not hard to understand why. “In America and Canada,” says Loder, “people have to pay for medical cannabis themselves. In Germany, it is reimbursed, via statutory health insurance (which covers about 90% of Germans). That is a big difference. In the U.S. and Canada, it seems to me this business is all about the money. Here it is more about people.”
It is also about networks on the professional side to begin to normalize an industry that still, truth be told, still has a whiff of stigma, no matter where you are. Loder is the cofounder of the Verband der Cannabis Versorgenden Apotheken e.V. (or VCA for the non-Deutsch, tongue-twisting acronym).
In such a position, Loder is also well aware that the industry is developing here as opposed to Canada. “You cannot reach everything just with money. You can’t just buy revenue, much less patients. It is about service, reputation, and care,” he says.
“We founded the VCA in late 2018, early 2019 because we recognized that the industry still has a lot of problems—with insurance, doctors, availability, with starting a new section of the pharmacy. All of us had the same problems. The first meeting took place over two days in a group of 8 pharmacists. The idea was to give more weight to the discussion. We currently have 35 pharmacy members and about the same number of member companies who make up other critical parts of the medical cannabis supply chain.”
That said, Loder is also a realist about what is currently happening in the Deutsch cannabis market. “The bigger German companies are now entering the cannabis space in a big way—even the old-fashioned pharma companies. Obviously there will be a market consolidation at some point. The established Canadians will be around, but they are now coming into direct competition with established German teams who know the market much better than any of the Canadians ever will.”
If it sounds a bit “canna-nationalistic”, the reality is that most German firms have been kept out of the process by the unfolding of reform so far here—including the first cultivation tender. Loder’s voice is in fact the authentic one of a person who happens to be German, but also wants his community, first and foremost, as well as his country, to have access to a plant he knows makes a difference—and of a life-changing kind.
Greenly Forward Where Few Pharmacists Have Gone Before
One of the most surprising things to Loder so far has been the reaction of his customers, also known as cannabis patients. “They love us. Obviously, we are not the only pharmacists in the industry who dispense cannabis, but people seem to know that we take them seriously. We do not discriminate or stigmatize. And we get such incredible feedback. This has never happened before in the pharmacy. We even get presents,” he said a bit sheepishly, but also very proudly. “People write to us saying that we changed their lives. This absolutely inspires us as a team.”
Loder has every reason to be proud of his success, as well as his growing band of dedicated fellow pharmacists. “I am an entrepreneur as well as a pharmacist. One of the things that I love about being in the cannabis industry is that you can follow your ideas. What I had to learn in the past is how to bring out your ideas in old fashioned business. Here, we are one of the first. We are creative, flexible, young. This is typical of the cannabis industry. There is nobody who defends their business. Here nobody has cannabis revenue, and they want to get it. People are much more open to collaboration.”
Greenly forward indeed.
Disclaimer: Lux99 is one of the sponsors of the translation of the author’s new book about the German cannabis industry, into German.