Medical Cannabis: Canada Dominates Global Exports, Germany Fuels Consumption Growth

The medical cannabis industry is the subject of much interest. More and more countries are getting involved and trying to establish themselves through their production and exports. Since late 2024, the strong increase in demand in the two largest medical cannabis markets outside the United States, Germany and Australia, has triggered a race among exporters to capitalize on this growth. In its Global Medical Cannabis Market Review published earlier this year, Prohibition Partners, a leading platform dedicated to the professional cannabis market, both medical and recreational (in countries where consumption is legal), paints a picture of a rapidly evolving sector.

On one side, Canada, whose market is expected to represent $339 million in 2026, is asserting itself more than ever as the dominant exporting power in the sector. On the other side, countries like Israel, Australia, and Portugal are trying to build their own national supply chain and exist as exporters, facing competition from Canadian producers, restrictive regulations, and still limited levels of demand. Favorable conditions created by a lack of training for doctors and the use of sometimes aggressive marketing techniques have led to the rise of teleclinics in several countries - including Australia, the UK, but especially Germany, which has become the main destination for exporting countries like Denmark, North Macedonia, or South Africa - a decisive factor in market development. Legislative reforms under discussion in several countries, including Germany, could reshape access conditions to medical cannabis as well as market evolution prospects.

Canada: Between Cannabis "Superpower" and Saturated Domestic Market

Since the legalization of recreational cannabis in Canada in 2018, massive investments from producers have led to the creation of gigantic production capacity. As a result, the country has gradually established itself as a powerful player in the global medical cannabis market, benefiting from the infrastructures created. After a significant increase in its export volume between 2023 and 2024, rising from 63 to 107 tons of therapeutic cannabis exported, it saw this same volume explode last year. "In 2025, according to export data published by the Canadian regulator, annual exported volumes exceeded 275 tons — more than 2.5 times the volume recorded in 2024,” the report states.

A spectacular increase of 168 tons that must then be sold. "Canada has a huge production surplus that significantly reduces profit margins in the Canadian domestic market,” explains Alex Khouradji, cannabis industry analyst and co-author of the report. Many companies are therefore looking to expand internationally to "find new sources of revenue and gain market share elsewhere.”

But "even when exporting to foreign markets, Canada still maintains a surplus of supply in its own market.” This surplus strengthens its ability to cut prices, also supported by a product of "relatively consistent quality.” A situation that frustrates other producing countries because "Canada does not import medical cannabis. In their domestic market, they are very protectionist” and "anti-competitive,” creating an imbalance.

^{Canadian medical cannabis exports, 2020-2025. Source: Global medical cannabis market review 2026, via Statistics Canada.}

Competitors Too Expensive or Undersized

Among those dissatisfied with this Canadian dominance is Australia, whose imports exceeded domestic production in 2023. Unable to meet its own demand, it had to resort to importing more medical cannabis from Canada, whose low prices compete with those of local producers. Some local operators claim they must meet stricter requirements than importers to ensure consistent analysis results from batch to batch for their products. In 2024, the country imported 80 tons of medical cannabis against 40 tons produced on its soil. In Israel, some producers have called for the implementation of protectionist policies. After initially considering an import tax mechanism, the idea was ultimately abandoned by the government on the grounds that it could "hinder the development of the national market and penalize patients by increasing product prices.”

At the same time, some countries are emerging, such as Thailand, South Africa, or Lesotho, and are beginning to position themselves to export medical cannabis to international markets. In South America, Uruguay, Colombia, or Brazil have the capacity to produce at low costs, just like North Macedonia or the Czech Republic in Europe. According to the analyst, all are "competitive players,” but they currently produce "volumes incomparable to those of Canada.”

On the European side, German, Greek, or British growers must comply with strict rules, forcing them to set a high price, inevitably higher than that of Canadian imports.

Despite this, in some countries, the preference for local products drives persistence and gives meaning to the existence of local production as in Germany, Australia, or the UK. According to Alex Khouradji, they "can offer more consistency to patients,” who prefer to know that their cannabis comes "always from the same farm” and that "the treatment will remain stable over time.”

Greece and Portugal Export More Than They Consume

Greece has adopted a different strategy. By banning imports of medical cannabis, it has, according to Alex Khouradji, "wanted first to develop its domestic market (...) to avoid a massive influx of products that could crush a still nascent local industry.” Today, demand remains low. It suffers from a reluctance among doctors to prescribe this product, linked to a lack of education. The number of patients is increasing modestly, and public perception of medical cannabis remains largely negative. It therefore exports its production surplus to other markets like Germany or the UK.

Portugal, too, exports more than it consumes. "What it lacks is mainly a framework for patient access," specifies Alex Khouradji. The country allows "about seven products on (its) market. For a medical cannabis product developed by a company to be authorized, the registration process is extremely long and patient demand is almost non-existent as very few doctors prescribe it.” In 2024, the country was still by far the largest European exporter, with over 31 tons of medical cannabis sent to neighboring countries, far ahead of Denmark with 10 tons or Spain with 6 tons.

Since 2018 and the establishment of a legal framework for the use of cannabis for medical purposes in Portugal, the country has strived to become an international platform for the cultivation and processing of medical cannabis. It now serves as a huge processing hub, even though there are still investments in production favored by low production costs and a suitable climate.

The Lack of Training for Doctors and the Rise of Teleclinics: Key Factors in Market Development

A large part of the study is devoted to the key role that telemedicine plays in the rise of the medical cannabis market, providing a solution to the lack of training for doctors. "If I want to go to the doctor, there is a good chance, depending on where I come from, that the doctor will tell me he is not comfortable with it, that he is not trained, that he thinks it is bad. There is a real stigma. (...) Facing a refusal or judgment can be very discouraging for some patients,” notes Alex Khouradji. It is in this context that telemedicine has developed, connecting patients with doctors who consider cannabis a medical treatment.

In 2025, Australia, Germany, and the UK had 47, 35, and 29 teleclinics respectively, with a surge in unique visitors in Germany: 4.2 million people visited the websites of the five largest teleclinics in the country, four times more than in the UK and ten times more than in Australia.

^{Total number of visitors to the websites of the five main medical cannabis teleclinics by country, in October 2025. Source: Global medical cannabis market review 2026, via Similar Web.}

These data make Germany a unique case where teleclinics have benefited, as the analyst explains, from the private payment model: "in Germany, there are two ways to obtain medical cannabis: either go through a telemedicine clinic paying out of pocket, or follow the traditional route, that is, general practitioner then specialist, with possible coverage by insurance.”

In many teleclinics, it is therefore enough to register and fill out a questionnaire without necessarily having direct interaction with a doctor. Depending on the symptoms checked, the request is forwarded to a doctor, sometimes located elsewhere in the European Union, who examines and validates the prescription.

"The fact that there is no need for a face-to-face consultation is what has really exploded this model,” observes Alex Khouradji. "But today, it is also increasingly contested by regulators.”

The Need for Legislation in Germany

Germany is currently facing, like Poland at the end of 2024, the need to legislate on telemedicine, discussing the idea "of returning to in-person consultations for prescriptions, and eliminating teleclinics as well as online questionnaires.”

If this is implemented, Alex Khouradji speaks of a probable decrease of about 50% in the market, with a scenario similar to what happened in Poland, which, four months after the implementation of regulation, saw the number of prescriptions drop by half, from over 72,000 to nearly 33,000. "But we would also anticipate a certain capacity for rebound. Many of these clinics have generated significant revenue over the past two years, and it is likely that they will adapt by developing hybrid models, or even mobile units allowing for in-person consultations on the ground,” thinks Alex Khouradji.

Poland, for its part, has seen its number of prescriptions increase again since March 2025, with levels now comparable to those before the drop. The analyst explains this by a temporary decrease in prices, linked to many products remaining in stock, followed by a sustainable adaptation of players who have developed hybrid models between mobile clinics and telemedicine.

As the report concludes, Germany's regulatory decisions regarding telemedicine will be scrutinized by regulators and operators from other countries. Among them, France, which, according to Alex Khouradji, "has enormous potential in terms of the number of patients ” and is about to vote on a decree setting the criteria for assessing the appropriateness of patient care and the conditions for reimbursement of treatments based on therapeutic cannabis.

What is meant by "medical cannabis"?

There is currently no universal or legally binding definition of "medical cannabis", applied uniformly across all countries.

On December 2, 2020, cannabis and cannabis resin were removed from Schedule IV of the 1961 Single Convention on Narcotic Drugs, reserved for substances considered particularly dangerous and having little or no recognized therapeutic value. By this decision, the United Nations Commission on Narcotic Drugs, the UN's decision-making body on drug policy, recognized its medical value. At the international level, cannabis remains a controlled substance, but its use is permitted for medical and scientific purposes.

Each country can then legally define what constitutes a "medical cannabis" product, its prescription conditions, and the forms it allows.

"Medical cannabis" can therefore be prescribed in the form of cannabis flowers generally intended for vaporization, in the form of oils or standardized extracts (pharmaceutical preparations whose composition is rigorously controlled and reproducible) or medications containing THC (tetrahydrocannabinol), CBD (cannabidiol), or both. Some countries limit their authorization to only cannabis-based medications that have market authorization.