Business of Cannabis write
The French medical cannabis market is now in the very final stage of decision-making before being implemented nationally, as the HAS presented its draft for the pricing and reimbursement strategy earlier this week.
Since the launch of its pilot project in 2021, efforts to expand access beyond the 3000 patients the programme saw at its peak have been a slow and often frustrating battle.
Over the last few months, thanks to a more stable political situation and a willing regulator, that pace has shifted gears and nationalisation is now likely just months away.
Yet, as we race towards the finish line, questions are now being raised by industry stakeholders, clinicians and patient communities over whether the system is being built for patients, or for the institutions that govern them?
During yesterday’s Cannabis Europa Paris 2026, this issue dominated the afternoon’s sessions, with panellists ranging from patients-turned-entrepreneurs, US industry leaders, pharmaceutical scientists and vaping specialists all weighing in to provide a forensic analysis.
A good start that was never designed to last
The pilot programme was always considered a precursor to the national framework, but was only ever designed as a proof of concept set to last two years. Over multiple extensions, issues with available products and formats began to surface, and the permanent framework has largely carried these over.
A primary concern was the severely limited product range, primarily oils, which fell short of what a mature market requires. Patients need both slow-release and fast-acting formats, and the absence of the latter is not a minor inconvenience. For conditions requiring rapid onset, like acute cancer pain, PTSD, and severe spasticity, waiting 40 minutes for an oil to take effect is clinically unacceptable.
There is no universally superior format, the panel argued. Each delivers a different pharmacokinetic profile suited to different conditions. For instance, sublingual tablets for chronic pain and neurological conditions, inhalation extracts for acute needs, suppositories for IBD. Clinicians need half-life data, Tmax and Cmax profiles for each format to prescribe appropriately.
Later in the day, Helene Klein, who represented a main pilot programme stakeholder throughout the experimentation, offered a revealing assessment of the delays. The officials responsible were not from the pharmaceutical world and were learning as they went.
Their core ambition, she recalled from a private conversation with a DGS official, was to generate data and become the first country to build a proper evidence base for a reimbursed medical cannabis market. This ambition ultimately shaped the entire market, but also led to the multi-year delays.
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