Medical cannabis in France
In early October, a decree authorizing the experimentation of therapeutic cannabis was published by the Ministry of Solidarity and Health. This is a first victory for advocates of cannabis therapy, who see this publication as a first step in the desired generalization of cannabis use for therapeutic purposes.
The text aims to provide a legal framework for the therapeutic use of cannabis. Despite this, the authorized date for the start of the experiments is set for March 31, 2021 at the latest, which is almost six additional months compared to the previously announced deadline of October 2020.
A decree aimed at providing a general framework for experimentation
Highly anticipated by patients, the decree reiterates the already established fundamentals of the conditions of application and modalities of the experimentation, namely:
- - The supervision of the experimentation and future framing decisions that will be taken by orders from the Directorate General of Health.
- - A mobilization of 3,000 patients to participate in the experimentation. These patients will be selected from those suffering from a relevant pathology (neuropathic pain, epilepsy, palliative care situations, support for oncology treatment or painful muscle hypertonia) and who remain in therapeutic failure.
- - A mobilization of doctors and pharmacists who will be chosen on a voluntary basis and who will be required to undergo prior training.
- - All products supplied by the companies participating in the experimentation must be entirely free of charge for all 3,000 patients concerned. This latter modality was the subject of an amendment in the National Assembly aimed at reconsidering the free provision of products and requesting remuneration for supplier companies, considering that, by nature, the call would be made to foreign private establishments that could claim a preference during the generalization of the system.
This same amendment also provided for authorizing production on French soil from the beginning of the experimentation. The government opposed the amendment, claiming that these provisions would jeopardize the timeline and the launch of the experimentation at the end of the first quarter of 2021.
The first step in a long process
Even if advocates of therapeutic cannabis use welcome the publication of the decree, difficulties still lie ahead, and disillusionment is possible. The task is immense, as it is now a matter of selecting and convincing 3,000 patients to participate in this experimentation and finding voluntary professionals. The latter will also need to be trained before they can prescribe and dispense therapeutic cannabis, actions for which execution modalities will need to be established.
It is also important to find the financial means and actors for the development of a cannabis production sector on French soil should the experimentation be generalized. This experimentation also requires a certain logistics that will need to be financially supported, and thus a budget will have to be allocated to it.
Finally, an important factor to consider is that it will be essential to find one or more foreign suppliers who agree to provide products free of charge for all the needs of the 3,000 patients throughout the study period, which is one year.
Can we expect generalized use of therapeutic cannabis in the short term?
Even if the launch of the experimentation is maintained on March 31, 2021, it will last one year, and then a six-month period will be needed to obtain reliable and concrete feedback. These steps lead, at the earliest, to a possible generalization at the end of the fourth quarter of 2022, it should be noted that during this period a new presidential election will take place, leading to great uncertainty about the future of therapeutic cannabis in France.
