The army’s monopoly on the production of medical cannabis prevents Italian patients from accessing cannabis

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While Italy is both one of the first and largest markets for medical cannabis in Europe, new data has revealed the continued failure of its system to “meet patient needs”.

Italy’s medical cannabis market has seen double-digit growth for several years, but the country continues to see its military hold a monopoly on domestic cultivation.

With domestic army production failing to grow since 2019, this monopoly is strangling the growth of one of Europe’s largest medical cannabis markets, which is now Europe’s second largest in terms of patient numbers.

Conor O’Brien, industry and data analyst at Prohibition Partners, told BusinessCann, “The government monopoly on medical cannabis production in Italy has been a complete failure. »


New figures obtained from the Italian Ministry of Health by Italian journalist Fabrizio Dentini show that while domestic supply increased last year from a low in 2020 of just 37kg, it still represents only a fraction of total demand.

In 2021, the Italian military grew 101,904kg of medical cannabis, marking a 175% increase from the previous year, but this was a 17% drop from 2019’s 123kg.

Despite recovering from such a dramatic drop in 2020, this represented a small share of the total medical cannabis sold in Italian pharmacies that year.

Year Kilos sold in pharmacies Kilos grown in Italy % of domestic market
2014 59 0 0%
2015 119 0 0%
2016 138 0 0%
2017 351 56 16%
2018 578 113 20%
2019 861 123 14%
2020 1,123 37 3%
2021 1,271 102 8%

“The numbers speak for themselves,” Dentini told BusinessCann.

“Indeed, if we compare to the 1,400 kilograms estimated by the Ministry of Health as a national need for 2021, the military agency has only managed to cover 8% of the 1,271 kilograms concretely distributed during the same year “.

“The monopolistic production regime de facto fails to fulfill the functions for which it was put in place, and the absence of production permits for the private market blocks the development of a healthy and competitive production chain. »

After launching its medical cannabis program in 2007, the Italian government took steps to enable its military to start producing medical cannabis in 2015 as part of a project to “fully meet the growing needs of Italian patients”. “.

The government continues to tender for all production in the country, and it is understood that it has only awarded 5 licenses to distribute medical cannabis so far.

“To deal with the obvious inability to produce, the Italian State is appealing to the cyclical structural import of medical cannabis from Holland (≈900 kilos imported in 2021)”, explained Mr. Dentini.

Despite importing limited quantities of medical cannabis from Canada and, more recently, Australia, through agreements with Aurora and Little Green Pharma respectively, the limited number of licenses results in a continued shortage of medical cannabis in the country.

According to Mr. Dentini, this situation has led to the launch of “numerous emergency procedures” for the “import a tantum batches of cannabis for medical use”.

On August 24, he launched a new call for the emergency import of batches of medical cannabis to meet the growing deficit.

The appeal, with a deadline of October 5, 2022, requires 630 kg of dried cannabis, including 530 kg of high-THC cannabis, 50 kg of high-CBD cannabis and an additional 50 kg of balanced-strength cannabis. .

“The aforementioned quantity was determined by taking as a reference a unit price per gram estimated at €3 and setting the maximum contractual amount of the supply at €1,810,000. »

Home cultivation on the horizon

“The government’s strict control over the domestic production and importation of medical cannabis has meant that many patients in need of relief have been unable to obtain their medication. Shortages like this are a circuit breaker for the industry as well. If patients and physicians experience even a single shortage, they feel they cannot count on the same drug to be consistently available in the future. »

Current supply issues make the legislation being considered by the Italian government even more important for the country’s medical cannabis patients, who are now estimated to number well over 20,000.

In July, a bill on the decriminalization of cannabis, which had been in the legislative limbo of the Justice Commission since 2019, had finally reached the Chamber of Deputies, the lower house of the Italian parliament.

The bill should be passed by the Senate in September. If passed, the law will be changed to allow any Italian adult to grow up to four cannabis plants for their “personal use”.

While the bill does not actively address the country’s supply problems with medical-grade cannabis, it is designed to prevent those in need from turning to the black market, a problem that O’Brien says , continues to hamper market growth.

“Shortages like this create a circuit breaker for the industry as well. If patients and physicians experience even a single shortage, they feel they cannot count on the same drug to be consistently available in the future. »

“This pushes some patients to leave the legal cannabis space, return to illicit use or seek alternatives such as opiates. This is a major reason why the use of legal medical cannabis in the country has not increased as much as it should have over the past five years. »

“The government must produce a lot more, but in the short term it must also open import licenses if it really wants to meet the needs of patients. »

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