Key highlights
- 1The Europe medical cannabis market is expected to reach USD 22 billion by 2036, at a CAGR of 18.0% from 2026 to 2036.
- 2Germany is the largest market, followed by the United Kingdom, Poland, Italy, and the Czech Republic.
- 3Dried flower is the largest product form, followed by extracts and oils, with chronic pain the leading indication.
- 4Germany reclassified cannabis as a non-narcotic through the Cannabis Act (CanG) on 1 April 2024, allowing standard prescription and e-prescription.
- 5German medical cannabis imports rose from 32.5 tonnes in 2023 to 72.9 tonnes in 2024 and 201 tonnes in 2025.
- 6German medical cannabis prescriptions increased by over 3,300% by December 2025 compared with March 2024, and sales reached about EUR 2 billion in 2025.
- 7France moved its medical cannabis programme from pilot to a permanent framework on 1 April 2026.
- 8A proposed German amendment to restrict telemedicine prescriptions and mail-order supply passed a first reading in December 2025 but is not yet in force.
- 9Key producers include Tilray Brands, Inc., Aurora Cannabis Inc., Bedrocan International B.V., Cantourage Group SE, and Demecan GmbH.
Report Overview
The Europe medical cannabis market covers cannabis and cannabis-derived products prescribed for medical use, including dried flower, extracts, oils, tinctures, capsules, and finished cannabis medicines, supplied through pharmacies and other channels under national regulation. The market changed substantially after Germany reclassified cannabis as a non-narcotic in April 2024, which allowed doctors to prescribe medical cannabis as a standard prescription medicine and introduced electronic prescriptions. This increased prescriptions, imports, and sales in Germany, the largest market in Europe, and other countries, including the United Kingdom, Poland, Italy, the Czech Republic, and, from April 2026, France, have expanded access. Most product is imported, with production concentrated in the Netherlands, Denmark, Portugal, Spain, and North Macedonia. This report examines the market's size, drivers, segmentation, geography, pricing, competition, recent developments, and outlook, and provides recommendations for participants.
Market dynamics
Drivers
- 01Germany's reclassification of cannabis as a non-narcotic in April 2024 removed the narcotic-handling requirements that had limited prescribing, allowed standard and electronic prescriptions, and led to a large increase in prescriptions and imports, with German imports reaching 201 tonnes in 2025 and prescriptions rising by over 3,300% by December 2025 compared with March 2024.
- 02Wider physician willingness to prescribe greater patient awareness, and the growth of pharmacies and telemedicine platforms that connect patients to prescribers have supported this growth.
- 03Broader access in other countries and the move of France to a permanent framework in April 2026, add further demand.
Opportunities
- 01Because most product is imported there is an opportunity to expand European Union Good Manufacturing Practice (EU-GMP) cultivation and manufacturing within Europe to reduce reliance on imports and shorten supply chains, with production growing in Denmark, Portugal, Spain, and North Macedonia.
- 02New and expanding country markets including France's permanent programme from April 2026, Poland, the Czech Republic, and the United Kingdom's private-clinic channel, offer routes for growth.
- 03Extract and finished-product manufacturing concentrated in Germany and the United Kingdom, offers higher-value activity than flower distribution.
Trends
- 01As supply has increased prices have fallen, and lower-cost, high-tetrahydrocannabinol (THC) flower accounts for a large share of German demand.
- 02Access is increasingly organised through telemedicine platforms and online pharmacies, which connect patients to prescribers and dispense by mail.
- 03In response to the rapid growth and the pattern of prescribing German authorities have proposed restricting telemedicine prescriptions and mail-order supply, a measure that passed a first parliamentary reading in December 2025 but is not yet in force.
- 04Supply is also diversifying with product sourced from the Netherlands, Denmark, Portugal, Spain, North Macedonia, and outside Europe.
Report Summary
| Base Year | 2025 |
|---|---|
| Forecast Period | 2026-2036 |
| Market Size (2025) | USD 3.5 billion |
| Market Size (2026) | USD 4.2 billion |
| Market Size (2036) | USD 22 billion |
| CAGR (Value) | 18.0% (2026-2036) |
| Segments Covered | By Product Type (Dried Flower; Extracts, Oils & Tinctures; Capsules & Softgels; Finished Cannabis Medicines; Other Formulations); By Indication (Chronic Pain, Neurological Disorders, Cancer & Palliative Care, Mental Health & Sleep Disorders, Other Indications); By Distribution Channel (Retail Pharmacies, Online Pharmacies & Telemedicine, Hospital Pharmacies) |
| Countries Covered | Germany, United Kingdom, Poland, Italy, Czech Republic, Netherlands, Denmark, Portugal, Spain, France, and Rest of Europe |
| Key Producers | Tilray Brands, Inc., Aurora Cannabis Inc., Bedrocan International B.V., Cantourage Group SE, Demecan GmbH, Vertanical GmbH, Curaleaf International, Little Green Pharma Ltd, Organigram Global Inc., Jazz Pharmaceuticals plc |
Segmental analysis
By Product Type
- Dried flower taken by vaporization, accounts for the largest share, particularly in Germany, where high-THC flower drives much of the volume.
- Extracts oils, and tinctures, taken orally, are a large and established category used across indications.
- Capsules and softgels provide standardized oral dosing.
- Finished cannabis medicines including nabiximols (an oral spray for multiple sclerosis spasticity) and cannabidiol (CBD) medicines for certain epilepsies, are licensed pharmaceutical products used for specific indications.
- Other formulations including vaporizable products and topicals, complete the range.
Dried flower leads by volume, while extracts, oils, and finished medicines account for significant shares.
By Indication
- Chronic pain including neuropathic pain, accounts for the largest share of prescriptions.
- Neurological disorders including multiple sclerosis spasticity and certain epilepsies, are established indications, with licensed medicines available for some conditions.
- Cancer and palliative care use cannabis for nausea appetite, and pain.
- Mental health and sleep disorders including anxiety, post-traumatic stress, and insomnia, account for a growing share of prescribing.
- Other indications complete the range.
Chronic pain leads the market, while neurological, oncology, and mental-health indications account for significant demand.
By Distribution Channel
- Retail pharmacies dispense medical cannabis on prescription and account for a large share.
- Online pharmacies and telemedicine platforms which connect patients to prescribers and dispense by mail, account for a growing share, particularly in Germany following the introduction of electronic prescriptions, and are the focus of proposed regulatory restrictions.
- Hospital pharmacies supply cannabis for inpatient and specialist care.
Retail and online pharmacies account for most dispensing, and the balance between them is a central issue in current regulatory review.
Geographic analysis
Germany Medical Cannabis Market
Germany is the largest medical cannabis market in Europe. The reclassification of cannabis as a non-narcotic through the Cannabis Act in April 2024 removed narcotic-handling requirements, allowed standard and electronic prescriptions, and led to a large increase in access. German medical cannabis imports rose from 32.5 tonnes in 2023 to 72.9 tonnes in 2024 and 201 tonnes in 2025 , prescriptions increased by over 3,300% by December 2025 compared with March 2024, and sales reached about EUR 2 billion in 2025 . Germany is both the largest market and a centre for extract manufacturing and distribution. Its regulatory change, scale, and infrastructure make it the leading market in Europe.
United Kingdom Medical Cannabis Market
The United Kingdom is the second-largest market served mainly through private clinics. Medical cannabis has been legal in the United Kingdom since 2018, but access through the National Health Service is limited, and most prescriptions are issued through private clinics. The country reported record medical cannabis imports for 2025, and it is a centre for extract manufacturing. The large private-clinic channel and manufacturing base make the United Kingdom the second-largest market in Europe, though access through the public health system remains limited.
Poland and Czech Republic Medical Cannabis Market
Poland and the Czech Republic are significant and growing markets. Poland has become one of the larger importers of medical cannabis in Europe, with a growing patient base and pharmacy access. The Czech Republic has allowed medical cannabis since 2013 and expanded its rules in 2026, and has a growing patient base. Both countries combine growing demand with functioning pharmacy channels. Poland and the Czech Republic, with their growing patient numbers and pharmacy access, are significant and expanding markets in Central Europe.
Italy and Netherlands Medical Cannabis Market
Italy and the Netherlands are established markets with distinct systems. Italy has a medical cannabis programme supplied by both domestic production, including state-linked production, and imports, serving a range of indications. The Netherlands operates a long-established programme through its Office of Medicinal Cannabis, supplied by a licensed domestic producer, and is also a production and export base. Both countries have established regulatory systems and patient access. Italy and the Netherlands, with their established programmes and, in the Netherlands, domestic production, are important markets.
Portugal, Spain, and Rest of Europe Medical Cannabis Market
Portugal Spain, and other European countries are important for production and for growing access. Portugal and Spain are major EU-GMP cultivation and export bases, supplying product across Europe, though domestic patient access in Spain is limited. France moved its medical cannabis programme from a pilot to a permanent framework in April 2026 , opening a new national market. Other countries, including Denmark, a production base, and additional markets, contribute to production and demand. Portugal, Spain, France, and the rest of Europe, as production bases and expanding markets, account for a growing part of the market.
Pricing Analysis
Medical cannabis prices in Europe are shaped by supply, competition, sourcing, and reimbursement. As supply has increased, particularly of imported flower, competition has pushed prices down, and lower-cost, high-THC flower accounts for a large share of demand in Germany. Sourcing affects cost, as most product is imported from the Netherlands, Denmark, Portugal, Spain, North Macedonia, and outside Europe, with domestic European cultivation generally more expensive than lower-cost international supply. Quality and compliance costs, including EU-GMP cultivation, testing, and pharmacy handling, add to price, as do currency and logistics. Reimbursement varies: in Germany, most patients pay out of pocket, while statutory insurance covers cannabis only with prior approval for specific cases, so patient cost is a factor in demand, which supports lower-priced products. Telemedicine and online-pharmacy channels also influence pricing through competition.
Overall, prices have fallen as supply has grown, and the market has shifted toward lower-cost, high-strength products.
Competitive landscape
The Europe medical cannabis market includes cultivators, extract and finished-product manufacturers, importers and distributors, and pharmacies. Competition centers on producers that cultivate and manufacture medical cannabis, importers and distributors that supply pharmacies, and platforms that connect patients to prescribers and dispensing. Producers compete on product quality and consistency, EU-GMP compliance, product range, price, and reliability of supply, while distributors and platforms compete on access, service, and price. As prices have fallen, scale and cost efficiency have become more important, and the market has seen consolidation as larger companies acquire smaller operators.
Producers and distributors active in the market include Tilray Brands, Inc., which supplies medical cannabis into the German pharmacy channel under the Tilray and Aphria ranges, Aurora Cannabis Inc., which operates a facility in Leuna, Germany, Bedrocan International B.V. in the Netherlands, and German companies including Cantourage Group SE, Demecan GmbH, which holds a German cultivation licence, and Vertanical GmbH. Curaleaf International, Little Green Pharma Ltd, Organigram Global Inc., which acquired Sanity Group in 2026, and Jazz Pharmaceuticals plc, which supplies licensed cannabis medicines, are also active. These companies compete on quality, compliance, cost, and supply as the market consolidates.
Voice of Customer
Primary interviews conducted for this study noted that eased regulation increased prescribing, that price and access shape demand, and that regulatory review creates uncertainty. Three representative perspectives are summarized below.
"After the reclassification, prescribing became a normal part of practice rather than a bureaucratic exception, and patient interest rose quickly. The open question is how the proposed rules on remote prescribing will change access." — Physician, pain clinic
"Patients are price-sensitive because most pay out of pocket, so demand has moved toward lower-cost flower. Reliable supply and consistent quality are what keep patients on treatment." — Pharmacist, dispensing pharmacy
"The German change created the largest market in Europe almost overnight, but falling prices mean only efficient, compliant suppliers will remain. That is driving consolidation." — Executive, medical cannabis producer
Analyst perspective
In our assessment, the Europe medical cannabis market is defined by Germany's April 2024 reclassification, which turned a small, tightly controlled market into the largest in Europe within about two years. The change was regulatory rather than clinical: by removing narcotic-handling requirements and allowing standard and electronic prescriptions, Germany made prescribing straightforward, and imports, prescriptions, and sales rose sharply, with imports reaching 201 tonnes and sales about EUR 2 billion in 2025. Two features stand out. First, most demand is met by imported, lower-cost, high-THC flower dispensed increasingly through telemedicine and online pharmacies, which has drawn regulatory attention and a proposed, but not yet enacted, restriction on remote prescribing and mail-order supply; this is the main uncertainty for the German market. Second, growth is broadening beyond Germany, with the United Kingdom's private-clinic channel, growing markets in Poland and the Czech Republic, and France's move to a permanent framework in April 2026 opening new demand. On supply, production is concentrated in a few countries, and falling prices are pushing consolidation among producers and distributors. We expect continued growth over the forecast period, though at a slower rate than the initial German surge, and we see the outcome of the German regulatory review as the main factor that could change the trajectory.
Key Strategic Developments
- February 2026 — Germany, Organigram Global acquires Sanity Group: the Canadian producer Organigram Global acquired the German company Sanity Group. Impact: adds to consolidation in the German market and expands an international producer's presence.
- Q1 2026 — Germany, imports exceed 50 tonnes: Germany imported more than 50 tonnes of medical cannabis in the first quarter of 2026, following 201 tonnes in 2025. Impact: shows continued growth, though at a slower rate than the initial post-reclassification surge.
- April 2026 — France, permanent medical cannabis framework: France moved its medical cannabis programme from a pilot to a permanent national framework, without authorising telemedicine prescribing. Impact: opens a new national market and adds demand in Europe.
- June 2026 — Germany and United Kingdom, record 2025 imports: Germany and the United Kingdom reported record medical cannabis imports for 2025, with Germany at 201 tonnes. Impact: confirms both as the two largest markets in Europe.
- 2026 — Germany, proposed telemedicine and mail-order restriction: a proposed amendment to restrict purely remote prescribing and mail-order supply of cannabis flower, which passed a first parliamentary reading in December 2025, remained under debate in 2026 and was not in force. Impact: creates regulatory uncertainty for the telemedicine and online-pharmacy channel that drives much of German demand.
Strategic Recommendations
- Prioritize Germany while planning for regulatory change. Germany is the largest market, but participants should plan for the possible restriction of telemedicine and mail-order supply and avoid over-reliance on the remote-prescribing channel.
- Compete on cost and reliable supply. As prices fall, focus on cost efficiency, EU-GMP compliance, and consistent supply, which determine which producers and distributors remain viable.
- Expand into new and growing markets. Build positions in France following its April 2026 permanent framework, and in Poland, the Czech Republic, and the United Kingdom's private-clinic channel, to diversify beyond Germany.
- Develop European production capacity. Because most product is imported, invest in EU-GMP cultivation and manufacturing in Europe, including in Portugal, Spain, Denmark, and North Macedonia, to shorten supply chains and reduce cost.
- Focus on quality and compliance. As regulators review the market, maintain high standards of quality, testing, and compliance, which support access and reduce regulatory risk.
- Prepare for consolidation. With falling prices and many sub-scale operators, participants should plan for further mergers and acquisitions, either as consolidators or as acquisition targets.
Sustainability impact
Improving Patient Access to Treatment
Eased regulation and expanded supply have increased patient access to medical cannabis for conditions such as chronic pain, with German prescriptions rising by over 3,300% by December 2025. Wider access allows more patients to obtain prescribed treatment.
By improving access to prescribed medical cannabis for patients who may benefit, the market supports patient care and treatment options, an important social outcome of regulatory change.
Building Regulated, Quality-Controlled Supply
The growth of EU-GMP cultivation and manufacturing supports a regulated, quality-controlled supply of medical cannabis, in place of unregulated sources. Regulated production applies pharmaceutical-standard quality and testing.
By building a regulated, quality-controlled supply chain, the market supports patient safety and product consistency, an important part of responsible provision of medical cannabis.
Supporting Responsible Prescribing and Oversight
Regulatory review, including proposed restrictions on remote prescribing, reflects efforts to ensure that prescribing remains clinically appropriate as access expands. Oversight aims to balance access with appropriate medical control.
By supporting responsible prescribing and regulatory oversight, the market and regulators work to ensure that expanded access is matched by appropriate clinical control, an important element of sustainable provision.
Reducing Cross-Border and Supply-Chain Impact
Expanding European production reduces reliance on long-distance imports, shortening supply chains and the associated transport and logistics. Local EU-GMP production can supply nearby markets.
By developing European production capacity, the market can reduce the distance product travels and the associated logistics, supporting a more efficient and local supply chain.
Table of contents
15 chapters · 185 pages · click to expandFrequently asked questions
The Europe medical cannabis market was valued at USD 3.5 billion in 2025 and is projected to reach USD 22 billion by 2036, at a CAGR of 18.0% from 2026 to 2036, supported by eased regulation led by Germany, expanded access across countries, and growing prescribing.