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This article was translated using AI-assisted translation tools. Despite careful review, linguistic inaccuracies or deviations in meaning cannot be entirely excluded. The original version of the article shall prevail.
With its judgment of April 23, 2026 (Case No. 37 O 55/25), the Düsseldorf Regional Court issued a decision of significant importance for the telemedicine and pharmacy market. Pharmacies can be held jointly liable for impermissible questionnaire-based prescriptions issued by telemedicine platforms if they are integrated into the platform’s distribution system and dispense the corresponding prescriptions. In the case decided, the platform “Dr. Ansay” was affected in connection with the prescription of medical cannabis.
The judgment is not yet final and binding. Nevertheless, it sends a clear signal not only to pharmacies, but also to telemedicine platforms and the technical design of their services.
What was the case about?
The subject of the proceedings was an injunction claim by the North Rhine Chamber of Pharmacists (AKNR) against a pharmacist. The pharmacist had dispensed prescriptions obtained via the technical infrastructure of “Dr. Ansay” which had apparently been issued solely on the basis of an online questionnaire completed by the consumer—that is, without any personal contact between doctor and patient.
The Court’s legal reasoning
The Düsseldorf Regional Court bases its decision in particular on § 17 para. 8 ApoBetrO (German Pharmacy Operations Ordinance). Under this provision, pharmaceutical staff must counter any recognizable abuse of medicinal products in an appropriate manner and refuse dispensing where there is a reasonable suspicion of abuse.
In the court’s view, it was recognizable to the pharmacy that the model practiced through the platform was prone to abuse. The pharmacy was aware that the prescriptions were regularly issued solely on the basis of an online questionnaire and without any personal contact between patient and physician. Particularly in the area of medical cannabis—which is associated with substantial risks and a potential for abuse—the pharmacy was therefore not permitted to dispense such prescriptions without further scrutiny.
The court formulates this position particularly clearly, following the AKNR:
“The defendant therefore knew that this system regularly results in cases of abuse in which there is no medical indication, or in which the prescription does not comply with the legal requirements and recognized professional standards”.
The consequence of this assessment is far-reaching: in the view of the Düsseldorf Regional Court, a German pharmacy may not participate in such a business model. Anyone who nevertheless dispenses such prescriptions risks consequences under both competition and professional law.
Classification within existing case law
The Düsseldorf Regional Court’s decision does not stand alone. In recent times, courts have already addressed the question of whether a mere online questionnaire is sufficient for prescribing medical cannabis.
The relevant background is in particular § 9 HWG (German Therapeutic Products Advertising Act). Under this provision, advertising for remote treatment is generally impermissible, unless personal contact with a physician is dispensable according to generally recognized professional standards.
Particularly in the treatment with medical cannabis, courts—as well as parts of the government, in light of the planned amendment to the MedCanG—increasingly hold the view that such personal contact is regularly required. This is justified in particular by the potential for dependency, possible side effects, and other health-related risks of cannabis therapy.
In this context, the following decisions in particular should be noted:
- Hamburg Regional Court, judgment of March 11, 2025 – 406 HKO 68/24
- Munich Regional Court, judgment of June 2, 2025 – 4 HK O 11377/24
These decisions, too, are not yet final and binding as of the current date.
What does this mean in practice?
For practice, the decision of the Düsseldorf Regional Court could have considerable implications. Pharmacies will in future have to scrutinize even more carefully the user flow through which prescriptions issued via telemedicine platforms come about. It will no longer be sufficient to rely solely on the formal existence of a prescription where there are simultaneously indications that the underlying business model is unlawful or prone to abuse.
This is particularly relevant for pharmacies that are technically closely linked to telemedicine platforms.
Supervisory authorities are also likely to focus more strongly on this issue. According to a representative of the AKNR, corresponding violations are to be monitored more intensively in the future.
Action required for telemedicine platforms
While the decision is directly directed against a pharmacist, in substance it concerns the entire business model of telemedicine platforms in the field of medical cannabis.
If platforms wish to prevent conflicts with pharmacies, professional chambers, and supervisory authorities, they must carefully review their technical setup. From a legal perspective, much currently suggests that a model based solely on an online questionnaire entails a substantial compliance risk.
To enable pharmacies to integrate in a legally secure manner and at the same time safeguard patient welfare, it is advisable to provide for a video consultation as a mandatory component of the user flow for obtaining a prescription. This applies all the more where there is a contractual relationship between the pharmacy and the platform regarding the provision of the technical infrastructure, since in such cases significant liability risks may also exist on the part of the platform operators vis-à-vis the pharmacy.
Olivia Ewenike, LL.M. (Compliance) | Cannabis, Compliance, Criminal Law
As an attorney focused on Cannabis Regulatory and Compliance, I advise companies along the regulatory requirements of this dynamic market, including in particular telemedicine platforms. Especially in this area, continuous monitoring of case law and legislative developments is essential, as legal requirements are constantly being further specified. This may necessitate adjustments to the operational setup as well as a review and further development of existing contractual relationships. With a forward-looking advisory approach, supported by my many years of experience in compliance and criminal law, I help clients identify regulatory pitfalls and compliance risks at an early stage and establish robust structures for long-term market participation.
