Events
'Science in the City' in Bordeaux discussed the regulation of medicinal cannabis in France
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The importance of medical education, the harmonization of European products and laws, and the reimbursement of medical cannabis prescriptions were three of the most discussed topics during the Science in the City conference, held in Bordeaux on September 11 and 12. The event, led by Andrew de Angelo, was very focused on the current situation in France, but other topics were also addressed, such as the urgency of facilitating patients' access to medicinal cannabis and the routes of administration (up to the point of reaching the tablet) in order to respond to the specific needs of each patient and condition.
Science in the City is a conference focused on industry, political developments, legal issues, and regulatory frameworks – and not so much on the scientific side of cannabis. Therefore, the discussions revolved more around technological innovations in equipment... trimming, processing and extraction; consumption devices; lighting, systematization and crop monitoring; as well as the legal challenges presented by a market with 27 different legislations, a number of community regulations and all their variations.
The round tables therefore covered all these subjects, including developments in seed production (France is the largest seed producer in Europe and the world) and methods and techniques of breeding or reproduction of cultivars/strains and clones, more stable and genetically manipulated or not.
France in the sights of industry
France is in a transitional period regarding medicinal cannabis, following the end of the pilot project launched in 2021, through which more than 3,000 French patients were able to test and benefit from medicinal cannabis treatments. In March of this year, against all expectations given the country's political crisis—and when patients were already seeking alternatives, unsure whether they would be able to continue their treatment—the Haute Autorité de Santé (HAS) took the plunge and sent three documents to the European Union (EU) proposing the legalization of medicinal cannabis in the country, how and when.
The first “stoppedThe decree defines the regulatory framework for medicinal cannabis in accordance with TRIS (EU's Technical Regulation Information System). The others reflect current conditions and define the details, the diseases for which it can be prescribed, with what type of prescription (or not), and how the use of medicinal cannabis will be integrated into the national health system. All of this now awaits the EU's response so that it can be implemented by the end of March 2026. Meanwhile, a public consultation was also held – the deadline for which ends today, September 16th.
The proposed French regulation, as in the pilot project, provides for the use of medicinal cannabis for five medical conditions:
- Neuropathic pain
- Severe treatment-resistant epilepsy
- Support for oncological diseases
- Palliative care
- Spasticity associated with diseases of the central nervous system (such as Multiple Sclerosis and fibromyalgia).
As in Portugal, it could be used as a last-line treatment if patients can prove that all available options have failed – an important detail that, curiously, was not given much importance by the participants at the event.
Being integrated into the national health system treats cannabis like any other medicine. However, to be approved and distributed in the country, operators must be registered as a pharmaceutical company or partner with one. As The Cannabis Herald explains in this... article, all products made available must meet all standards applied to medicines. The flower must meet the standards defined in monograph Cannabis Flower Ph. Eur. 3028 from the European Directorate for the Quality of Medicines and Healthcare Products (EDQM) and can only be sold in closed vaporizers with an EU certificate.
As for other forms of administration (edibles or oils), they will allow products that fit into three pre-defined profiles: THC dominant, THC/CBD equivalent and CBD dominant.
“France is known for being tough when it comes to setting prices, so this phase of evaluating the subsidies is going to be critical,” said Marie Sanchez, a lawyer.
Following the public consultation, training programs will be created for doctors, and only those who obtain this training and the necessary certification will be able to prescribe medicinal cannabis.
Overall, both during the conferences and in informal conversations, almost everyone agreed that the French framework is serious and positive, but has some limitations that could jeopardize the success of the initiative.
In the roundtable discussion “Fragmentation vs. Harmonization: The EU Regulatory Dilemma,” French lawyer Marie Sanchez gave an overview of the situation in the country. "In France, we've already moved past the point of discussing what model we should have for medicinal cannabis. The model is defined. But unlike many countries, we have several authorities: the main one is the ANSM, the drug authority (equivalent to the US FDA), and its role is to authorize medicinal cannabis medicines. It will grant a five-year license for these medicines based on a list of defined criteria. The second and third authorities, for the next steps once the products are authorized, are the Haute Autorité de Santé (HAS) and the CEPS [Comité Économique des Produits de Santé], which sets the prices. Therefore, the HAS is responsible for defining whether a drug/medicine will be reimbursed or not and to what extent—depending on the type of product, the comparison with existing therapies on the market, and the patients' access needs." Based on this independent assessment, the CEPS will then decide the price of the products. "And this is where talks with the industry will begin," Sanchez explained, adding a caveat: "And France is known for being tough on pricing, so this phase of evaluating co-payments will be critical."
Yes, Aurelien Bernard, founder of the website newsweedDuring the debate "Cannabis Regulation in Transition: The French R&D Model and International Perspectives," he further explained that "it will no longer be necessary to prove clinical data for patients to apply—and this will simplify the process—and it's also good that we now have a specific policy. However, medical cannabis has stricter standards than other types of treatments, and the effectiveness of the medication will need to be proven."
In other words, there are still loose ends that are leaving both patients and professionals uneasy.
Participation or not?
The issue of reimbursement is one of the details yet to be determined that is causing the most anxiety. For both patients and the organizations that work with them, as well as legislators, it seems obvious that medical cannabis should be reimbursed to allow access to all those who need it. This is especially true if we consider that, depending on the disease and the need for treatment, the price can be considerably higher than that of other medications, and it would be unfair to the patient if the government did not support treatment.
The legal consultant Anthony Traurig He discussed other models of medical cannabis reimbursement, in which the state reimburses for some diseases and not others, and pointed to the worst-case scenario. "Authorities can exclude cannabis [from the reimbursement], but it's important to keep in mind that what's good for patient safety comes at a price. And now we also need to consider what happened with the [French] government, which fell again in September, and that, if a crisis hits, they may not be able to move forward [with the reimbursement]."
Aurélien Bernard put it another way: "We can analyze this in two ways: one is how much we'll spend on reimbursement; but I prefer to analyze first how much we'll save. HAS will have to make a decision based on the factors driving the sector and patients, but I don't think they'll analyze what they'll save."
“If we provide access but not co-payment, we are losing patients to the illicit market,” said Sita Schubert, founder of the European Medicinal Cannabis Association (EUMCA).
A good way to assess this cost reduction is to study what's happening in other countries. Canada and the United States are two good starting points. During the presentation "Cannabis in the EU: Regulation, Research, and Market Readiness," the American analyst Beau Whitney He explained that medical cannabis prices are 326% higher in the US than in France, and even prescriptions are more expensive, “but when cannabis is introduced and access is made easier, opioid use is significantly reduced, and so are costs [for the government] – there are fewer medical emergencies and fewer hospitalizations – because cannabis is proactive, not reactive.” Furthermore, there is also a considerable reduction in deaths from overdose of opioids, therefore, according to Whitney, cannabis “not only saves on costs, but it saves on deaths.” And concluding in a few words, he said: I think it all depends on the co-payments, that can be a killer [without this, everything could be lost]”.
By the way, here are the numbers Whitman put forward about the possibilities of the French market: "France has a potential market of 2,3 million patients, and some analysts put it at 21 million, although I think this is more for all of Europe."
Sita Schubert, a lawyer and founder of the European Medicinal Cannabis Association (EUMCA), has previously stated that "access and reimbursement of medical cannabis are two key factors." With extensive experience dealing with regulators in various countries, this lawyer considers several important factors, but "what we try to present when we go to hearings and meetings with governments is that one of the most important things is to combine access and reimbursement," she said. "I think this is the best way to support access; otherwise, if we provide access but not reimbursement, we are losing patients to the illicit market."
Portugal is a prime example of this. The price of medicinal cannabis (starting at €150 per 15g bag of flower) and the difficulty of access are barriers that many patients struggle to overcome. In Portugal, only the two formulations sold in hospitals (Sativex and Epidiolex) are subsidized, but even after the discount, the final price for the patient starts at €250 per bottle.
Frederik Bockslaff, CEO of Nimrod Rechtsanwälte, a cannabis law firm with a strong presence in the Franco-German field, also said that France could learn from Germany: "To obtain reimbursement, the patient goes before a judge. It's very simple. If the doctor says they need cannabis, the judge will say yes." There's a significant lack of knowledge, and a judge is unlikely to rule against the doctor, he explained. However, what Bockslaff considers best about the French model is "the price cap, even though the entire process—from seeds to product—is expensive. The pharmacy is just the final step."
What not to do
Schubert, for his part, got to the bottom of the matter, explaining that "with the German Supreme Court's decision, politicians had to make quick decisions because the Court allowed patients to cultivate, even though they couldn't receive insurance reimbursement. But at the time, according to the Single Convention [of Geneva, 1961], there was no way to legalize this model. So they created a very good law that stated: flowers, oils, anything containing cannabinoids, will be reimbursed. But it wasn't so much a question of getting reimbursed, but rather of whether the doctor had all the documentation properly completed—which was also very poor at first, since there was no regulation governing how to do things. This situation improved, but then the approach of telemedicine, which is a private prescription, began, which was very confusing for the market because they didn't inform the patient that they were entitled to reimbursement; it wasn't part of the business model."
"Pharmacokinetics is a problem," Assi Rotbart, Panaxia.
Furthermore, these types of consultations are brief. Often, they're simply for the doctor to write a prescription, without a thorough evaluation or follow-up of the patients. According to the lawyer, "this Telemedicine approach of a prescription for €1 was very damaging and is now even being questioned in Germany. And my discussion with the Spanish authorities was: the main idea of having flowers available [for smoking or vaporizing] is pharmacokinetics—how to treat pain immediately, and not after an hour? How to do this? And the Spanish government's response was, "Do we also want prescriptions for €1?" But "regulators aren't asleep, they're not foolish or stupid; they live in this world too," she concludes, leaving a reflection: "Everything you're doing has an effect. This rushing in and rushing out—this kind of reasoning bothers me, because you're treating patients; don't you feel responsible? It could be your mother, your daughter, your aunt."
And then Portugal came into the conversation, obliquely, for all the wrong reasons: "So, why have GACP and throw [the flower] down who-knows-what obscure routes...? But this ended up splashing Infarmed [the Portuguese medicines authority] and now they're changing the whole model, thank God!"
In conclusion, Schubert pointed to another issue: "And now, harmonization," he said, "when we talk about harmonization, it already exists. We have pharmaceutical legislation that tells us how to do it, so if we don't go down the path of 'how to get around the regulations,' I think we're already there. The biggest obstacle is this 'how to get around the regulations' mentality—this is causing a lot of problems in all countries."
A single market, with 27 different legislations
"Harmonization" was, in fact, one of the most frequently heard words and debated topics in Bordeaux. This term, which has been gaining prominence in the world of medicinal cannabis, refers to the standardization of various European regulations, quality standards, and best practices, in order to simplify life for producers and patients, and facilitate trade between member states and imports into the EU.
While many considered this a utopian idea not long ago, the issue is certainly increasingly debated and has many supporters. It seems crucial for those who see the European market as a single market—which, supposedly, it is. The situation is comparable to that in the United States, where it would also be much easier to operate if cannabis were legalized and regulated at the federal level.
The industry prepares to operate in France
Routes of administration are another important issue discussed in Bordeaux, repeatedly bringing up the topic of pharmacokinetics, which we discussed above. Each condition and situation has its own set of needs: some people can't wait an hour or so for a pill, capsule, or edible to take effect. These forms of treatment may work for those suffering from chronic pain or those in palliative care. But those with nausea, acute pain, or epileptic seizures need solutions that guarantee a rapid effect. Considering that France will not authorize the use of flowers or smoked cannabis, it is important to ensure that French patients have alternative solutions and formulations and the ability to access the product they need in the most appropriate way.
Using his grandmother, who suffers from Parkinson's, as an example of the difficulty many patients have when using cannabis (grinding the flowers in a new grinder, filling cartridges, choosing vaporizers, oils, strains, cannabinoid compositions, etc.), Assi Rotbart, from the Israeli pharmaceutical company Panaxia, pointed to the need to have “market redness”, or to be prepared with different solutions, accepted in the country, to offer patients suitable and easy-to-adopt products, because “pharmacokinetics is a problem”.
During the presentation "Global Lessons, Local Opportunities: Business Paths for Medicinal Cannabis in France and Beyond," Rotbart predicted that "the future of cannabis products involves all routes of administration: tablets, capsules, liquids (for vaporizing), oils." Added to this are the thousands of possible compositions of cannabinoids, terpenes, etc. To overcome these difficulties, Panaxia has been developing and "analyzing products for five years." In parallel, he explained, "we ask thousands of questions to patients and doctors, and we process the information to understand how we can align a specific molecule with a specific patient—we're creating molecules that make it easy." This way, he guarantees, they can "ensure that your pill will be right month after month." Because for this pharmaceutical entrepreneur, for everyone to be able to use medicinal cannabis, it really is necessary to "get to a pill."
“The global cannabis seed market is valued at $12,1 billion in 2025 and is projected to reach $22,04 billion by 2033, with a compound annual growth rate (CAGR) of 10,51% over the forecast period.”, report “Cannabis Seeds Market by Applications: Italy | France | Switzerland | Spain | Netherlands”, Market Research Intellect.
Panaxia currently has over 65 different products, including tablets, extracts, oils, tinctures, creams, and vaporizer cartridges. All are medicinal and comply with GMP (Good Manufacturing Practices) standards. For now, however, in France, they will only be able to sell vaporizers containing cannabis extracts (with different cannabinoid compositions), and they are already operating commercially in the country.
Once again, Israel shows it's at the forefront. Medicinal cannabis is already well-accepted by most of the medical community and patients, and is seen as another family of medications (in various forms and formulations) integrated into the national healthcare system, which can be used from the first day of treatment.
It all starts with the seed
But not everything comes down to production, processing, and administration routes. Despite the production of clones from mother plants, we often forget that everything, absolutely everything, must start with a seed. And although the seed market is always somewhat obscure, it is an important sector, highly recognized in the industry, and generates billions of dollars globally. While in Portugal the production and trade of cannabis seeds are not permitted, Europe currently ranks as the second largest producer in the world, with a market valued at over $6,6 billion, which could reach $7,25 billion by 2029 (estimated annual growth of 3.18%). In turn, France is the third European country, behind the United Kingdom and Germany, with the highest profits from cannabis seed sales ($88.352 billion in 2025), according to the “Europe Cannabis Seeds Market Report 2025” from Cognitive Market Research. This includes seeds for all types of crops, with France being the European leader in hemp production. According to the Report, “Cannabis Seeds Market by Applications: Italy | France | Switzerland | Spain | Netherlands”, published in August by Market Research Intellect “the [global] cannabis seed market is valued at $12,1 billion in 2025 and is projected to reach $22,04 billion by 2033, with a compound annual growth rate (CAGR) of 10,51% over the forecast period.”
This growth is based on "increasing demand, technological advances, favorable policies, and the expansion of applications in emerging markets," they explain in the report.
Technology and innovation, from seed to product
Technological advances were precisely one of the topics discussed in Bordeaux during the roundtable "Innovation in Cultivation: How Genetics and Production Standards Will Shape the Next Phase of Medicinal Cannabis." During this panel, breeders , the Maxence “Max” Majot, Technical Manager and Grow Expert at Royal Queen Seeds; Dominique van Gruisen, CEO of Belgian biotech Innexo Av., Oussama Badad, Chief Scientific Officer of the North American Trilogene Seeds; Paul Bleuchot, CEO of Green Exchange Lab; Rui Soares, CEO of the Portuguese equipment company Paralab and Jouany Chatoux, spokesperson for the Association Française des Producteurs de Cannabinoides (AFPC) explained what they have been doing and discussed the best ways forward for the situation in France.
Speaking specifically about the French situation, Max Majot offered this advice: "They may have a lot of money, but they don't know the market, what products are needed, and what the price is. Things will certainly go very badly. If France wants to start producing indoors at a high cost, being very honest and straightforward, the best option would be to go to sunny places that produce at cheaper prices. I don't think that makes sense here. Biomass is the answer, at a lower cost. And seeds too. Those who produce are already switching to seeds, with 20% of their production coming from seeds."
"Beans, soybeans, etc., gave us the knowledge, but we need to give the technology time to develop," Oussama Badad, CSO Trilogene Seeds.
Dominique van Gruisen recommends testing before starting. "We collect this data to provide to the company so they can implement safely, efficiently, with the right genetics, etc. Everything needs to be consistent, and if there are inconsistencies, we'll say it's still ready." This can save companies a lot of money, hassle, and headaches. "It's a window into the future," said the entrepreneur.
Oussama Badad brought up a topic that may be of interest to many breedersAlthough in Europe, due to our legislation, it doesn't apply: genetic editing and, following this, the issue of triploids, or "cannabis that has 30 chromosomes instead of 20." According to Badad, "it's difficult to produce viable pollen and seeds, but with more money, we have the capacity to reproduce much more quickly with the legacy that horticultural science has left us," he explained. "Beans, soybeans, etc., gave us the knowledge," he said, admitting that the seeds are not particularly stable, but that "we need to give the technology time to develop," and informing that they are giving away free seeds for testing.
Rui Soares highlighted the issue of consistency, saying that the technology works, but one of the many things he often observes is that "the technology works, but when applied to medicinal cannabis pharmaceutical products, consistency is a problem." According to him, "sometimes it's not so much about the hardware, but rather the procedures and small adjustments to the equipment." However, he added, "sometimes it's not the adjustments, it's the measurements—if you don't measure everything in your process and assume everything is under control, but if you don't measure, you're not in control."
A connection message
One of the most surprising moments of Science in the City was the presentation of Kamau Z. Akabueze, founder of the Alien School of Creative Thinking. For a change in form and content, this New Yorker with a hypnotic voice delivered an inspiring presentation on the power of creativity and the importance of feeling the connection that exists between everyone working in this industry. "We are there for each other, and it was so good to hear about harmonization here today, because we are all working toward harmonization—to harmonize our relationship with our mother [Earth], and even if your motivation is purely financial, the ripple effect of your efforts can help other humans lift their spirits." As Akabueze said, "This is all about intentionality—the practical nature of the work you are doing to deliver truly good medicine to the people around you is the intentionality of the plant in action and your intentionality in action, in a beautiful and magnificent way."
It was an unexpected presentation, and judging by the reactions seen during the session and in the hallways afterwards, few people were indifferent to the message Akabueze left in the air: "this plant is a catalyst for creativity, and regardless of each person's motivations, the effort everyone is making here is incredibly valuable."
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[Disclaimer: Please note that this text was originally written in Portuguese and is translated into English and other languages using an automatic translator. Some words may differ from the original and typos or errors may occur in other languages.]____________________________________________________________________________________________________
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Margarita has been a regular contributor to CannaReporter since its inception in 2017, having previously worked for other cannabis-focused media outlets such as Cáñamo magazine (Spain), CannaDouro Magazine (Portugal) and Cannapress. She was part of the original team for the Portuguese edition of Cânhamo in the early 2000s and was part of the organisation of the Global Marijuana March in Portugal between 2007 and 2009.
She recently published the book “Canábis - Maldita e Maravilhosa” / "Cannabis - Cursed and Wonderful" (Ed. Oficina do Livro / LeYA, 2024), about the history of the plant, its ancestral relationship with Humans as a raw material, an entheogen and a recreational drug, as well as the infinite potential it holds in medical, industrial and environmental terms.
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