A patient with multiple sclerosis suffers from severe spasticity. His neurologist mentions Sativex, a cannabis-based medication. The following question is almost always the same: how to obtain it legally in France, in a framework that has yet to stabilize?
Sativex in France: an authorized medication but not yet available in pharmacies
Sativex (nabiximols) has received marketing authorization in France. Its indication is for spasticity related to multiple sclerosis when standard treatments have proven insufficient.
Having a marketing authorization does not guarantee availability in pharmacies. Sativex is still not marketed or reimbursed in France. A medication can be legally authorized without ever being found on the shelves of a city pharmacy.
In light of this situation, patients and doctors must navigate heavier administrative processes, but these are regulated. The concrete options still available are detailed on the Le Réseau Santé website.
Prescription of therapeutic cannabis: the transitional framework of 2026
The French experiment with medical cannabis began in March 2021 and ended on December 31, 2024. Since then, no new patients can be integrated. Those already treated continue to receive extended follow-up.
According to Service-Public.fr (verified on September 14, 2026), this transitional period has been extended until three months after the publication of the HAS opinion. The goal is simple: to avoid any treatment interruption for patients still under care.
Why these successive extensions? The definitive regulatory framework does not yet exist. The decree setting the rules for care has been submitted to the Council of State for review during the summer of 2026, and the HAS has not yet issued its final evaluation.
It is the absence of complete regulatory texts on reimbursement and implementation that blocks real access. The legal basis exists. What is missing is the operational circuit to transform this theoretical right into effective treatment.
Concrete steps to obtain Sativex legally
Three access routes are provided by French law. None go through a standard consultation with a general practitioner.
Temporary authorization for individual use
The nominative ATU, renamed “compassionate access” since 2021, allows a hospital physician to request the use of a non-marketed medication for a specific patient. The request is submitted to the ANSM, which decides on a case-by-case basis.
- The prescriber must work in a healthcare facility, most often in neurology
- The file must prove the failure or contraindication of available treatments
- The ANSM grants or refuses authorization for a specifically designated patient
- Dispensing is done through the hospital pharmacy, never through a city pharmacy
This procedure takes time and requires close coordination between the neurologist, the hospital pharmacy, and the drug agency.
Regulated import from a European country
Sativex is marketed in several European Union countries. Germany, for example, has integrated it into its standard pharmaceutical circuit.
A French doctor can, in exceptional cases, initiate an import procedure via the ANSM. The patient cannot order the product themselves from abroad: any personal import of a THC-containing medication remains illegal.
Inclusion in post-experimentation follow-up
Patients who participated in the national experiment before March 27, 2024, can still receive prescriptions for cannabis-based medications. Only patients already included before this date are concerned, and their follow-up continues in the initial reference structures.
For a new patient in 2026, this route is closed. The options left are compassionate access or waiting for the permanent framework.
Evaluation by the HAS: what is blocking and what is progressing
In July 2025, the HAS published its evaluation method for cannabis-based medications. This document, adopted by the College on July 23, 2025, describes how the transparency commission will examine these products.
A crucial point for patients: the HAS excludes from this evaluation medications that already have a marketing authorization. Sativex, which has one, falls under a separate evaluation circuit. This administrative nuance directly alters the access timeline.
The French model is moving towards a regulated pharmaceutical circuit, not towards a dispensary system comparable to what exists in Canada or certain U.S. states. Each cannabis-based medication will be evaluated individually by the transparency commission, according to the criteria of medical service rendered.
- The implementing decree, submitted to the Council of State during the summer of 2026, must set the conditions for prescription and reimbursement
- The HAS opinion, expected after this step, will determine the end of the transitional period
Spasticity related to multiple sclerosis is among the priority indications selected during the experiment. The data collected from treated patients will inform the final evaluation.
The process to obtain Sativex in France remains primarily hospital-based. The treating physician can refer to a hospital neurologist, but the initial prescription, the request for compassionate access, and the dispensing go through the hospital. As long as the permanent regulatory framework is not published, this reality will not change.
