Bureaucracy is a burden

"The offer 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 Natalie Badie from the Department of Strategy at the University of Economics.

According to her, the demand can be derived from the data of the State Institute for Drug Control (SÚKL), according to which there are at least 800,000 people who use cannabis in the Czech Republic. However, those who get it from a doctor were only 6,079 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. Analysts say that besides legislative barriers, it is the administration that is limiting the market.

Paperwork is such a burden for doctors that they simply prefer not to work with cannabis.

There are eight medical cannabis growers in the Czech Republic, and 204 doctors prescribe cannabis for medicinal use, according to data from the State Agency for Cannabis for Medical Use, which falls under the SÚKL.

Doctors are bothered by the obligation to report their patients to SÚKL.

"The 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.

Instead of helping other patients, I write out paperwork that officials just file somewhere.

"When you have hundreds of these patients, it's very challenging. Nobody will pay you and instead of helping other patients, you write out forms 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.

Will an amendment to the law help?

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

"The consumption of cannabis for medicinal use has not been 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 are entitled to 90 percent reimbursement

Patients who are prescribed medical cannabis are entitled to 90 per cent of the cost. They can use a maximum of 30 grams per month, and only a reviewing physician can prescribe larger amounts, 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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