Distribution Channels: Pharmacies vs. Cannabis-Specific Systems in Europe and Israel

Once a medical product is approved or authorized, how it reaches patients is critical to the healthcare equation. In Europe and Israel, the distribution of pharmaceuticals is highly regulated and consistent. But when it comes to medical cannabis, the rules are still catching up — and they differ significantly from traditional pharmaceutical channels.

Pharmaceuticals: A Standardized, Secure Supply Chain

In the world of traditional medicine, distribution is straightforward and intensely regulated.

• In Europe, approved drugs follow a supply chain involving licensed wholesalers and registered pharmacies. Every product is traceable, with strict cold-chain or temperature-sensitive protocols when needed.

• Israel operates similarly, with all pharmaceuticals distributed through approved pharmacies under the Ministry of Health’s supervision.

Doctors prescribe, pharmacies dispense, and national insurance schemes often reimburse part or all of the cost.

Medical Cannabis: A Different Distribution Model

Despite its medical classification, cannabis is not distributed like conventional medicine in most parts of Europe or Israel.

🇮🇱 Israel: A Centralized Cannabis Supply System

Israel has developed a semi-centralized model:

• Patients require a license from the Ministry of Health (via the Medical Cannabis Unit).

• Once approved, patients can purchase products from a select network of authorized pharmacies or licensed distributors.

• Products are prescribed by trained physicians (who complete cannabis-specific certification) and are typically not covered by national health insurance.

Israel’s system ensures controlled access, but it also creates bottlenecks in availability and sometimes limits patient choice to specific strains or brands.

🇪🇺 Europe: Fragmented and Country-Specific

The situation in Europe is more fragmented, as cannabis regulations differ by country:

• Germany allows medical cannabis prescriptions to be filled at regular pharmacies, but the products are often imported and handled under EU-GMP.

• The Netherlands operates through a single supplier model, with Bedrocan providing standardized cannabis products via pharmacies.

• Other countries, like the UK or Czech Republic, have special access schemes or pilot programs, but rely on limited prescriber networks and non-reimbursed private payment models.

In many cases, medical cannabis is dispensed through pharmacies but not integrated into broader pharmaceutical distribution systems.

Challenges in Cannabis Distribution

Key issues in the cannabis supply chain include:

• Product inconsistency (due to strain variability)

• Import dependencies (particularly in Europe)

• Limited physician training

• Insurance and reimbursement gaps

These issues often create access delays, high costs, and a lack of confidence from healthcare providers and patients.

Looking Ahead: Toward Integration

As more clinical data becomes available and regulatory frameworks mature, the expectation is that medical cannabis will gradually be integrated into standard pharmaceutical distribution systems.

Both Europe and Israel are taking steps in that direction, but for now, cannabis continues to travel a parallel track — prescribed differently, delivered differently, and governed by a distinct set of rules.