Denmark’s pilot medical cannabis program - which began in January 2018 - offers more product access and options, as well as better reimbursement opportunities, than several other countries' well-established medical programs. While the federal government continues to oppose full legalization of recreational cannabis use, the country’s patient-oriented medical program and clear regulatory environment demonstrate that Denmark is taking medical legalization and access seriously. With domestic production set to truly ramp up in 2021 and in turn more products being approved for prescription by the Danish Medicines Agency – opening up a bottleneck that has thus far limited pilot program patient access, the country will be among the most promising in terms of long-term, sustainable growth prospects, though total domestic market size will be limited by the country’s small population of <6 million.

Medical cannabis is legal in Denmark with a prescription from a doctor, and products are dispensed to patients via pharmacy. There are four ways to obtain legal medical cannabis in Denmark: authorized medicines, compassionate use permits, magistral preparations, and products permitted through the medicinal cannabis pilot program.

• Authorized medicines

Authorized pharmaceuticals can only be prescribed by specialists for a defined set of conditions. Today, Sativex and Epidyolex are the only products that fall within this category and may only be prescribed by neurologists to treat patients with multiple sclerosis.

• Compassionate use permits

The compassionate use exception allows doctors to apply for a permit to import cannabis medicines that are not otherwise authorized or sold in Denmark, including Marinol and nabilone capsules.

• Magistral preparations

According to the Danish Medicines Act, a doctor can write a prescription for magistral preparations using isolated cannabinoids (pure THC and/or CBD) in the form of oils or capsules. The doctors create a “recipe” for each individual patient, defining contents and dosage, and pharmacists around the country may prepare the prescribed product.

• Medicinal cannabis pilot program

Per the Medicinal Cannabis Pilot Program Act, doctors can prescribe authorized types of cannabis products for medicinal use, to be dispensed to participating patients. Flower and extracts, such as capsules, can be accessed through the pilot program. A financial supplement program for the trial period took effect on January 1, 2019 reimbursing terminally ill patients at 100%, and covering 50% of medical cannabis spending for all other patients, up to an annual reimbursement of DKK 10,000 (~$1,600 USD). Companies looking to have their products included in the pilot program must apply to participate by submitting to the Danish Medicine Agency for review.

Danish medical cannabis patients are distributed as follows:

Once additional product formats become available through the country’s pilot program, expected in 2021 as a result of domestic production to the high standards required by the Danish Medicines Agency, and physician visits and new patient enrollment resurge as COVID-19 dies down, the program’s relatively stagnant growth is expected to pick back up and drive the majority of new patient enrollment.

Medical Market Producers & Manufacturers

Various companies – both local and foreign (via local subsidiaries or partnerships) – are authorized as cannabis producers and/or bulk manufacturers in Denmark, meaning they may grow and process cannabis to fuel the Danish medical market or for export. Nearly 60 permits of this nature have been granted as of late-2020, though the vast majority (44) allow for "cultivation and handling" while only seven are permitted to perform "bulk manufacturing", and eight "intermediate product manufacturing" (importing raw materials and processing them in Denmark):

Authorized Bulk Manufacturers

• • Vertanical Denmark ApS
  • Movianto Nordic ApS
  • Sterigenics Denmark A/S
  • Schroll Medical ApS
  • Canopy Growth Denmark ApS
  • Aurora Nordic Cannabis A/S
  • Medican A/S

Authorized Intermediate Product Manufacturers

• • Scanleaf ApS
  • Movianto Nordic ApS
  • Sterigenics Denmark A/S
  • Schroll Medical ApS
  • Aurora Nordic Cannabis A/S
  • Canopy Growth Denmark ApS. Authorization for producing cannabis intermediate products from cannabis grown in Denmark
  • STENOCARE A/S
  • CannGros ApS

Full list of authorized producers and manufacturers available here.

Pilot Program Producers

Currently, two companies have products available for purchase through the medical cannabis pilot program: CannGros and Aurora Cannabis.

• Aurora's local subsidiary, Aurora Nordic, has received authorization to sell the only softgel available on the market: Sedamen. Aurora Nordic 1 is the company's first cultivation facility in the country, a 100,000 square-foot retrofit greenhouse which has the ability to product 8,000 kilograms of cannabis annually. Aurora Nordic 2, a massive 1-million square-foot greenhouse designed to produce over 120,000 kilograms per year, had construction halted in late 2019 to cut down on company expenditures. Aurora announced in June 2020 that it would “immediately ramp up cannabis production at its Nordic 1 facility in Europe, from which it believes it can adequately service the European market with EU-GMP certified product.”
• CannGros is a Danish company that imports raw cannabis products from Dutch cultivator Bedrocan and sells items for medical use. CannGros has the largest number of products available in the pilot program, all of which are in dry flower format. Three varieties of Bedrocan flower (Bedica, Bediol and Bedrocan) are available through CannGros.

Stenocare, a Danish company founded in 2017, cultivates, imports, produces, and sells prescription-based medical cannabis. Stenocare was the third company to sell products into the pilot program, but they were taken off the market in 2019 after the company's Canadian supplier, CannTrust, was caught utilizing illegal grow rooms. Stenocare has since partnered with Panaxia Pharmaceuticals Industries (Israel) and is planning to bring their products back to the Danish market in the future.

Pharmaceuticals

In addition to these pilot products, GW Pharmaceuticals has marketing authorization for its cannabis pharmaceutical products Sativex (which is distributed by Almirall in Denmark) and Epidyolex. Marinol and nabilone can be imported with an exception from the government.

Patients can visit any doctor for a prescription for medical cannabis and fill their prescription at their local pharmacy. All magistral preparations must be prepared in a pharmacy according to the dosage and instructions detailed in a patient’s prescription.