Eleven euros per day, says the manufacturer. Ten times more expensive than flower, says the German Hemp Association. Both figures are correct—they just describe different things. And the most important number is missing from both calculations: six.
📑 Inhaltsverzeichnis
Since July 30th, statutory health insurance no longer covers dried cannabis flower; finished pharmaceutical products now take priority. Now Exilby is entering the market as the first preparation to fill this gap, bringing the price debate with it. The German Hemp Association has published figures that can be verified. Here’s what we found.
The Numbers Under Dispute
Manufacturer Vertanical cites therapy costs of around eleven euros per day. The German Hemp Association counters: a 600-milligram THC bottle costs €745.40. Based on the same active ingredient amount, Exilby is roughly twice as expensive as previous prescription extracts and about ten times more expensive than the former flower reimbursement rate.
Running through the association’s calculation, €745.40 for 600 milligrams yields approximately €1.24 per milligram of THC. For comparison: in the proceedings before the Frankfurt Social Court, which we reported on last week, flower was priced at €8.50 per gram. At the typical 20 percent THC content of medicinal flower, that works out to roughly 4 cents per milligram. The factor thus falls in the double-digit range depending on the comparison price used. The association’s order of magnitude is therefore plausible.
We couldn’t independently verify the bottle price itself. Drug prices are listed in the Lauer Taxe, which requires a paid subscription, and freely accessible databases only show prices after registration for professionals. The figure comes from the German Hemp Association and we cite it as such.
Why the Price Isn’t Actually Fixed Yet
This is the crucial point missing from the debate. Germany uses a two-stage system for newly approved finished pharmaceuticals: for the first six months after market entry, manufacturers can set the dispensing price freely. Only afterward do negotiations between the manufacturer, the Joint Federal Committee, and health insurers determine the reimbursement amount, based on a benefit assessment. We’ve detailed how this process works in our article on price formation through AMNOG.
The current price is therefore a starting price, not a negotiated one. The Hemp Association’s graphic states the price is „now set.“ More accurately: it’s been set, and it’s up for negotiation in six months. For those who think it’s too high, criticism is better directed at the entity that can correct it—not the manufacturer, but the assessment procedure.
For patients, this changes nothing in the short term. For the question of whether eliminating flower ultimately saves money, it changes everything: whether the legislature’s calculation works out will be decided only when the reimbursement amount is set.
Where the Comparison Works—and Where It Breaks Down
The per-milligram comparison is a legitimate measure if you want to know what the same active ingredient amount costs. But it overlooks what you’re paying for with an approved pharmaceutical.
- What supports the price. Exilby underwent an approval process and is based on a placebo-controlled Phase 3 trial whose results appeared in Nature Medicine. That costs money that doesn’t apply to a compounded preparation. Add to that defined dosing, manufacturer liability, and a reproducible product.
- What argues against it. The active ingredient is the same one available as a compounded preparation at significantly lower cost, and the study evidence doesn’t justify arbitrary markups. The AMNOG process exists precisely for this reason: to tie price to demonstrated added benefit, not to willingness to pay.
Another point gets lost in the outrage: for existing patients who previously received flower on insurance, a reimbursable preparation is better than no reimbursement at all. In the Frankfurt case, a patient faced monthly costs of around €1,020 that she would have to pay herself. Eleven euros in daily therapy costs falls below that—provided insurance covers it. That doesn’t make the price reasonable, but it reframes the question: it’s less about whether Exilby is expensive than about whether eliminating the cheaper option was justified.
The Context Heating Up the Debate
The sharp criticism is rooted in the backstory. In July we documented the economic and political interests surrounding the legislative change, including campaign donations from the manufacturer’s sphere, while distinguishing what’s documented from what remains speculation. See our article Who Benefits From the Finished Pharmaceutical Privilege.
For the price question itself, however, this context is secondary. A high starting price is standard for newly approved pharmaceuticals and not evidence of misconduct. Conflating the two weakens your own criticism—and that’s a poor trade-off when the issue involves supplying tens of thousands of people.
What to Watch Next
Three dates will determine how this plays out. First, the benefit assessment by the Joint Federal Committee, whose documents are publicly accessible. Second, the subsequent reimbursement amount negotiation, whose results will also be published. And third, how many physicians actually prescribe the preparation, given that pain medicine specialists have sharply criticized the current regulatory situation.
We’ve requested a statement from Vertanical on price formation. We’ll add their response here as soon as it arrives.
Note: This article reflects the status as of August 2026 and does not constitute medical advice. The €745.40 price figure comes from the German Hemp Association and was not verified by us using the Lauer Taxe. Questions about the suitability of a medication in individual cases should be directed to the treating physician; ongoing therapies should not be altered without medical guidance.
Sources: German Hemp Association announcement from August 27, 2026; Die Welt from August 27, 2026 (paywall); own calculations; Section 130b SGB V; own reporting.
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