For UK prescribers, distributors and policy-watchers: the European medical cannabis landscape in 2026 looks materially different from the picture in 2020. This brief summarises where the largest European markets stand, what has changed in the last 18 months, and what it implies for UK supply, demand and clinical practice. It is a regulatory overview written for an HCP and B2B audience.
Why Europe matters to a UK clinic
Most cannabis-based products for medicinal use (CBPMs) dispensed in the UK originate from a small number of European producers and a handful of non-European manufacturers exporting into Europe. Continental regulatory shifts therefore feed straight into UK clinic shelves through three channels: which manufacturers can produce, which countries permit export, and which destination markets pull volume away from UK availability. A clinic that ignores European policy is a clinic operating on a one-quarter horizon at best.
Germany: the CanG aftermath and the 2026 corrections
Germany’s Cannabis Act (CanG) came into force on 1 April 2024. The Act decriminalised limited personal possession and cultivation for adults and, critically for medical supply, was accompanied by the rescheduling of medical cannabis out of the German Narcotics Act (BtMG) into the Medicinal Cannabis Act (MedCanG). The administrative effect was significant: prescribing was simplified, telemedicine flourished, and import volumes rose sharply.
The market response has surprised regulators. Imports in 2024 substantially exceeded historic levels. Most growth came not from statutory health insurance reimbursement but from privately paid prescriptions, often initiated via telemedicine platforms. By late 2025, the federal government was consulting on amendments to tighten the framework — in particular, a requirement for in-person consultation before initiation, annual in-person review for continued prescribing, and restrictions on shipping. A Bundestag vote on the amendment was expected in early 2026.
For UK stakeholders, three implications matter:
- Germany remains by some distance the largest demand source in the European medical cannabis system; UK supply is influenced by anything that shifts German pull.
- Tightening of German prescribing rules in 2026 may free supply for other European destinations, including the UK.
- Conversely, a slowdown in German import volumes could pressure manufacturers’ overall European pricing strategies.
Netherlands: Bedrocan, the OMC, and a policy in transition
The Dutch Office of Medicinal Cannabis (OMC), operating under the Ministry of Health, Welfare and Sport, has run a tightly controlled single-cultivator model since 2001. Bedrocan Nederland B.V. is the sole licensed cultivator and supplies the OMC, which historically managed all domestic distribution and international exports.
That model is now in transition. The Ministry of Health has signalled an intention to narrow the OMC’s remit to import and export licensing, removing the export cap that has constrained Bedrocan’s international availability. Bedrocan has communicated the change as a structural shift towards a more market-oriented framework, while emphasising continuity of supply to Dutch pharmacies throughout 2026.
The implication for UK distributors and clinics: more Dutch-origin product should become available across Europe over the course of 2026 and into 2027, although the timing of the legislative finalisation remains the binding constraint. Bedrocan-origin strains have long been a clinical reference point for UK specialists; expanded availability matters for treatment continuity.
Czech Republic: a quietly significant expansion
The Czech Republic operates under the supervision of the State Institute for Drug Control (SÚKL) and has moved decisively to widen access. From April 2025, general practitioners were permitted to initiate medical cannabis prescriptions for chronic pain — a significant departure from the prior specialist-only requirement. Prescription validity was extended to three months, and reporting burdens on doctors were reduced.
The market response has been visible. Prescription volumes in 2025 climbed sharply, with SÚKL data showing more than 41,000 prescriptions issued in the first three quarters of 2025. By autumn 2025, the volume prescribed was already approaching the entire 2024 figure. Domestic cultivation capacity is being expanded; the number of SÚKL-licensed cultivators has increased materially.
For UK observers, the Czech example is instructive in two ways: it shows that opening primary-care initiation in a tightly regulated European system can be done without obvious system instability, and it adds a credible European producer footprint that may, over time, offer additional supply diversity.
Poland: scale without the headlines
Poland has operated a medical cannabis framework since the November 2017 amendment to its Act on Counteracting Drug Addiction. All medical cannabis sold in Poland is imported under licences issued by the Chief Pharmaceutical Inspector. The model relies heavily on pharmacy-compounded magistral preparations from imported raw material.
Despite the relative lack of international attention, Poland is now one of the largest European medical cannabis markets by patient numbers. Industry estimates place the active patient base at well over 100,000 by the end of 2025. A November 2024 change ended teleconsultation initiation for controlled substances including medical cannabis, requiring in-person examination before prescribing; this disrupted private telemedicine providers but does not appear to have stopped underlying growth.
The Polish market matters to UK stakeholders mainly as a demand sink — Polish import volumes are large enough to influence pricing and availability of products that UK clinics also rely on.
Italy: a state-monopoly model under strain
Italy’s medical cannabis system is unusual in Europe. Domestic cultivation is conducted exclusively by the Italian military at the Stabilimento Chimico Farmaceutico Militare (SCFM) facility in Florence, which produces in the order of 100 kg per year of two proprietary strains (FM1, FM2). Domestic production is structurally insufficient to meet patient demand, and Italy supplements supply through imports — historically led by Bedrocan under a long-term supply arrangement.
The 2025 data continues to show a patient base above 10,000, with up to 80% of costs reimbursed in eligible cases. The supply-constrained model means Italy will remain a meaningful pull on European import volumes. For UK clinics, Italy is less directly relevant than Germany, but Italian demand competes for the same Bedrocan and other Northern European supply that UK clinics depend on.
France: the long transition from experiment to framework
France ran an experimental medical cannabis programme from March 2021. The original endpoint was March 2024; the programme was extended, and in practice the experimental phase has been further extended to 31 March 2026 to ensure continuity for treated patients. France’s permanent generalised framework was submitted to the European Commission in March 2025 and notified onward through the EU technical process, with French regulatory and constitutional steps progressing through 2025.
As of the date of writing, full generalisation has not yet been published in the Journal Officiel. The Haute Autorité de Santé (HAS) has been running its evaluation in parallel, with reimbursement recommendations expected in the first quarter of 2026. France becoming a fully open reimbursed market would represent the single largest expansion of European medical cannabis demand since Germany’s 2017 framework. UK observers should expect the French signal to feed through into European pricing and availability within months of the framework being formally activated.
Switzerland and the non-EU adjacency
Switzerland sits outside the EU but inside the European supply ecosystem. The Swiss reform removed the requirement for an exceptional authorisation from the Federal Office of Public Health for medical cannabis prescriptions in August 2022, simplifying physician-led prescribing. Swiss volumes are modest relative to Germany or Poland, but Switzerland matters as a manufacturing and quality-assurance hub for several European-facing producers, and a small number of Swiss-domiciled operators are active in cross-border B2B supply.
UK-EU regulatory divergence post-Brexit
The UK left the EU regulatory framework on 31 December 2020, with full divergence in medicines regulation effective from 1 January 2021. For CBPMs, the practical consequences are:
- UK importers can no longer rely on intra-EU free movement; CBPMs entering the UK require Home Office import licences and full UK regulatory handling.
- Quality assurance recognition is bilateral. UK regulators continue to recognise quality standards of established EU manufacturing sites in practice, but assurance and audit are now UK-specific processes.
- UK clinical guidance (NICE NG144) is independent of EU equivalents; the two systems can drift over time.
- Patient-specific cross-border supply between EU member states is a feature of the EU system that UK patients and clinicians can no longer access directly. UK-based clinics must source through UK-licensed importers and wholesalers.
The divergence has not made UK supply impossible — but it has made the UK a slightly more expensive and slightly slower destination than it was in 2019.
What UK stakeholders should plan around in 2026
From the country picture above, four working assumptions for 2026:
- German demand growth is decelerating but not reversing. Any UK supplier dependent on European volumes should model German demand as a moving variable, not a constant.
- Dutch supply will incrementally open. Plan the procurement window to take advantage, but do not assume immediate availability.
- Polish and Czech demand will continue to grow. Pricing pressure on shared product lines is likely.
- France becoming a fully reimbursed market is the single largest 2026 risk to UK supply continuity. A clinic without redundant supply lines will feel it.
About MUZO Health
MUZO Health was created to raise the standard of cannabis-based medicines in the UK, with a focus on quality, consistency and clinical integrity. Our mission is to support clinicians, empower patients and help move cannabis medicine forward responsibly, transparently and without compromise. Learn more about MUZO Health.