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Established export sector with ~70 licensed producers; under government review.
North Macedonia has become a significant cannabis export market since 2016, with approximately 70 licensed producers. In July 2025, the government announced a review of all medical cannabis licences, creating uncertainty in the sector.
July 2025 government licence review introduces regulatory uncertainty for export operations.
North Macedonia legalised the cultivation and manufacture of medical cannabis in 2016, establishing itself as one of Europe's earliest and most commercially active medical cannabis producers.
66 companies hold licences to produce medical cannabis (as of 2022), though only a fraction have succeeded in producing and exporting commercially. Several companies have achieved EU-GMP certification for cannabis-related manufacturing.
Patient treatment with medical cannabis was also legalised in 2016, though patient access remains extremely limited.
Who can prescribe: Only government-approved doctors with a specialisation in the relevant illness. Eligible conditions include:
Patient access is extremely limited in practice, with no significant domestic patient market having developed despite the long-standing legal framework.
The North Macedonian medical cannabis sector is primarily export-oriented. Domestic patient access is minimal.
North Macedonia is one of Europe's most significant producers of medical cannabis for export, with several EU-GMP certified facilities supplying the German, Czech, and other European markets.
North Macedonia has established itself as a key medical cannabis production hub in Europe. It is a significant exporter to Germany, Czech Republic, and other EU markets.
66 companies hold production licences as of 2022, with several achieving EU-GMP certification. Export volumes have grown significantly since 2016.
Yes. North Macedonia has been exporting medical cannabis since 2016 primarily to Germany and the UK. It has approximately 70 licensed producers. The government announced a licence review in July 2025 that has created uncertainty.