The European medical cannabis industry has seen steady growth over the past year and it is projected to reach over €516 million in sales by the end of this year. The UK is set to become the second largest European market over this time, as has been long-predicted by analysts.
A large and increasing diversity of suppliers, from a variety of countries, have presence in the market, with Germany and the UK receiving the overwhelming majority of the new supply. Some progress is being made towards regional regulatory harmonisation, with a monograph on CBD flower products being created at the European level by the European Medicines Agency (EMA).
Despite it being a tough year for European medical cannabis companies financially, market activity at the end of 2022 gave cause for some optimism.
These are medical cannabis markets open to free market competition.
🇩🇪 Germany – High public reimbursement. Currently a large number of suppliers and intense competition. Relationship with key distributors is essential.
🇬🇧 UK – Very little public reimbursement. Access is almost exclusively through private clinics. As with Germany, there are a large number of suppliers and competition is intense. Relationships with distributor and private clinic networks are essential.
🇨🇿 Czech Republic – High public reimbursement. Patient access is limited by a reasonably small pool of prescribing doctors that have to apply to become authorised medical cannabis prescribers. High competition, approximately five current suppliers with recent reports of further suppliers entering the market. Domestic production regulations are currently in transition, which could see a new domestic supply being set up in the coming years.
These are countries which have national medical cannabis pilot programmes which run until a specified end date, beyond which, it is likely medical cannabis access will be widened (if the trial programme is not extended). Products used in these programmes require approval from health authorities, which makes market entry difficult.
🇮🇪 Ireland – Programme runs until July 2026. Less than 100 patients are currently receiving treatment, with growth being slow. Six products have been approved from four producers.
🇫🇷 France – Programme runs until 26 March 2024, approximately 2,200 patients have been treated under the programme over the past two years. Nine products approved from six producers, provided to the programme free of charge by producers. A tender process is currently underway to secure additional supply for the final year of the programme, with producers being paid for products supplied.
🇩🇰 Denmark – Programme runs until 31 December 2025, currently 400-500 patients treated each quarter, with seven products approved from three producers.
🇱🇺 Luxembourg – Original programme ended in 2021, after which came a long review period of its success. A second pilot programme is expected to come into operation in the near future. Patient numbers approximately 1,000 annually. Low number of products, from three suppliers.
TIGHTLY CONTROLLED MARKETS
These are medical cannabis markets which are under tight governmental control. This can take the form of product approval requirements, tenders for supply, government-controlled distribution etc.
🇳🇱 The Netherlands – Market supplied entirely by one domestic producer, under a tightly controlled supply agreement. Govern- ment-controlled distribution. No market entry possible unless negotiated directly with the government. Approximately 13,000 patients annually.
🇮🇹 Italy – Market supplied by tenders, limited domestic production, and supply agreements negotiated by the government. Four producers supply approximately ten products. Market inefficiencies exist, product shortages are common. Approximately 50,000 patients annually.
🇵🇱 Poland – All products must go through an application process which can take two to three years. Currently eleven products are on the market, from six producers. No public reimbursement, treatment is prohibitively expensive for patients. Market inefficiencies exist, product shortages are common. Approximately 20,000 patients annually.
MARKETS IN TRANSITION
These are markets where the regulations around medical cannabis treatment have recently changed significantly, so the market is undergoing a transition.
🇨🇭 Switzerland – A change in regulation in August 2022 has opened the Swiss market to new suppliers, via both imports and the establishment of Swiss-based production. Previously a tightly controlled market, where medical cannabis access was granted based on special authorisation from the health authority. Any doctor can now prescribe medical cannabis at their own discretion. Still no public reimbursement, approximately 4,000 patients treated in 2022.
These are markets where medical cannabis treatment is legal, but patient numbers are extremely low due to the lack of a developed infrastructure for treatment – e.g. lack of prescribing doctors, restrictive conditions for prescribing, incomplete regulatory framework for medical cannabis treatment, lack of available products, lack of awareness of structures and processes for medical cannabis treatment. They include:
🇲🇰 North Macedonia
EXCEPTIONAL ACCESS MARKETS
These are markets where medical cannabis is only accessed under exceptional circumstances. Patients are given authorisation on an individual basis, and products are imported in extremely low quantities on their behalf in:
Find more about the current state of play in the European medical cannabis industry by downloading The European Cannabis Report: 8th Edition. Also available for purchase are market sizing and patient population forecasts (2023-2027) broken down by country.
To access the free-to-download version of The European Cannabis Report: 8th Edition, paid-for market sizing data packages and European Adult-Use Cannabis Report, click here.