Today (February 19, 2026), Cannabis Europa returns to the French capital for the first time since 2019 at a critical juncture for the incoming French medical cannabis industry.

Just the evening before, French authorities met with industry stakeholders to present the first draft of the country’s long-awaited medical cannabis reimbursement framework, the final regulatory piece needed to move France from pilot programme to permanent market. Delegates arriving at the venue this morning did so knowing they were about to receive a first-hand account of what was discussed.

Stephen Murphy, Co-Founder and CEO of Prohibition Partners, opened proceedings by highlighting just how far the market, and Europe as a whole, has come in the seven years since Cannabis Europa last visited the city.

“We’ve moved from the perception of ‘is medical cannabis legitimate’ all the way through to actually getting medical cannabis into the hands of patients,” Murphy told delegates. “France is probably, in my mind, one of the most important European conversations taking place this year.”

Below, we’ve summarised the key insights from the day’s sessions, and we will be updating in real time.

The draft reimbursement structure

Last night (February 18, 2026) a consultation meeting, organised by the Direction Générale de la Santé (DGS) and the Direction de la Sécurité Sociale (DSS), saw stakeholders receive the first concrete view of the planned economics of the incoming market. 

This morning, delegates were given an overview of the government’s economic model for cannabis medicines in concrete terms for the first time.

UIVEC President Ludovic Rachou, whose organisation helped coordinate the reimbursement dossier submitted to HAS last September, laid out the newly revealed plans to the room.

In December 2025, the Haute Autorité de Santé (HAS), the body responsible for evaluating medicines and approving them for coverage under France’s public health system, paused its assessment of cannabis medicines after concluding it could not finalise reimbursement structures without the published decree. That decree has now been drafted.

Key takeaways:

• The proposed model establishes a tiered reimbursement structure tied directly to Haute Autorité de Santé’s (HAS) assessment of each product’s therapeutic benefit.
• Coverage rates will be set at 65%, 30%, 10%, or 0%, corresponding to major, moderate, minor, or insufficient benefit, respectively.
• However, Rachou noted that the headline rates may be less significant than they appear for many patients. Since the majority of eligible patients suffer from long-term conditions qualifying for ALD status under the French system, most should ultimately access cannabis medicines at 100% coverage regardless of the base reimbursement tier. That question, he noted, is still being finalised.
• Pricing will be structured by homogeneous product categories, grouping medicines by pharmaceutical form, composition, and clinical characteristics, with a single price applied across each category.
• Prices will be fixed for three years and can be revised upward or downward if new clinical evidence emerges.
• The consultation period following the February 18 meeting is expected to last between three weeks and one month, during which stakeholders can submit formal comments on the draft text.
• If proceedings go to plan, the outstanding regulatory decrees, including those covering cultivation, technical specifications, and the legal status of cannabis-based medicines, will be formally adopted in June.
• At that point, companies will be able to begin product registration with the French drug agency ANSM, while HAS simultaneously resumes its evaluation.
• A final HAS opinion on reimbursement is anticipated around October-November 2026, with patients still enrolled in the pilot programme covered under an extended scheme until 31 December 2026.
• The precise pricing methodology for each product category remains subject to ongoing discussion between UIVEC and the authorities, a process Rachou indicated the trade body intends to pursue actively in the months ahead.

Reimbursement in Practice: Who Pays, For What, and When

With the draft reimbursement decree barely 24 hours old, a later French-language roundtable brought together some of the leading voices in the French market to test the announced measures.

Key Takeaways

• France operates a single-payer system, meaning companies negotiate directly with the ministry, there is no room for case-by-case deals as in Germany. As one speaker put it: either you make a deal with the ministry, or you’re out.
• The government is expected to work from a pre-set budget envelope for medical cannabis rather than evaluating each product on pure clinical merit. HAS will likely be open on reimbursement in principle, but will seek to protect public finances by keeping the therapeutic benefit rating, and therefore the reimbursement rate, as conservative as possible.
• The target patient population will be one of the most contested issues. A tightly defined population keeps budget exposure manageable for the ministry, but too broad a definition risks losing control of spend. Panellists warned that companies presenting inflated volume projections will face pushback, reassuring authorities with conservative, epidemiologically grounded estimates is likely to be more effective.
• The choice of clinical comparator will be crucial in determining the price. Whether cannabis is compared to opioids, surgical interventions, or intrathecal implants (depending on indication) will significantly affect what price the ministry is willing to accept. Panellists noted the risk that authorities will exploit any ambiguity in comparator selection to push prices down.
• A single fixed price per product category, as confirmed in yesterday’s consultation, creates a difficult dynamic for the industry. With no ability to promote products and no price differentiation permitted, companies will struggle to compete on anything other than cost structure. Those with high production costs, particularly foreign operators who underestimate the full cost of the French pharmaceutical model, risk being unable to align with whatever price is set.
• The real cost risk for international operators is not the price of dried flower. It is the full weight of French pharmaceutical compliance. Trained physicians, patient follow-up data obligations, narcotics management controls, and the requirement for a responsible pharmacist and an exploitant. All of this must be factored into price negotiations.
• Driving prices too low carries its own risk. If companies respond by chasing volume to compensate, they will overshoot the patient population defined by HAS and breach the budget envelope, triggering further regulatory intervention.
• A health economics argument may be the industry’s strongest card. Data from the pilot programme showed that medical cannabis reduced patients’ consumption of other treatments. The case that a single cannabis medicine can address multiple symptoms simultaneously, potentially replacing five to seven separate prescriptions, represents a compelling cost-efficiency argument for the social security system, and one panellist said should be developed further.
• Made-in-France production is increasingly being seen as a negotiating asset, as domestic sourcing aligns with broader government priorities and may provide leverage in price discussions.
• Patient access timelines remain a concern. Even once reimbursement is confirmed, restrictions on which specialists can initiate prescriptions, pain centres, and multidisciplinary requirements could create significant bottlenecks in the early phase of the market.

Key insights from across the morning sessions 

Beyond the reimbursement deep-dive, the morning’s broader sessions reinforced a consistent theme: France has built a rigorous framework that protects patients and quality, but the commercial and human cost of further delay is becoming harder to justify.

On domestic cultivation, speakers were clear that France is a pharmaceutical model, not a low-cost growing market, greenhouse-only, GACP-compliant, and tightly linked to pharmaceutical supply chains. GMP certification remains the critical and expensive gatekeeper, with one speaker warning companies to ‘triple your budget and triple your time.’ Germany’s ongoing price compression is reshaping global supply chains and will continue to accelerate.

On patients, the testimony was stark. A patient association president described an 18-step regulatory journey stretching back to 2018, and pointed to patients who have died in the 18 months since new pilot programme inclusions were halted, people who could not access cannabis medicine in their final months. Without viable pricing, there will be no industry, she argued, and without reimbursement, there will be a two-tier system, access only for those who can afford to pay.