A judgment from the Düsseldorf Regional Court places operators of online platforms for medicinal cannabis in a new legal light. The judges ordered a mail-order pharmacy to cease operations and declared it an accomplice liable for the advertising of the platform operator it worked with. For the rapidly growing telemedicine industry, this is a warning signal, though legal experts assess the ruling’s scope differently.
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What the Düsseldorf Regional Court Decided
The judgment is dated April 23, 2026, and bears the case number 37 O 55/25. The lawsuit was filed by the North Rhine Pharmacy Chamber against a pharmacist who distributed medicinal cannabis through his mail-order pharmacy. The business model followed an increasingly common pattern. Patients filled out an online questionnaire on an internet platform, selected disease indications and specific cannabis strains, and subsequently received a prescription forwarded to the pharmacy. The pharmacy provided the platform with its inventory data in return.
The court identified three violations. First, the presentation violated the prohibition on direct-to-consumer advertising for prescription medications under Section 10(1) of the Advertising of Medicinal Products Act. Second, the pharmacist was liable as an accomplice for the platform operator’s advertising representations. Third, the model violated the obligation under Section 17(8) of the Pharmacy Operations Ordinance to prevent recognizable medication misuse.
Why the Pharmacy Is Liable as an Accomplice
The core of the decision is accomplice liability. The court justified this by stating that the pharmacist knew of the possible illegality of the advertising from prior cease-and-desist notices. Although he repeatedly asked the platform operator to stop the representations, he continued the business relationship unchanged. From this knowledge and the conscious continuation, the judges derived independent responsibility. Thus, the Regional Court transferred principles that the Federal Court of Justice developed regarding advertising prohibitions to the cooperating pharmacist. How this reasoning developed is shown in our report explaining that medicinal cannabis remains legally a pharmaceutical product and the advertising prohibition remains unchanged.
Legal expert Christoph Graeber, who analyzed the ruling, considers this transfer contestable. European legal clarification is still pending, and the extension of Federal Court of Justice principles to the cooperating pharmacist represents an independent legal assessment by the Regional Court that is not necessarily binding. An appeal proceeding could reopen the question. Furthermore, no documented case exists where a pharmacy lost its operating license due to such a model.
What the Ruling Means for Telemedicine and Mail-Order Distribution
For platform operators, the ruling draws a clearer boundary. Advertising representations with medical indications violate the Advertising of Medicinal Products Act. Factual information without advertising character continues to move within a gray area that is difficult to determine on a case-by-case basis. Political pressure on the industry is growing in any case, as evidenced by the fact that cannabis telemedicine must anticipate stricter regulations for online prescriptions. The reform of the Medicinal Cannabis Act also touches on precisely this question, as our analysis of the dispute over the MedCanG and the threatened setback in patient care demonstrates.
Physicians should ensure that their final medical decision is documented and that telemedicine standards under Section 7(4) of the Model Professional Regulations for Physicians are observed. For pharmacies, experts recommend not panicking but rather reviewing their own compliance and closely monitoring the pending European legal clarification. The conversation with legal expert Olivia Ewenike about open questions in telemedicine and cultivation associations also describes what expectations the industry has for a reliable legal framework.
Noteworthy is the location of the proceedings. Düsseldorf has set precedents in cannabis jurisprudence several times, for example when a court declared the sales ban for certain CBD products unlawful. At the same time, the case shows how important well-founded education remains. That structured continuing education has an impact is demonstrated by offerings such as the workshops for pharmacies as part of Cannovum Medical Education. Those who know the rules can design models that withstand judicial scrutiny.
Frequently Asked Questions
Which court decided and what was the case about?
The Düsseldorf Regional Court ruled on April 23, 2026, under case number 37 O 55/25. It concerned a mail-order pharmacy that distributed medicinal cannabis through an online platform with questionnaires and strain selection. The court ordered the pharmacist to cease the operations.
What does accomplice liability mean in this case?
The pharmacist is liable because he knew of the platform’s potentially unlawful advertising and continued the collaboration despite cease-and-desist notices. From this conscious participation, the court derived independent responsibility for the advertising representations.
Is advertising for medicinal cannabis fundamentally prohibited?
Direct-to-consumer advertising for prescription medications is prohibited under Section 10 of the Advertising of Medicinal Products Act. This also affects advertising representations with medical indications. Purely factual information without advertising character remains in a difficult-to-distinguish gray area.
Should patients fear for their supply now?
No, the ruling targets a specific advertising and distribution model, not telemedicine itself. To date, no pharmacy has lost its operating license for this reason. Supply with physician-prescribed medicinal cannabis remains possible.
Is the decision final?
Not necessarily. Legal experts consider the transfer of Federal Court of Justice principles to the cooperating pharmacist contestable, and European legal clarification is still pending. An appeal proceeding could reassess individual points.
Source: Krautinvest, analysis by Christoph Graeber of the Düsseldorf Regional Court ruling from April 23, 2026, case number 37 O 55/25 (North Rhine Pharmacy Chamber v. Mail-Order Pharmacy).
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