Contents
Market Overview
Luxembourg established its medical cannabis framework on 20 July 2018, with the national programme becoming operational in February 2019. The system remains tightly regulated, with medical cannabis accessible only through trained physicians and hospital pharmacies.
Under current legislation, only doctors licensed in Luxembourg who have completed specific training are permitted to prescribe medical cannabis. Prescriptions are limited to patients suffering from defined, severe medical conditions, and all treatments are dispensed exclusively through hospital pharmacies under public health insurance coverage.
As of 1 January 2025, the government removed high-THC flower products from the list of prescribable options. Patients may now access only balanced or high-CBD flower and oil-based extracts (high-THC, balanced, and high-CBD formulations). This change reflects the government’s long-term objective to phase out all flower-based treatments in favour of standardised extract products.
In January 2025, Tilray Deutschland GmbH was awarded the official government tender to supply up to 100 kilograms of medical cannabis flower, marking a continuation of Luxembourg’s strategy of centralised procurement through competitive tendering.
Regulatory Framework
Luxembourg’s medical cannabis legislation was introduced through amendments to the Social Security Code (Article 19b[1]), which defined eligible patient populations and prescribing conditions. The framework is supervised by the Ministry of Health, with oversight of product authorisations, physician training, and supply logistics.
Key features include:
- Prescribing restricted to qualified physicians trained in medical cannabis use.
- Dispensing exclusively through hospital pharmacies, ensuring traceability and dosage control.
- Full public reimbursement under the national health insurance system (Caisse Nationale de Santé, CNS).
- Centralised import and distribution model, managed through government tender agreements.
The 2025 update to remove high-THC flower aligns with Luxembourg’s policy goal of promoting pharmaceutical-grade extract treatments and discouraging combustible cannabis use within the healthcare system.oice.ed by the European Medicines Agency, such as Sativex, which remains available under a restricted prescription pathway.
Patient Access
Who Can Prescribe?
Only licensed physicians in Luxembourg who have completed certified training are authorised to prescribe medical cannabis.
Eligible Conditions:
Medical cannabis may be prescribed for:
- Serious chronic diseases (long-term illnesses as defined under Article 19b[1] of the Social Security Code) in advanced or terminal stages resulting in severe chronic pain, after failure of conventional therapies.
- Nausea and vomiting induced by chemotherapy.
- Symptomatic muscle spasticity associated with multiple sclerosis (MS).
Dispensing and Reimbursement:
All medical cannabis is dispensed via hospital pharmacies and is fully covered under public health insurance. Prescriptions are issued electronically, with treatment monitoring conducted through hospital networks.ad patient access, though reimbursement and bureaucratic complexity often limit uptake.
Products & Supply
Following the 2025 regulatory update, the Luxembourg medical cannabis market includes:
- Balanced and high-CBD flower (low-THC formulations)
- Cannabis oil extracts in high-THC, balanced, and high-CBD variants
The removal of high-THC flower significantly narrows patient options and may reduce total prescription volumes in 2025.
The government’s tender for 2025 was awarded to Tilray Deutschland GmbH, which will supply up to 100 kilograms of cannabis flower tops for the national programme. Tilray’s consistent participation highlights the cross-border dependence of Luxembourg’s medical cannabis system on established European suppliers.
Industry Landscape
Luxembourg’s medical cannabis market remains small but tightly managed, with around 1,100 registered patients as of early 2025. The system’s centralised structure and limited list of eligible conditions have resulted in stable but low growth since its inception.
The shift away from flower products toward extracts mirrors broader European trends favouring pharmaceutical consistency and dose standardisation, though it may further constrain patient choice and clinical flexibility.
Luxembourg’s programme continues to rely on imports rather than domestic production, with Germany and Canada serving as primary supply origins.
Outlook
Luxembourg’s medical cannabis framework remains one of Europe’s most conservative and controlled, offering secure access for a small, defined patient base. The government’s policy direction indicates an intention to transform the programme into a fully extract-based model within the next two years, reducing reliance on flower altogether.
While patient numbers are unlikely to expand significantly under the current system, Luxembourg’s structured model provides a stable regulatory template—prioritising pharmaceutical oversight, patient safety, and controlled distribution.
