Denmark has passed legislation to make its medical cannabis pilot program a permanent part of the national healthcare system, which is viewed as a victory for patients. The new law, known as L135, was first proposed in November 2024 and has undergone extensive consultations. Despite this progress, the reimbursement system for medical cannabis remains a significant issue for domestic businesses, leading to calls for reforms before the program’s official launch on January 1, 2026.
The pilot program, active since 2018, has served approximately 1,800 patients and issued around 20,000 prescriptions. However, many stakeholders in the cannabis industry, including Jeppe Krog Rasmussen, CEO of DanCann Pharma, express concerns that the reimbursement policies are inadequate. They argue that the current system is fundamentally flawed and needs to be addressed to ensure effective and functional medical cannabis access for patients.
Thomas Skovlund Schnegelsberg, CEO of Stenocare, criticized the new legislation for replicating the existing pilot program’s framework without major modifications. He pointed out that the government adopted a conservative approach, opting not to address significant issues within the current system. This lack of change is particularly troubling for businesses struggling with an unbalanced reimbursement landscape, where one pharmacy has dominated the market due to favorable government reimbursement rates. This pharmacy, one of only two in Denmark that can produce magistral cannabis preparations, has reportedly made hundreds of millions of Danish Krone over recent years by selling products at significantly marked-up prices.
In 2022, figures submitted by DanCann highlighted a stark contrast in reimbursement rates: approximately 85% of the costs for magistral THC products were covered by subsidies, while only 37% of costs for cannabis under the pilot program received reimbursement. Over a four-year period, magistral products benefited from over DKK 93 million in public subsidies, compared to just DKK 17 million for pilot scheme products. This disparity has incentivized patients to choose the more expensive magistral options, which are often 6-7 times pricier than those available under the pilot scheme.
The approval process for magistral products is considerably quicker than for those under the pilot program, allowing pharmacies to manufacture new products within a week, while companies in the pilot scheme face lengthy and costly development timelines. Schnegelsberg noted that the majority of the medical cannabis market in Denmark is being captured by this single pharmacy, which has taken around 50% of the estimated total annual sales of DKK 60 million (approximately £6.8 million).
As the law stands, it does not clarify how many products can be approved at one time, which limits companies’ capacity to expand their offerings despite government calls for enhanced market competition. Additionally, there are no clear guidelines for patients regarding driving under medical cannabis treatment, nor is there sufficient medical education for doctors.
Despite these challenges, industry leaders remain optimistic about the potential for reforms. The final version of L135 grants the Ministry of Health and the Danish Medicines Agency the authority to implement necessary changes. Stakeholders hope that the input from the public consultation will influence adjustments to address these ongoing imbalances before the program officially transitions to its permanent status.
Both Rasmussen and Schnegelsberg agree that while the current framework contains significant flaws, the establishment of a permanent medical cannabis law is a vital step forward for the thousands of patients in Denmark who rely on cannabis treatment.
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