Key Points
- Remote medical cannabis treatment in Germany must meet medical safeguards, and advertising is subject to separate restrictions.
- EU cross-border telemedicine creates opportunities while leaving important questions about advertising and professional standards unresolved.
- Proposed changes to the Medical Cannabis Act would require in-person consultations for cannabis flowers and restrict mail-order dispensing; the amendments remain unadopted.
In This Article
Digital healthcare is transforming Germany’s medical cannabis market. While technology makes treatment more accessible, the legal framework remains complex, particularly for online platforms, prescribing physicians and companies seeking to reach patients.
A Growing Market Meets a Complex Legal Framework
Patients can now consult physicians, receive prescriptions and access medical cannabis without visiting a doctor’s office. Telemedicine reduces geographical barriers, especially in rural areas, and creates opportunities for digital healthcare providers. Yet Germany’s rules governing remote treatment, prescriptions, platforms and advertising are not always aligned.
Can Medical Cannabis Be Prescribed Online?
Yes, subject to medical safeguards. Since a reform of German medical professional rules in 2018, German physicians have generally been permitted to treat patients exclusively through telemedicine where medically appropriate in the individual case.
The physician must be able to assess the patient reliably without a physical examination. Video consultations may suffice in some cases; others require an in-person visit. For medical cannabis prescriptions, physicians must review medical history, symptoms, treatment needs and potential drug interactions, and establish a medical justification. If a reliable assessment is impossible remotely, an in-person consultation is necessary.
Telemedicine is therefore an accepted method of treatment, not an exemption from medical standards.
Cross-Border Telemedicine: Opportunities for International Providers
A September 2025 judgment of the European Court of Justice clarified the rules governing cross-border healthcare (Case C-115/24). Healthcare services provided exclusively through telemedicine are generally governed by the laws and professional standards of the EU Member State where the physician is established.
Accordingly, physicians established and authorised to practise medicine in another EU Member State may, in principle, provide exclusively remote healthcare services to patients in Germany without obtaining an additional German medical licence, subject to applicable EU and national requirements.
Physicians outside the EU cannot generally rely on these rules. Platforms must nevertheless assess the applicable legal requirements in the physician’s home country and in Germany.
A subsequent decision of the German Federal Court of Justice (BGH) highlights the distinction between providing telemedicine and advertising it. Cross-border telemedicine by EU-based physicians, including advertising for their services by a German platform, falls within the freedom to provide services under Article 56 of the Treaty on the Functioning of the European Union (TFEU). German advertising restrictions may interfere with that freedom, but the BGH considered them justified on public health grounds. It referred to the European Court of Justice the question whether Germany may prohibit advertising for cross-border telemedicine that fails to meet German medical standards. The issue remains unresolved (BGH, decision of 26 March 2026, Case I ZR 118/24).
What Are Telemedicine Platforms Allowed to Do?
Digital platforms may connect patients with physicians and pharmacies, but must respect physicians’ professional independence. Where German professional rules apply, platforms generally act as intermediaries or technical service providers rather than treating patients themselves.
Physicians retain responsibility for diagnosis and prescriptions. Platforms must not improperly influence medical decisions or restrict patients’ freedom to choose physicians. Patient-referral fees or commissions calculated as a percentage of physicians’ fees may violate professional and competition law requirements.
Advertising: The Biggest Challenge for Cannabis Telemedicine?
German law distinguishes between providing remote treatment and advertising it. Under Section 9 of the German Healthcare Advertising Act (Heilmittelwerbegesetz, HWG), advertising for remote treatment is generally prohibited unless, according to generally accepted professional standards, personal contact between physician and patient is unnecessary.
A physician may legitimately decide that remote treatment is suitable for an individual patient, while advertising the same service broadly may still be unlawful: an advertisement cannot establish whether remote treatment is appropriate for every prospective patient.
In March 2025, the Higher Regional Court of Frankfurt ruled that advertising an initial consultation for medical cannabis treatment as available either in person or digitally violated Section 9 HWG. However, the court considered advertising digital follow-up consultations permissible where the advertised treatment model included an initial in-person consultation and subsequent remote consultations were offered only where medically appropriate (Higher Regional Court of Frankfurt, judgment of 6 March 2025, Case 6 U 74/24).
The BGH also confirmed that advertising treatment for erectile dysfunction based solely on online questionnaires violates Section 9 HWG when assessed against generally accepted medical standards in Germany (BGH, decision of 26 March 2026, Case I ZR 118/24). Although the case did not concern medical cannabis, it illustrates the importance of medical standards for advertising telemedicine services.
The precise scope of advertising claims matters. Broad promises of convenient online prescriptions may create substantial legal risks.
Prescription Drugs Cannot Be Advertised to Consumers
Section 10 HWG generally prohibits advertising prescription-only medicines to the public, including medical cannabis. Platforms must distinguish between promoting a healthcare service and promoting prescription medicines.
In a landmark decision, the German Federal Court of Justice (BGH) ruled that a telemedicine platform violated this prohibition by promoting medical cannabis as a treatment for certain conditions while enabling patients to request consultations with cooperating physicians. Importantly, the Court clarified that advertising may be unlawful even without mentioning specific cannabis products or manufacturers (BGH, judgment of 26 March 2026, Case I ZR 74/25).
Neutral and factual information about medical conditions and treatment options may be permissible. However, the overall presentation must not be designed to encourage patients to seek prescriptions for medical cannabis.
Proposed Changes to Germany’s Medical Cannabis Act
In October 2025, the German government approved a draft bill to amend the Medical Cannabis Act (MedCanG). It would require an initial in-person consultation before prescribing medical cannabis flowers and at least one further in-person consultation annually. Mail-order dispensing of cannabis flowers would also be prohibited, although pharmacy delivery services would remain possible. These measures could significantly disrupt platforms relying on fully remote consultations and online pharmacy deliveries. The amendments have not yet been adopted, and whether they will become law remains uncertain (German Bundestag, BT-Drs. 21/3061).
What Does This Mean for the Industry?
Germany offers opportunities for medical cannabis telemedicine, but businesses must ensure medically sound treatment models, independent prescribing decisions and compliant advertising. Cross-border operations and pharmacy partnerships require particular scrutiny.
The central challenge is balancing patient protection and access to care with innovation in digital healthcare. How Germany resolves that tension will shape the future of its medical cannabis market.
FAQs
Can medical cannabis be prescribed through telemedicine in Germany?
The article explains that remote treatment may be appropriate when a physician can assess the individual patient reliably and meet applicable medical standards. Cases requiring a physical examination need an in-person consultation.
Does permission to provide telemedicine also permit advertising it?
Providing remote treatment and advertising it are governed by different rules. Germany’s Healthcare Advertising Act places limits on remote-treatment advertising and generally prohibits public advertising of prescription medicines, including medical cannabis.
Have the proposed restrictions on cannabis flower prescriptions become law?
As of the author’s October 12, 2026, submission, the amendments have not been adopted. The proposal would introduce initial and recurring in-person consultations and prohibit mail-order dispensing of cannabis flowers while retaining pharmacy delivery services.
Featured image: National Cancer Institute / Unsplash.
