WHILE Italy is both one of the earliest and largest medical cannabis markets in Europe, new data has revealed the ongoing inability of its system to ‘serve patients’ needs’.
Italy’s medical cannabis market has been growing by double-digit percentage points for a number of years, yet the country continues to see its military hold a monopoly over domestic cultivation.
With the military’s domestic production failing to grow since 2019, this monopoly is strangling the growth of one of Europe’s most important medical cannabis markets, now the second largest in Europe by number of patients.
Prohibition Partners’ Industry and Data Analyst Conor O’Brien told BusinessCann: “The government monopoly over medical cannabis production in Italy has been an unmitigated failure.”
Undersupply
New figures procured from the Italian Ministry of Health by Italian journalist Fabrizio Dentini show that while domestic supply grew last year from a low in 2020 of just 37kg, it was still a fraction of total demand.
In 2021, the Italian military grew 101.904kg of medical cannabis, marking a 175% increase on the previous year, but this was a 17% decline on the more comparable 123kg in 2019.
Despite the recovery from such a dramatic decline in 2020, this represented a fraction of the total medical cannabis sold in Italian pharmacies that year.
Year
Kg Sold to Pharmacies
Kg Grown in Italy
Domestic %
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 figures speak for themselves,” Mr Dentini told BusinessCann.
“In fact, if compared to the 1,400 kilos estimated by the Ministry of Health as national requirement for 2021, the military agency only managed to cover 8% of the 1,271 kilograms concretely distributed during the same year.
“The monopoly production regime de facto fails to carry out the functions for which it was put into operation, and the lack of production authorisations for the private market blocks the development of a healthy and competitive production chain.”
After launching its medical cannabis programme in 2007, the Italian government moved to allow its military to begin producing medical cannabis in 2015 as part of a project designed to ‘fully meet the growing needs of Italian patients’.
The government continues to tender all production in the country, and is understood to have granted only five companies a licence to distribute medical cannabis so far.
“To cope with the evident production inability, the Italian state makes use of the cyclical structural import of medical cannabis from Holland (≈900 kilos imported in 2021),” Mr Dentini explained.
Despite also importing limited amounts of medical cannabis through Canada and, most recently, Australia, via agreements with Aurora and Little Green Pharma respectively, the limited number of granted licences means that large gaps in supply and continued deficits persist throughout the country.
According to Mr Dentini, this has resulted in ‘numerous emergency procedures’ being initiated for ‘una tantum import of batches of medical-grade cannabis’.
On August 24 this year, called for another emergency batch of medical cannabis to meet the growing deficit.
The call, which has a deadline of October 5, 2022, requires 630kg of dried cannabis, including 530kg of high-THC cannabis, 50kg of high-CBD cannabis and an additional 50kg of cannabis with a balanced titration.
“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 strict control being kept by the government over domestic production and import of medical cannabis has meant that many patients in need of relief have been unable to source their medicines. Shortages like this create a circuit breaker for the industry, too. If patients and doctors experience even one shortage, then they feel they can’t rely on the same medicine being available consistently in the future.
The ongoing supply issues make legislation currently being considered by the Italian Government even more important for the country’s medical cannabis patients, which are now thought to number well over 20,000.
In July, BusinessCann reported that a cannabis decriminalisation bill, which had been in legislative limbo with the Justice Commission since 2019, had finally reached the Chamber of Deputies, the lower house of parliament in Italy.
The bill is expected to be voted on by the upper parliamentary Senate some time in September, and if passed would see the law changed to allow any Italian adult to grow up to four cannabis plants for ‘personal use’.
While the bill may not actively address the country’s supply issues regarding medical-grade cannabis, it is designed to prevent those in need turning to the black market, an issue Mr O’Brien points out continues to hamper the growth of the market.
“Shortages like this create a circuit breaker for the industry, too. If patients and doctors experience even one shortage, then they feel they can’t rely on the same medicine being available consistently in the future.
“This causes some patients to leave the legal cannabis space, going back to illicit consumption or to seek alternatives such as opiates. It’s a key reason the use of legal medical cannabis in the country hasn’t grown as much as it should have over the past five years.
“The government needs to produce a lot more, but, in the near term, needs also to open up licensing for imports if they are serious about serving patient needs.”
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