France Submits Decree for the Reimbursement of Medical Cannabis

France’s incoming generalised medical cannabis framework has edged tantalisingly close to clearing its last remaining hurdle, as the outstanding decree governing the reimbursement of cannabis medicines has been submitted to France’s highest administrative court.

Two weeks ago, we reported that France’s health minister had confirmed that these delayed regulatory texts needed to push through medical cannabis generalisation would be published in July.

According to Newsweed, the Minister Delegate for Relations with Parliament confirmed this week that the text had received approval from the Ministry of Economy, Finance and Industrial and Digital Sovereignty, and the decree was submitted to the Conseil d’État on 2 July.

Now, the Conseil d’État must complete its legal review, the final step before it is published in the Journal Officiel, and becomes law.

The review is expected to be completed over the summer recess, with the government targeting publication at the opening of the autumn parliamentary session on 1 October.

Why is the decree so important?

Without this decree, France’s entire reimbursement process cannot move forward. The Haute Autorité de Santé’s (HAS) Transparency Commission, the body that formally decides which medicines qualify for national health coverage, is legally unable to open evaluation sessions until the procedural framework established by this decree has been published.

HAS was tasked with evaluating cannabis medicines by the health minister in March 2025, and published its methodology in July 2025. By the first quarter of this year it had received manufacturer dossiers and completed preparatory analysis. The committee was ready, but the evaluations were not because the decree was not there.

The text defines how the Transparency Commission conducts its assessment, including how manufacturers submit dossiers, what evidence is considered, how the commission deliberates, and on what timeline. Critically, it does not itself set reimbursement rates, those follow from the HAS opinion, which in turn triggers price negotiations with the state. As such, this decree is more the starting gun than the finish line.

The indications in covered remain the same five which were established in the pilot trial in 2021, namely refractory neuropathic pain, refractory epilepsy in adults and children, painful spasticity from multiple sclerosis or other central nervous system conditions, oncology-related refractory symptoms, and advanced palliative care.

All are last-resort, meaning patients must have exhausted available alternatives before cannabis medicines can be considered.

What the decree is likely to contain

While the final text will not be available to the public until it is published in February, our sister publication, Business of Cannabis, detailed the draft framework presented to industry stakeholders at Cannabis Europa Paris, the first concrete view of the government’s proposed economic model.

At that stage, the draft proposed a tiered reimbursement structure tied directly to HAS’s assessment of each product’s therapeutic benefit, with coverage rates set at 65%, 30%, 10%, or 0%, corresponding to major, moderate, minor, or insufficient benefit respectively.

Since the majority of eligible patients suffer from long-term conditions that qualify for ALD (affection de longue durée) status under the French system, most could access cannabis medicines at 100% coverage regardless of their base reimbursement tier, though that question was still being finalised at the time.

Pricing under the draft model would be structured by homogeneous product categories, grouping medicines by pharmaceutical form, composition, and clinical characteristics, with a single price applied across each category, fixed for three years and revisable if new clinical evidence emerges.

Whether the final text reflects those proposals precisely is unknown. The draft went through a stakeholder consultation period of three to four weeks following the February meeting, and the government will have incorporated feedback before submitting the final text.

The Conseil d’État may also request modifications during its own review. The published decree, when it arrives, may differ in detail, but the economic architecture described in February has not been publicly contradicted.

If the review completes over the summer and the decree is published at the parliamentary opening on 1 October, HAS could deliver its reimbursement opinion before the year is out, with price negotiations to follow and first prescriptions under a permanent framework possible in 2027. The roughly 700 patients still enrolled in the pilot are covered until 31 December 2026, a deadline that now looks, for the first time in five years, like it might not need to be extended again.