A structured overview of the European medical cannabis sector in 2026 — market size, licensed operators, prescribing volumes, GMP manufacturing capacity and key regulatory developments, drawing on EUDA data and national authority publications.
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The European medical cannabis market entered 2026 in a period of structural consolidation following several years of rapid growth. Germany's April 2024 partial legalisation — rescheduling cannabis from Schedule I narcotics to a controlled substance — has been the most significant single regulatory event in the European market, accelerating prescribing volumes, reducing stigma among healthcare professionals and creating the largest prescription medical cannabis market in Europe.
Across the continent, 32 European jurisdictions have established some form of medical cannabis programme. The quality and depth of these programmes varies substantially — from comprehensive pharmaceutical frameworks with domestic GMP manufacturing (Germany, Netherlands, Portugal) to nascent prescription systems dependent entirely on imported product (most Central and Eastern European markets).
This snapshot draws on publicly available data from the European Union Drugs Agency (EUDA), national competent authority publications, licensed manufacturer public filings and EMA regulatory documents. Where data is estimated, the basis for estimation is noted. ECI does not have access to proprietary market research data.
The European medical cannabis market reached an estimated €800 million–€1.2 billion in 2025, with Germany accounting for approximately 40–45% of total market value. Analyst projections for 2026 range from €1.0–1.5 billion, driven by continued German market growth, expansion in France (where the medical pilot programme extended in 2025) and early market development in Central and Eastern Europe.
These figures should be treated with caution — the European cannabis market lacks the reporting infrastructure of mature pharmaceutical markets, and available data reflects a combination of licensed pharmacy dispensing data, import/export statistics and market participant estimates.
Germany became the world's largest legal cannabis market by population following the April 2024 CanG legislation. Key developments in 2025–2026:
Germany's combination of large patient population, well-developed pharmacy infrastructure and increasing insurance coverage makes it the primary target market for European cannabis manufacturers and exporters.
The Netherlands operates the most mature pharmaceutical cannabis manufacturing programme in Europe. Bedrocan, the state-licensed producer, supplies standardised pharmaceutical-grade cannabis flower to domestic pharmacies and approved export markets. The Besloten Club (private club) system for adult use operates alongside the medical programme.
The Netherlands is notable as the only European jurisdiction with a fully vertically integrated state pharmaceutical cannabis supply model — from licensed cultivation under GACP to pharmacy-dispensed EU GMP finished product. This model has served as a reference point for regulatory frameworks developed elsewhere in Europe.
Portugal established its medical cannabis regulatory framework in 2018 and has developed into a significant European export hub. Several facilities have obtained EU GMP certification for cannabis processing, and Portugal is a significant supplier to the German market. The temperate climate and existing agricultural infrastructure make Portugal cost-competitive for outdoor and greenhouse cultivation.
Infarmed, the national pharmaceutical authority, has been active in issuing and renewing GMP certificates for cannabis manufacturers. Portugal's position within the EU single market and its established pharmaceutical regulatory relationship with Germany make it a natural exporter.
France launched a medical cannabis pilot programme in 2021, extended in 2023 and again in 2025. The pilot covers specific indications — treatment-resistant chronic pain, certain epilepsies, palliative care, multiple sclerosis spasticity and nausea/vomiting associated with cancer chemotherapy. Approximately 3,000–5,000 patients were enrolled in the extended pilot as of early 2026.
France represents a significant medium-term opportunity given its population size (67 million) and the established precedent of the pilot programme. Full programme launch, if approved by the French Senate, would create one of Europe's largest potential markets.
The UK market operates under MHRA post-Brexit regulation, which broadly mirrors EU GMP requirements. Medical cannabis has been legally available on prescription since 2018, primarily through specialist clinics and private prescribers. NHS prescribing remains extremely limited; private prescribing has grown to an estimated 30,000–50,000 active patients.
The UK market is primarily served by imported product. UK import certificates require MHRA review of product quality and manufacturing compliance. UK GMP is recognised as equivalent to EU GMP for most purposes, though formal equivalence arrangements post-Brexit have introduced some complexity.
GMP-certified cannabis manufacturing capacity in Europe is concentrated in:
| Country | Estimated GMP facilities | Primary products | Primary markets served |
|---|---|---|---|
| Netherlands | 1 (state) | Standardised cannabis flower | Netherlands, Germany, selected EU |
| Portugal | 4–6 | Flower, extracts, oils | Germany, UK, EU export |
| Germany | 3–5 | Flower, extracts | Domestic and EU |
| Denmark | 2–3 | Extracts, medical preparations | EU and global export |
| Malta | 1–2 | Flower, extracts | EU export |
| Czech Republic | 1–2 | Flower, medical preparations | Domestic and EU |
These figures are estimates based on publicly available licensing information and regulatory authority publications. The actual number of licensed facilities at various stages of GMP compliance is higher — many facilities hold manufacturing licences but have not yet completed full GMP qualification.
The majority of European countries with medical cannabis programmes are import-dependent — they have no domestic GMP manufacturing capacity and rely on product imported primarily from Canada, Australia, Colombia and European GMP manufacturers.
Key import markets include Poland, Czech Republic, Greece, Romania, Hungary, Croatia, Slovenia and the Baltic states. These markets collectively represent significant medium-term growth potential as prescribing volumes expand and regulatory frameworks mature.
Key developments to watch in the 12-month period to mid-2027:
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