According to a market analysis conducted by experts at the Faculty of Business Economics of the University of Economics (VŠE) for the cannabis producer AstraSana, the demand and supply of cannabis for medicinal purposes could be high, but the Czech market remains small.

According to their calculations, cannabis worth CZK 30 million was prescribed last year, and the market could double in the coming years. However, the authors of the analysis warn that it could be even more.

The paperwork is such a burden on doctors that they simply prefer not to work with cannabis

Natalie Badie, University of Economics

"The supply would be. There are a number of companies that produce and distribute medical cannabis, it's quite a highly competitive environment. There would be demand as well," said team leader Natálie Badie from the Department of Strategy at the University of Economics.

According to her, the demand can be derived from data from the State Institute for Drug Control (SÚKL), according to which there are at least 800,000 people in the Czech Republic who use cannabis. But those who get it from a doctor were 6100 last year.

"Problems arise when cannabis reaches patients. Doctors, pharmacists and strict legislation come into play," Badie described.

Medical cannabis has to meet strict standards, which are monitored by the SCL. Growers must have a licence, which doctors and pharmacists must also have. According to analysts, it is the administration that is limiting the market.

There are eight growers of medicinal cannabis in the Czech Republic, and according to data from the State Agency for Medicinal Cannabis, which is under SÚKL, 204 doctors prescribe it and 96 pharmacies dispense it.

"Paperwork is such a burden for doctors that they simply prefer not to work with cannabis. We have also received information from a number of pharmacies that they do not have cannabis because local doctors do not prescribe it. In this respect we are in a vicious circle," Badie summarised.

Doctors are said to be most bothered by the obligation to report to SÚKL the patients they prescribe medical cannabis to.

"When you have hundreds of patients, it is very difficult. Nobody pays you and instead of helping other patients, you write out papers that officials just file somewhere. In the worst case, you treat patients and handle these administrative duties in your spare time," said Radovan Hřib, a doctor at the Centre for Pain Management at St Anne's Hospital in Brno. Pharmacists have a similar experience.

Patients are entitled to 90 percent reimbursement

However, according to SÚKL spokeswoman Klára Brunclíková, the institute has not recorded any complaints. Neither have patients complained.

"The consumption of cannabis for medicinal use is not decreasing over time, but on the contrary is growing - this is evidenced by statistics published by SÚKL on its website. Compared to other EU countries, we have a significant number of licenses granted for the cultivation of medicinal cannabis, which is also imported into the Czech Republic. The availability of quality medical cannabis that meets the legal requirements is continuously ensured," the spokeswoman told Práva.

Although an amendment to the law is in the pipeline that would open the regulated market for recreational cannabis in the Czech Republic, it will not solve the problem with medical cannabis, according to the director of cannabis producer AstraSana, Tomáš Ryška.

"This may lead to a paradoxical situation in which patients will use so-called recreational cannabis, which is not subject to such strict quality and safety requirements, for treatment. This will also logically be more expensive for them, because they will have to pay for the cannabis themselves instead of the insurance company," he warns. Patients who are prescribed cannabis for medical purposes are entitled to 90 per cent of the cost. They can use a maximum of 30 grams per month; larger amounts can only be prescribed by a reviewing physician, who will also determine the amount of reimbursement. However, the patient may not consume more than 180 grams per month.

Last year, the Ministry of Health set the maximum price for cannabis at CZK 158 per gram, including VAT. If a patient used the full 30 grams per month for CZK 4,740, the supplement would be CZK 474.

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