🇫🇷 Medical cannabis in France

C — hospital- and indication-gated. Cannabis-based medicines exist only within a closed state experiment (2021–2024) now in a transitional phase for existing patients; a permanent scheme of ANSM-authorised medicines, last-line only, with initial hospital prescription, is written into law but not yet operational.

The experiment was created by article 43 of the Loi n° 2019-1446 du 24 décembre 2019 de financement de la sécurité sociale pour 2020 (Social Security Financing Act 2020) and organised by Décret n° 2020-1230 du 7 octobre 2020; inclusion of new patients ended 27 March 2024 and the experiment formally ended 31 December 2024. The LFSS 2024 created a status of 'médicaments à base de cannabis' with a five-year, renewable ANSM authorisation, reserved to last-resort use ('dernier recours') in the experiment's indications, with initial prescription in hospital. Three regulatory texts were notified to the European Commission on 19–20 March 2025; as of September 2026 the decree fixing the HAS evaluation procedure has not been published (the Senate was told it went to the Conseil d'État on 2 July 2026) and HAS has not yet issued its opinion.

Source: ANSM — Dossier thématique « Cannabis à usage médical » (Medical cannabis topic file) · read 27 September 2026

Only the oil-based cannabis medicines supplied for the experiment (various THC:CBD ratios) remain available, and only to patients already enrolled. Flowers were withdrawn in 2024. No cannabis-based medicine has yet received the new five-year ANSM authorisation.

ANSM announced in February 2024 that the supply of inhalable flowers would stop within weeks and that no new flower treatment should be started. The March 2026 report of the Comité scientifique temporaire (temporary scientific committee) lists two suppliers (LGP and Intselchimos) providing oral oil solutions in THC-dominant, balanced and CBD-dominant ratios. HAS's evaluation frame (July 2025) covers oral, sublingual and vaporised forms, explicitly excluding smoking, in five last-line indications: refractory neuropathic pain, drug-resistant epilepsy, MS spasticity, cancer-related symptoms and palliative situations. Medicines with a marketing authorisation (e.g. Sativex, Epidyolex) are outside this scheme and follow ordinary AMM rules.

Source: ANSM — Cannabis médical : point d'étape sur la dernière année de l'expérimentation (status update, 20 Feb 2024) · read 27 September 2026

Treatment is started only by volunteer doctors in hospital 'structures de référence' who completed the ANSM e-learning; from the second month a trained community doctor (including a GP) chosen by the patient may renew. In practice no new patient can be enrolled today.

ANSM: initiation by 'médecins volontaires des structures de référence' (hospital reference centres); 'médecins libéraux, y compris médecins généralistes, volontaires pour prendre le relai des prescriptions dès le 2e mois'. The 2.5-hour e-learning attestation is 'une condition nécessaire et obligatoire' for registration. The March 2026 committee report counts 501 reference-centre doctors and 222 relay doctors, with no new physicians trained between September 2025 and January 2026. The permanent scheme in the LFSS 2024 keeps 'prescription initiale hospitalière'.

Source: ANSM — Professionnels de santé : formation, prescription, dispensation (Health professionals: training, prescribing, dispensing) · read 27 September 2026

Products above 0.3% THC go on a secure narcotic prescription ('ordonnance sécurisée') for at most 28 days; products at or below 0.3% THC go on an ordinary prescription.

ANSM FAQ: medicines with more than 0.3% THC require an 'ordonnance sécurisée qui doit être renouvelée au maximum tous les 28 jours'; lower-THC products 'peuvent être prescrits sur une ordonnance simple'. The 28-day ceiling matches the general narcotics rule (Code de la santé publique, régime des stupéfiants). ANSM pages do not mention a dedicated e-prescription for cannabis medicines.

Source: ANSM — Nos réponses à vos questions sur l'expérimentation du cannabis médical (FAQ) · read 27 September 2026

Not published. ANSM material describes the first consultation as a hospital consultation in a reference centre and says nothing about video consultations; no official text specifically allows or forbids a teleconsultation start for cannabis medicines.

The ANSM pages on the experiment (roles of hospital doctor vs médecin relais, follow-up schedule at months 1, 3, 6, 12, 18, 24, 30) contain no mention of téléconsultation or e-prescription. Because the pathway is closed to new patients and the permanent decree is unpublished, there is currently no lawful telemedicine route for a new patient. Whether follow-up renewals by the relay doctor may be done remotely is not addressed in any official page opened.

Source: ANSM — Focus médecins : qui fait quoi ? (Doctors: who does what) · read 27 September 2026

Dispensing is limited to hospital pharmacies (PUI) authorised to dispense to outpatients and to community pharmacies whose pharmacists did the ANSM training; ANSM publishes the list. No mail order.

ANSM: 'pharmaciens des pharmacies à usage intérieur (PUI) et pharmaciens d'officine', both after training; the page links a downloadable list 'des PUI autorisées à rétrocéder et des officines engagées' (file dated 13/08/2026). The prescribing doctor gives the patient the list of participating pharmacies in his area. The March 2026 committee report notes only 2 hospital and 3 community pharmacists newly trained between September 2025 and January 2026.

Source: ANSM — Professionnels de santé : formation, prescription, dispensation (list of PUI and officines) · read 27 September 2026

For the remaining experiment patients the medicines are free of charge under an exceptional state coverage that runs until three months after HAS publishes its opinion. Ordinary reimbursement for future patients does not exist yet and depends on the HAS opinion and the pending decree.

ANSM FAQ: 'Les médicaments à base de cannabis sont gratuits pour les patients'; coverage continues 'jusqu'à 3 mois après publication sur son site de l'avis de la Haute Autorité de santé (HAS)'. Service-public.gouv.fr lists the Arrêté du 27 mars 2024 and Arrêté du 4 avril 2024 as the coverage texts and 31 March 2026 as the previous end date, since extended. HAS (Haute Autorité de santé) was asked on 17 March 2025 to assess the medicines; its July 2025 note planned a final opinion for end of Q1 2026 'sous réserve du contenu du décret', which has still not been published.

Source: HAS — Médicaments à base de cannabis (evaluation frame, 29 Jul 2025) · read 27 September 2026

No public price. The experiment products are supplied free to enrolled patients; no price has been set for the future authorised medicines.

ANSM states the medicines are free for patients in the experiment/transitional phase. No official price list exists because no cannabis-based medicine has yet been authorised under the LFSS 2024 status or evaluated by the HAS Commission de la transparence.

Source: ANSM — Nos réponses à vos questions sur l'expérimentation du cannabis médical (FAQ) · read 27 September 2026

France applies a zero-tolerance, presence-based rule: driving after using a substance classed as a narcotic is an offence whatever the source, and a prescription is no defence. ANSM tells experiment patients not to drive during treatment.

Article L235-1 of the Code de la route (Highway Code) punishes driving after use of substances or plants classed as stupéfiants (2 years' imprisonment, €4,500 fine, licence measures); the offence is established by a positive test, with no THC threshold and no medical exemption. In a written answer of 4 April 2023 the government confirmed that 'le fait que le produit stupéfiant soit issu d'un produit dont la consommation est autorisée est sans objet' and that L235-1 'ne fai[t] aucune référence au caractère licite ou illicite de l'usage'. ANSM FAQ: patients 'ne devez pas conduire pendant votre traitement par cannabis médical'. (Légifrance returned HTTP 403 in this session; the article text was checked via the government answer and the ANSM FAQ.)

Source: Assemblée nationale — Question écrite n° 5197, réponse du 4 avril 2023 (written question on therapeutic cannabis and road safety) · read 27 September 2026

Within Schengen a French patient needs an Article 75 certificate from the ARS (one per medicine, with the original prescription). Outside Schengen, ANSM issues a transport attestation for at most 28 days of treatment, requested 10 days ahead. Visitors bringing narcotic medicines into France need no French health-authority attestation but must carry the original prescription.

ANSM: for Schengen states 'vous devez vous adresser à l'ARS de la région où exerce votre médecin prescripteur' (Article 75 Convention de Schengen form); for non-Schengen 'L'ANSM est l'autorité compétente pour la délivrance des attestations de transport', requested 'dix jours minimum' before departure, for 'une durée de traitement ne dépassant pas la durée maximale de prescription autorisée de 28 jours'. For foreigners entering France: 'aucune attestation de transport personnel de médicaments stupéfiants n'est requise de la part des autorités de santé de la France' — carry 'l'original de l'ordonnance' and check customs rules. ARS Île-de-France details the form (patient completes sections 4–11, one form per medicine, shown on request to Schengen authorities or French customs).

Source: ANSM — Voyager avec mes médicaments (Travelling with my medicines) · read 27 September 2026

A non-resident cannot be started on cannabis medicines in France today because the scheme is closed to all new patients; a foreign prescription for a cannabis medicine cannot be filled in a French pharmacy; a visitor may bring their own lawfully prescribed medicine with the original prescription (Schengen Art. 75 certificate for Schengen residents).

(1) Non-resident prescription: no official text distinguishes residents from non-residents, but inclusion ended on 27 March 2024 for everyone and only hospital reference centres could enrol — so there is no route for any new patient, resident or not (ANSM FAQ). (2) Foreign EU prescription: France transposed Directive 2011/24/EU Art. 11 by Décret n° 2014-1525 du 17 décembre 2014 (Code de la santé publique art. R. 5132-6-2), per the government's answer to written question n° 87096; cannabis-based medicines here exist only as experiment supplies dispensed by registered pharmacies to enrolled patients, so there is no dispensable product for an outside prescription — whether narcotic prescriptions are formally excluded under Art. 11(6) could not be verified because Légifrance returned 403 (not published in any page opened). (3) Bringing medicine in: ANSM — no French attestation required for foreigners; carry the original prescription; Schengen residents use the Art. 75 certificate from their home authority; the general 28-day narcotics ceiling applies to French-issued attestations. (4) Foreign telemedicine prescription: not fillable, for the same reason as (2); ANSM publishes no rule on foreign e-prescriptions.

Source: ANSM — Voyager avec mes médicaments (rules for foreigners entering France) · read 27 September 2026

The permanent framework is pending: a decree on the HAS evaluation of cannabis-based medicines went to the Conseil d'État in July 2026 and a second decree on authorisation is ready; HAS's opinion is expected after publication, and existing patients stay covered until three months after that opinion. ANSM extended its monitoring committee to 31 December 2026.

Timeline from official pages: EU notification of three texts 19–20 March 2025; HAS asked 17 March 2025, evaluation frame 29 July 2025, opinion originally planned end Q1 2026 'sous réserve' of the decree; transitional coverage first set to 31 March 2026 (Décret n° 2024-259, Arrêté du 27 mars 2024) then extended to three months after the HAS opinion (ANSM FAQ); Senate written question of 12 February 2026 still 'en attente de réponse' at last check; ANSM Décision n° 2026-30 du 27 mars 2026 prolongs the Comité scientifique temporaire to 31 December 2026. No publication date for the decree is official.

Source: ANSM — Décision n° 2026-30 du 27/03/2026, prorogation du CST « Suivi de l'expérimentation » (committee extended to 31 Dec 2026) · read 27 September 2026

About 3,000 patients were enrolled in total (3,035 by February 2024); around 700 were still being treated in January 2026 (724 by pharmacist count; 690 ± 157 by stock estimate).

ANSM (20 Feb 2024): 3,035 patients included since March 2021, 1,842 still treated. ANSM CST report (meeting January 2026, published 23 March 2026): '724 le nombre de patients encore traités' and '690 ± 157 patients, toutes indications confondues'; indication split as of July 2025: neuropathic pain 60.2%, MS spasticity 15.0%, epilepsy 9.3%, palliative 6.4%, oncology 5.6%, other spasticity 3.5%. A Senate question of February 2026 cites 1,650 patients — a different (older or cumulative) figure.

Source: ANSM — Compte rendu du CST « Suivi de l'expérimentation française de l'usage médical du cannabis » (committee minutes, 23 Mar 2026) · read 27 September 2026