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Could Czech Republic be Europe’s Most Progressive Medical Cannabis Market?

Could Czech Republic be Europe's Most Progressive Medical Cannabis Market?
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Medical cannabis sales in the Czech Republic increased year-on-year by 63% in 2021. And the space is expected to show potential for further growth in the next 12 months on the back of a recent law change that could see prices driven down for medical cannabis as the country’s legal market opens up to growers.

Official figures reveal that a total of 109.4kg of medical cannabis was released to Czech patients last year compared to 66.9kg in 2020, as the country now adopts one of the most broadminded attitudes in Europe towards cannabis legalisation. On average, 9.1kg of medical cannabis was distributed every month in Czechia last year, compared to an average of just 5.6kg in the same time frame in 2020.

The State Agency for Medical Cannabis (SAKL) statistics also reveal that the last three months of 2021 saw the most prescriptions issued, with 5,500 dispensed between October and the end of December. The total for the year was 19,441 – a 37% rise on 2020 – with November the busiest month with 1,976 prescriptions handed out by doctors.

Overall, more than 1,000 prescriptions were issued every month – the first time this has happened since medical cannabis was legalised in Czech Republic in 2013.

Patients & Prescriptions

The overwhelming majority of medical cannabis prescribed to patients – 80% – was to help alleviate chronic pain, followed by multiple sclerosis at 12%. Parkinson’s disease was also in the top three.

The unique number of medical cannabis patients in the Czech Republic also increased year-on-year by 22.5% from 3,755 to 4,601, according to the SAKL.

This is in stark contrast to 2019 when by the end of the year just 434 patients had been prescribed medical cannabis, with doctors issuing 4,145 prescriptions – an average of 345 a month.

Curiously, according to official data from 2020, 61.8% of Czechia’s medical cannabis patients are female, with just 38.2% men. This demographic data is different to most other countries in Europe, with most having a majority-male patient population for medical cannabis. The same report noted that 43.3% of all patients are aged 56-75, followed by 19.84% in the 45-55 age group, and 17.3% between 76-85.

The SAKL’s latest figures show the number of registered doctors authorised to issue therapeutic cannabis has risen from 78 at the end of 2019 to 170 in 2020 and 191 last year.

The steady increase in the issuing of prescriptions, and both patient and doctor numbers since 2019, can be attributed to the fact that since the beginning of 2020, 90% of the price of medical cannabis has been covered by health insurance up to a limit of 30g per month.

The Czech government has also set a price cap of €6.41 per gram, making the nation one of the most affordable markets in Europe for medical cannabis.

Progressive Legislation

With 2022 less than a month old, Alex Khourdaji, an analyst at Prohibition Partners, believes the Czech Republic could be on track to record another bumper year for its medical cannabis programme.

He said: “The figures have been increasing year-on-year and I don’t see them going down anytime soon. Products are becoming cheaper for insurers, there is more availability, and the number of doctors willing to prescribe is steadily increasing.

“I think there is definitely the potential for another big leap forward this year.”

Likely to play a big part in this is the softening of medical cannabis legislation, which came into force on January 1 in the Eastern European country. As of New Year’s Day, doctors no longer have to issue their medical cannabis patients with a special paper prescription, with everything instead being done electronically using e-prescriptions.

The THC level of industrial hemp has also been more than tripled from 0.3% to 1% of dried matter, including for tinctures and consumables, putting the country in conflict with the United Nations international drug convention, which more than 60 years after being ratified still determines global narcotics policy.

However, it brings the Czech Republic into line with Switzerland, where a similar regulation has been in place since 2011, but far exceeds the future threshold set by the EU under the new Common Agricultural Policy adopted in December last year, which will see the THC level for industrial hemp increase from 0.2% to 0.3% from January 1, 2023.

Under the new legislation in the Czech Republic, cannabis extracts or tinctures with less than 1% THC are also no longer considered addictive substances. More people can also legally grow medical cannabis, with production and distribution treated in the same way as for any other addictive substance.

Supply & Demand

Despite the Czech Republic being amongst the first European countries to legalise medical cannabis use nearly a decade ago, the early years were plagued with supply problems. Only imported supplies were initially available.

The last few years has seen Czechia’s State Drugs Control Institute (SUKL), which runs the National Agency for Medical Cannabis, buying a certain amount of cannabis from a selected supplier who won a public procurement process. But it is hoped the new law will increase competition, helping drive down the price for cannabis-based medical preparations.

Khourdaji says the move effectively opens up the market for private companies to move into Czechia. “This means the Czech Republic is going to be one of the most progressive medical markets in Europe.

“The country is already a very advanced research and development and technology space, so that combined with the law change means we are probably going to see a lot more diversity of products being offered.

“Based on the higher levels of competition we are expecting to see, we presume medical cannabis and CBD prices will naturally go down domestically. But the new law also opens the way for the Czech Republic becoming a big player not just in Europe, but on an international level as well.

“By raising the THC threshold for hemp products it means they can not only produce CBD extracts more economically, but make it cheaper for both businesses and consumers.”

Khourdaji adds: “The Czech Republic hasn’t been the focus of Europe in the medical cannabis market space, but I think there is going to be more interest going forward. I think we could well see Canadian companies looking to Czech Republic now as well as more Czech entities in the European and international markets, especially in the CBD space.

“The Czech Republic is without a doubt one of the most progressive countries in the Eastern side of Europe, which I think has a lot to do with its thriving IT and research and development sectors.

“The country is looking to boost its economy and is taking a scientific approach to that, which is why I believe they are opening their arms to medical cannabis.”

Czech Republic is opening up the market to private entities in a similar way to Portugal – which decriminalised the use of all drugs in 2001 and legalised therapeutic cannabis in 2018 – by allowing companies to cultivate medical cannabis.

Khourdaji said: “Year-by-year, Czechia has been making more and more progress. It is great for patients and for the European medical cannabis market in general.”

For an in-depth exploration of cannabis markets around the globe, see Prohibition Partners’ recently-released The Global Cannabis Report: Second Edition.

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