Medical cannabis in Switzerland: System failure at the expense of patients

The groundhog greets you every day. It happens every day in our mailbox and on the phone. People call, some of them desperate: “Do you have anything for my pain?”, “My doctor won’t prescribe anything” or “I can’t afford the pharmacy”.

As Bernese producers, this makes our hearts bleed. We know what our plants can do. We know how clean our production is. And yet we have to watch patients starve to death in Switzerland’s bureaucratic jungle.

A recent, disturbing report by SRF Wissen gets to the heart of the matter. It uses Dominic’s fate to show that the “legalization” of medicinal cannabis in 2022 is often a mere paper tiger in practice.

Source: SRF report: Grueling fight for therapy

The scandal: 1100 francs for cannabis flowers that should cost 450

The SRF report describes the case of 29-year-old Dominic, who regularly needs cannabis flowers. He suffers from unbearable pain (level 9 out of 10). Cannabis in flower form is the only thing that really helps him and enables him to live a dignified life again and makes his pain more bearable. It has been legally prescribable since 2022. Problem solved? Not at all.

SRF does the math:

On the black market (unsafe, contaminated) his dose costs around 450 francs.
In the pharmacy (legal) it costs 1100 francs.

The health insurance company won’t pay a penny. The reason: “Lack of evidence”.

Our opinion on this: This is bureaucratic madness. How can it be that a legal product that doesn’t cost a fortune to produce suddenly becomes a luxury item in the pharmacy? Somewhere between producers and patients, money seeps away or is burned through inefficiency. The result: Dominic is driven into illegality.

What we experience every day (and why it’s annoying)

We are perceived as experts. Customers ask us about dosages, medicinal effects, help, all the information that comes up about this wonderful plant. However, the absurd legal situation prevents us from giving advice, for example the Novel Food Regulation. According to the law, only a doctor or pharmacist is allowed to give advice. As experienced specialists, we have to pay close attention to what we say and how we say it.

But as Franziska Quadri rightly says in the SRF report: Many doctors simply have no idea, no time or no desire to report on cannabis . They are often still burdened with prejudices and therefore have an inner inhibition threshold to enrich themselves with the knowledge of what cannabis can do.

As producers who know the plant inside out, we have to remain silent. And the patient is left alone. This is not health protection; over-regulation accepts the fact that no help is provided.

The link to the consultation: Do you see the pattern?

Do you remember our last blog post on the CanPG consultation? 👉 Read our article here: What we think as producers

That is precisely the point we are criticizing there! The Dominic case is the perfect warning signal for the coming legalization in the pleasure sector: if the state makes the legal market more expensive through taxes, duties and bureaucracy, the black market always wins.

If we make the same mistakes with CanPG as we did with medicinal cannabis, we have major concerns about its implementation. We need a market that works – in terms of price and quality. Dominic shows us what happens when you “mean well” but deliver “badly done”.

We are ready – the system is not (yet)

We at Herba di Berna are in the starting blocks. We produce “Swiss Made” quality. We could supply the market – sustainably, cleanly and at fair prices. But as long as the hurdles in the medical sector are so high, we are concentrating on what we can already offer legally and without a prescription today CBD oils which have a THC content of less than 1%.

Many of our customers who are tired of fighting with health insurance companies therefore turn to our high-quality CBD products. No, CBD is not a substitute for high-potency THC for severe pain. But for many, it is a legal, affordable and readily available supplement for daily wellbeing and relaxation.

We will continue to fight for all aspects of the hemp plant to finally be normalized. Until then, we won’t leave you out in the rain.

Click here for our legal, high-quality CBD oils

Conclusion: Bern, wake up!

The SRF report is not an isolated case, but a symptom of a much bigger problem. Dominic is representative of thousands of people affected. Our demands are clear: less bureaucracy, fair prices and finally reimbursement by health insurance companies when medical necessity is proven.

The planned CanPG also still has considerable potential for improvement. The current system is far from practical and does not meet the needs of consumers or the wishes of many doctors.

It is important to be open about this:
The pharmaceutical industry invests heavily in lobbying so that doctors prescribe certain medicines or prefer them to others. In contrast, there is little or no comparable education and information work on cannabis. And you can’t even blame the prescribing doctors: If the administrative hurdles are so high, it is understandable that the additional work involved with the FOPH should be avoided wherever possible. However, it is precisely these structural barriers that prevent patients from receiving the therapy that could help them.

Sources & further links

So that you can form your own opinion, we have compiled the most important sources and further information for you here:
Herba di Berna Blog: Our opinion on the consultation (CanPG) Read here why we remain sceptical about the legalization of consumption when bureaucracy gets out of hand.

SRF Wissen Report: Cannabis in medicine: A grueling battle for therapy (SRF.ch)The main article to which we refer and which tells Dominic’s story.

Federal Office of Public Health (FOPH): Legal regulation on cannabis medicinal productsThe official information from the federal government on the change in the law from August 1, 2022.

Medcan – Patient:innen-Organization: Information and help for patients (Medcan.ch)
The contact point for patients, represented by Franziska Quadri.

FAQ: Medizinisches Cannabis, Kosten & Hürden in der Schweiz

Zahlt die Krankenkasse medizinisches Cannabis in der Schweiz?

Compulsory health insurance does not automatically reimburse cannabis medicines, but only in exceptional cases after a prior cost approval by the medical examiner. As the Federal Office of Public Health (FOPH) often still considers the scientific evidence for efficacy to be insufficient, applications are often rejected or approved only hesitantly. (Source: Federal Office of Public Health FOPH, “Cannabis medicinal products”)

Wer darf mir in der Schweiz Cannabis gegen Schmerzen verschreiben?

Since the law was amended in August 2022, any doctor in Switzerland has been allowed to prescribe cannabis medicines without having to obtain a special permit from the FOPH. In practice, however, this is often only done by specialized pain physicians or neurologists, as many general practitioners lack the specific knowledge on dosage and application. (Source: Swissmedic / FOPH, “Amendment to the Narcotics Act”)

Wie bekomme ich ein Rezept für medizinisches Cannabis?

The only way is to have a personal consultation with your treating doctor, where you must demonstrate that previous standard therapies have not been sufficiently successful. As the hurdles are high, it is advisable to bring detailed documentation of your medical history with you or to contact doctors who are open to cannabinoid therapies. (Source: Medcan.ch, patient association)

Warum wirkt CBD nicht gleich wie medizinisches THC?

Although CBD (cannabidiol) has an anti-inflammatory and relaxing effect, it has no intoxicating effect and binds differently to the receptors in the body than THC. In cases of severe pain, as in the case of Dominic (SRF report), the pain-relieving potency of pure CBD is often not sufficient, which is why medication containing THC is necessary.

Warum ist Cannabis in der Apotheke so viel teurer als auf dem Schwarzmarkt?

The high prices are the result of strict pharmaceutical quality standards, complex import processes or the individual production of extemporaneous formulations in pharmacies. While the black market has no safety controls, the legal market incurs costs for analyses, standardized cultivation methods and bureaucracy, which often more than doubles the price, according to SRF.

Welche Krankheiten qualifizieren für eine Cannabis-Therapie?

Medical cannabis is often used to treat chronic pain, spasticity caused by multiple sclerosis or severe nausea during chemotherapy. There is no exhaustive legal list of diseases; prescription is at the discretion of the doctor if conventional therapies are not effective enough or have too many side effects.

Was sind die Risiken, wenn ich mein Cannabis illegal kaufe statt in der Apotheke?

Cannabis from the black market is not subject to any quality controls and can be contaminated with pesticides, heavy metals, molds or even synthetic cannabinoids. For sick people with a weakened immune system, this poses a considerable health risk, which is why medically pure products are safer despite the higher price.

Was muss sich politisch ändern, damit Patienten besseren Zugang erhalten?

Patient organizations and industry representatives are primarily calling for the assumption of costs by health insurance companies to be simplified and regulated in a more binding manner. As long as medical cannabis is treated as an expensive luxury good and not as a normal medicine, patients will be left to bear the costs or be forced back into illegality.