Medical cannabis has been legal for more than three years in the Czech Republic, but a persistent lack of supply, price issues, and hassles facing doctors are setting the stage for a legal battle to expand cannabis access in the central European country.
Early estimates suggested the number of patients to enroll in Czechia’s medical cannabis program would number in the thousands, but in so far only a few dozen patients are participating in the medical cannabis access system.
A common complaint is that most doctors refuse to prescribe the herb, and it’s true. But unlike what you might expect, this reluctance to prescribe cannabis is not just due to the stigma surrounding the plant. The law in fact forces physicians to obtain a costly and complicated system of electronic registration of cannabis prescriptions. No more than about two dozen doctors in the whole country have obtained this so-called “e-prescription with restriction” system.
“My doctor has been trying to get all the papers for four months and she says it’s a bureaucratic nightmare,” one patient said in a discussion on Czech cannabis legalization NGO Legalizace.cz’s Facebook page.
The next problem for Czech patients—similar to patients in other countries—is that health insurers do not cover the costs of cannabis therapy, leaving disabled patients in the lurch. This past spring, Czech drug regulator SUKL refused the request of KOPAC, a Czech patient association for cannabis treatment, to include medical cannabis coverage in public health insurance. But KOPAC is not giving up: “We are encouraging and helping patients to apply for individual coverage of their medical cannabis and we will be informing people about this possibility in a new campaign in media,” the association’s director, Hana Vagnerová, a multiple sclerosis patient, explained to Leafly.
In the wake of recent victories of patients in Canadian and German courts, some patients are now considering to file lawsuits against the state in order to be allowed to grow and use their own medical cannabis. The Canadian court victories resulted in wider access to medical cannabis, the patients’ right to cultivate at home and extracts being made available alongside dried cannabis flowers.
In Germany a high court decision in April gave an MS patient the right to cultivate at home and forced the government to begin creating a robust system to increase access to medical cannabis for all Germans. But until such court victories are won in the Czech Republic, the lack of supply and prescriptions and the high prices will force thousands of patients to continue illegally sourcing their medical herbs.
Domestic cultivation woes
The latest developments in the Czech medical cannabis program show how the authorities’ Catch-22-style of implementing laws could destroy years of hard work. The Czech State Institute for Drug Control (SUKL) has taken applications for domestic growers, but in the past, rounds had chosen only one producer who grew just one strain with nearly 20 percent THC and very little CBD. The SUKL then refused to buy two of three pre-ordered batches of 23 pounds of dried cannabis from the sole supplier, a company called Elkoplast Slušovice, because of insufficient certification. The company’s CEO Ladislav Krajča announced on Nov. 10 that he’s considering legal steps to prove his company met all the requirements and simply couldn’t obtain this type of certification in the Czech Republic.
In the meantime, the SUKL has put out a new tender, which came under heavy criticism from patients and activists. Again, the aim is for just one producer to win the tender and supply only about 90 pounds of medical cannabis in the next four years. Sources close to the competition indicate that only two companies made bids, with one being too high and the other too low, so chances are nothing will come of it. Asked about the lack of competition in this market, SUKL press secretary Hana Pavlíčková told Leafly: “The law does not require us to create competition on the market.”