Keynote speech at the German Patient Roundtable on 03/08/2018, Maritim Hotel Pro Arte, Berlin

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Many thanks for the brief introduction Phil and of course thanks for having me here today. I am Kai-Friedrich Niermann, lawyer in Paderborn and I have first met Phil here in Berlin at the Cannabis Normal conference of the German (Hemp) Cannabis association in November. Phil had introduced himself as a patient lawyer from California now living in Germany. California has a much longer history in legalization of medical Cannabis. In November 2017 the legalization of Cannabis in Germany was then just six months „old“. Prior to this there were only very limited exceptional permissions for application.

Unfortunately in March 2018 there has only been little progress compared to the legal situation in April 2017. We have far too few doctors who are well versed in the subject matter and who would be prepared to prescribe Cannabis as medication for respective diseases. And the health insurances companies are mostly reluctant in taking over the costs for the expensive medical cannabis.

My professional empirical knowledge is that pain is a widespread disease demanding provision of a vast number of clinics and highly specialized pain specialists. Modern society seems to make people ill.  Costs for preventative health care are immense. Many patients are said to be beyond treatment, yet abatement is not in sight. 

Since Cannabis was criminalized in Germany over decades it is no wonder that the awareness of the potential of this plant has neither developed with doctors nor with patients. There has never been a scientific, state-run or commercial basis in Germany attending to the opportunities of this pain management option.

In Paderborn, where I cm from any doctor act dismissive on the topic and the chronic pain patient does even have the least of a clue that medical Cannabis could be an alternative therapy. And the situation hardly differs elsewhere in the Republic. 

And yet the opportunities of medical Cannabis application are immense and also by long conclusively scientifically defined. No one can be contented with the current situation where import is only possible from few countries, the safety relevant and bureaucratic requirements for importers in Germany is high and making the open tender process of the Cannabis Agency error-prone and non-transparent, and where tendered quantities were highly insufficient.    

So the patients reliant upon regular application of medical Cannabis are not accommodated. This does not serve incurable patients beyond treatment and who are forced to endure inflated pain therapy in high-tech clinics notably at cost for the community of solidarity. The latter is merely to the delight of the drug making industry and doctors, however not to the benefit of patients or the collective body of the insured.

Moreover this does not serve the interest of companies investing a lot in the research and development of medical Cannabis products without knowing whether or not the investment in the German market will ever pay off long term.

In my opinion and from patient point of view the action plan for 2018 should be focussed on establishing awareness for the potential of medical Cannabis and the various areas of application with doctors to ensure they address the matter in depth. 

At the same time pressure must be asserted on the health insurances in cases where they deny taking over the costs. The average Social Court Procedure (first chamber) will cost approximately 1000 €, up to completion of last chamber however not before three years ending, 3000 €. For needy patients the Government will bear the costs, in other cases legal cost insurance will meet the costs. Patients not entitled to legal aid can only be advised to effect legal cost insurance, and wait till the end of the three months qualifying period before applying for the meeting of costs. If taking over the costs is denied then, patients should not hesitate to take legal action  as this ensures maximum pressure on the health insurance companies, the Courts and respectively the Government.

This is the only way for Cannabis as medication effectively achieving societal benefit for the individual as well as for the companies. 

Thank you for your attention.      Rechtsanwalt Kai-Friedrich Niermann

RA Kai-Friedrich Niermann