Medicinal cannabis in Germany - Business Report

161 Confidential __________________________________________________________________________________ Many producers, especially from South America, Australia and Canada, are currently only looking for agents, distributors or cooperation partners for Germany who will take over the marketing of their products in Germany. Exclusive and many non-exclusive contracts are concluded. The first "smart dealers" are also establishing themselves, specialising in bringing these partners together and acting like licence brokers. A few of the importers extend their value chain to doctors, pharmacists and sometimes patients, and offer corresponding services, such as the one in Cannamedical in Cologne. Traditional pharmaceutical companies focus on Cannabis finished drugs such as Almirall with Sa- tivex® or AOP Orphan with Canemes®. Very rarely do we see the company engaging in both relevant sub-markets at the same time, i.e. offering both pharmacy formulated drugs and finished drugs in its portfolio. 10. Prices in the Cannabis market Cannabis therapy is comparatively cost-intensive. Per gram Cannabis flowers cost about 18 to 22 euros in pharmacies. The monthly costs of a therapy are therefore between 300 and 2,200 euros. An alternative opiate therapy, on the other hand, would be considerably more beneficial if chronic pain were to be considered as an indication. Less cost-intensive are Cannabis-containing finished drugs and Dronabinol formulations. The aver- age monthly costs for Dronabinol range from EUR 70 to 500, for Sativex® from EUR 30 to 373 and for Canemes® from EUR 1,026 to 2,052. In principle, every Cannabis therapy is currently associated with high costs, regardless of whether it involves ready-to-use drugs with Cannabinoids (APIs) or prescription drugs with Cannabis. Moreover, it should be borne in mind that Cannabis preparations are not, or only very rarely, used as causal ther- apy. Rather, in most cases of Cannabis therapy it is a so-called add-on therapy , i.e. an additional med- ication. Also, the therapeutic goal is not to eliminate the pathophysiological causes of the disease, but to control the symptoms and/or improve the quality of life. When looking at the price development, we must reflect two different market segments, on the one hand prescription drugs and on the other hand finished drugs. The pricing of finished drugs is carried out by the Pharmaceutical Price Ordinance and of prescription drugs by the contractual unit costs of retail pharmacist services.