Europe does not have a single market for digital health. It has twenty-seven of them, each with its own licensing regime, its own rules on remote prescribing, and its own timeline for deciding what counts as medicine and what counts as a smartphone app. For most companies, that patchwork is a cost center. For patients, it can mean the difference between getting care and being turned away. For Dr. jur. Can Ansay, closing that gap has been the foundation of a business.
Ansay founded DrAnsay.com in Hamburg in 2018 with five thousand euros and no outside investors. The platform has since facilitated more than three million online medical treatments and reached over one million patients, and it was recently named Germany’s fastest-growing digital health platform in the Similarweb Digital 100 Ranking. None of that happened because Germany’s regulatory environment was easy. It happened because Ansay, a lawyer by training, treated the regulatory environment as the terrain to be mapped rather than the wall to be avoided.
A Patchwork Instead of a Single Market
The economic case for cross-border e-health in Europe rests on an uncomfortable fact: patient demand for services like telemedicine consultations and medicinal cannabis access has grown faster than any single country’s regulatory apparatus can process. Germany moved early, permitting remote medical consultations in a 2018 legal change that Ansay’s company was positioned to act on within two months. Other markets have moved more slowly, more quickly, or in entirely different directions on questions as basic as who is allowed to prescribe what, remotely, and to whom.
That unevenness is usually described as friction. Ansay’s read on it is closer to an access gap that persists for patients until someone builds the infrastructure to close it. A company that has already built the compliance infrastructure, the physician network, and the patient trust in one heavily regulated market can extend that access to patients in a neighboring market as soon as its rules begin to shift in a similar direction.
Regulation as an Access Gap, Not Just an Obstacle
Germany’s own posture on telemedicine sick notes illustrates the pattern. After early resistance from doctors’ associations and regulators, the country’s statutory health insurers began offering telemedical sick notes themselves, according to reporting on the company’s early years. Whether or not that shift was a direct response to Ansay’s model, the sequence is notable: a service dismissed as reckless became a template the establishment adopted.
The same logic now applies to medicinal cannabis. Germany’s MedCanG framework, in effect since April 2024, formalized a path to legal access that DrAnsay.com’s platform had already been building toward. Ansay has framed the underlying philosophy in plain terms: “Digitalisation, AI, and above all telemedicine could make healthcare significantly better, faster, and more efficient – if we had the courage to truly think big and implement it. It is not knowledge we lack. It is determination.” The next gap he points to is not regulatory but clinical: AI-assisted triage and prevention, where the technology is ready long before the system is willing to use it.
Betting on the Slow Movers
What makes the cross-border case more than admirable is that the pattern is repeatable, and each repetition closes an access gap for patients who could not otherwise get care. Every European market that has not yet updated its telemedicine or medicinal cannabis rules is, in Ansay’s framing, a market where the infrastructure can be built before the regulation catches up to demand. That is a different kind of expansion strategy than most health-tech companies pursue, since it treats slow-moving jurisdictions not as markets to wait out but as markets to enter early, on the theory that the rules will eventually resemble the ones already proven in Germany.
It is a strategy that requires patience most venture-funded companies do not have, and legal fluency most technology companies do not have either. Ansay built DrAnsay.com without any kind of external pressure, which may be precisely why the company has been able to treat Europe’s regulatory patchwork as a map instead of a maze.
The cannabis vertical shows the same expansion logic in miniature. Before Germany’s 2024 reform, patients seeking legal medicinal cannabis faced a mix of stigma, inconsistent physician willingness to prescribe, and a black market that filled the gap the formal system left open. For many of those patients, that gap meant living with untreated symptoms, or turning to sources with no clinical oversight, while the law caught up. DrAnsay.com built a licensed marketplace connecting patients with partner pharmacies while the regulatory picture was still unsettled, so that when the law caught up, the infrastructure to serve the newly legal demand already existed. That sequencing, building ahead of the rule change rather than after it, is the part of the model that is hardest for competitors to copy, because it rewards conviction years before the market does. And it is patients, stranded on the wrong side of an access gap, who feel that head start first.
