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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 harmonization, 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 optimism.
Medical Cannabis Markets in maturity
There are several medical cannabis markets open to free market competition, such as;
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 authorized 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.
Countries with pilot programs
These are countries which have national medical cannabis pilot programs which run until a specified end date, beyond which, it is likely medical cannabis access will be widened (if the trial program is not extended). Products used in these programs require approval from health authorities, which makes market entry difficult.
Ireland: Program 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: Program runs until 26 March 2024, approximately 2,200 patients have been treated under the program over the past two years. Nine products approved from six producers, provided to the program free of charge by producers. A tender process is currently underway to secure additional supply for the final year of the program, with producers being paid for products supplied.
Denmark: Program runs until 31 December 2025, currently 400-500 patients treated each quarter, with seven products approved from three producers.
Luxembourg: Original program ended in 2021, after which came a long review period of its success. A second pilot program is expected to come into operation in the near future. Patient numbers approximately 1,000 annually. Low number of products, from three suppliers.
Markets with controlled access to medical cannabis products
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. Government-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.
Export oriented markets
These are markets where the regulations permit the medical cannabis cultivation, production and distribution.
Greece is among them, according to the Greek law medical cannabis products are characterized by the Greek law those products that are produced from cannabis plant that have more than 0,2 % THC concentration.
All products that have lower THC belong to the CBD category.
Greece is a member of EU, therefore Greek products can be exported to other EU member countries. The Greek legislation permits also the domestic sale to hospitals and to pharmacies.
The licensing procedure is still active, so the Greek state could receive new applications for new license.
source: prohibitionpartners.com
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