Who Gets Medical Cannabis in Switzerland? A Look at 1,193 Approved Patients | Research

The takeaway

Switzerland's medical cannabis licensing program grew 52% in one year, with most patients treated for chronic pain or spasticity and 91% paying out of pocket.

Read this if you want to understand how a regulated national medical cannabis program works in practice.

1,193 patients approved; 91% paid out of pocket for medical cannabis

What the researchers found

This study analyzed all 1,193 patients approved for medical cannabis through Switzerland's exceptional licensing program in 2013 and 2014.

The program grew rapidly: 542 patients were treated in 2013 compared to 825 in 2014, a 52% increase. Over half (57%) of patients were women, and the average age was 57 years.

Chronic pain (49%) and spasticity (40%) were the two most common symptoms, aligning with the strongest evidence base for medical cannabis. Seventy-eight different diagnoses were recorded, with multiple sclerosis (22%), soft tissue disorders (10%), and back pain (8%) being the most frequent.

Notably, 91% of patients paid for cannabis treatment out of pocket, indicating that insurance coverage had not caught up with medical practice. License extension rates increased from 26.4% in 2013 to 39.3% in 2014, suggesting growing satisfaction or perceived benefit among patients and their physicians.

Substantial regional variation existed in prescription rates, averaging 8 patients per 100,000 residents.

Why it matters

This is one of the few studies providing a comprehensive look at a national medical cannabis licensing program. The data on who receives cannabis, for what conditions, and at what cost provides a real-world picture of medical cannabis beyond clinical trials.

The numbers in context

1,193 patients total. 542 in 2013, 825 in 2014 (52% increase). 57% women. Mean age 57 years. 49% chronic pain, 40% spasticity. 78 different diagnoses. 22% multiple sclerosis. 91% paid out of pocket. 8 per 100,000 residents average.

How the study worked

Retrospective analysis of all requests for medical cannabinoid use approved by the Swiss Federal Office of Public Health in 2013 and 2014. Standardized data extraction captured demographics, diagnoses, indications, license duration, and payment source. Ethics approval from the Canton of Bern.

What this study cannot tell us

Administrative data cannot capture treatment outcomes, side effects, or patient satisfaction. The exceptional licensing framework may underestimate actual medical cannabis use if patients obtained cannabis through other channels. No comparison to non-cannabis treatment outcomes was possible.

How to read the evidence

Cross-sectional analysis of a national program with complete data capture. Moderate because it provides comprehensive descriptive data but no outcome measures.

When this study was published

Published in 2017, covering 2013-2014 data.

The bigger picture

The Swiss program demonstrates what a regulated, physician-mediated medical cannabis system looks like in practice. The predominance of evidence-supported conditions (pain, spasticity) and the involvement of hundreds of requesting physicians suggest the program was functioning as intended, though the out-of-pocket cost burden raises equity concerns.

Questions still open

Did patients who extended their licenses experience measurable improvement? Why does regional variation exist, and is it due to physician attitudes or patient demographics? Has insurance coverage expanded since 2014?

Common questions

What conditions are treated with medical cannabis in Switzerland?

Chronic pain (49%) and spasticity (40%) were the most common conditions. Multiple sclerosis (22%), soft tissue disorders (10%), and back pain (8%) were the leading diagnoses among 78 different conditions represented.

Is medical cannabis covered by insurance in Switzerland?

As of this 2013-2014 data, 91% of patients paid out of pocket for their medical cannabis, indicating very limited insurance coverage despite physician-approved use.

Read the original research

Medical use of cannabis in Switzerland: analysis of approved exceptional licences.

Swiss medical weekly, 147, w14463

View on PubMed ↗Publisher’s paper ↗

Citation

Kilcher, Gablu; Zwahlen, Marcel; Ritter, Christopher; Fenner, Lukas; Egger, Matthias. (2017). Medical use of cannabis in Switzerland: analysis of approved exceptional licences.. Swiss medical weekly, 147, w14463. https://doi.org/10.4414/smw.2017.14463