Cannabis Terapeutica in Italy: Prescriptions, FM2 and Who Pays

Four hundred kilograms. That is how much cannabis Italy's only authorized grower, the Military Chemical-Pharmaceutical Plant in Florence (SCFM), may produce in 2026 under the Health Ministry's quota decree of November 5, 2025. It is the same figure as the three previous years, and it covers a fraction of what pharmacies dispense.

The gap shapes the patient's experience: pharmacies sometimes wait for stock, and the product on your prescription may be Italian or imported. This guide explains how access works in practice. It is general information and not medical advice; talk to your doctor about whether cannabis suits you.

Who can prescribe, and for what?

Any doctor registered with the Ordine dei Medici can prescribe; no specialist license is needed. The prescription is a non-repeatable magistral prescription under Article 5 of Law 94/1998, and the doctor must collect the patient's written informed consent.

The health ministry's 2017 recommendations for prescribers describe cannabis as a symptomatic treatment that supports standard care when that care has failed or caused intolerable side effects. The listed uses are:

• Pain with spasticity — multiple sclerosis or spinal cord injury, resistant to conventional therapy.
• Chronic pain — especially neuropathic pain, when anti-inflammatories, steroids or opioids have not worked.
• Nausea and vomiting — from chemotherapy, radiotherapy or HIV therapy.
• Loss of appetite — cachexia and anorexia in cancer or AIDS patients, and in anorexia nervosa.
• Glaucoma — resistant to conventional therapy.
• Tourette syndrome — involuntary movements not controlled by standard treatment.

A doctor can prescribe outside this list at their own responsibility, but regional reimbursement is usually tied to specific conditions.

From prescription to pharmacy: the steps

1. Consultation
   Your GP or a specialist decides whether cannabis fits, chooses the product and the THC/CBD profile, and records age, sex, dose and indication for the national monitoring run by the Istituto Superiore di Sanità.
2. Prescription
   You receive a non-repeatable magistral prescription. It is personal: the cannabis cannot be given to anyone else.
3. Pharmacy
   Take it to a pharmacy with a galenic laboratory. It orders the substance and prepares the dose form.
4. Keep the stamped copy
   The pharmacist returns a stamped, signed copy of the prescription. It is your proof that you possess the cannabis lawfully, so carry it.
5. Reimbursement
   If your region covers your condition, the preparation is dispensed through the regional health service; otherwise you pay the pharmacy price.

FM1, FM2 and imported flower compared

FM2 is the balanced option and the one the ministry's prescriber guidance was written for. The SCFM describes itself as the only national center for cultivating, processing and distributing medical cannabis, and it also makes standardized oily extracts. In July 2025 Materia Medica Processing in Siena was presented as the first Italian GMP-certified company for processing and packaging cannabinoid active ingredients, according to Il Sole 24 Ore; it works with imported cannabis and does not grow the plant.

How patients take it

The ministry guidance covers two routes for FM2: a decoction, taken by mouth, and inhalation through a vaporizer. Pharmacies also prepare oils. Smoking is not a prescribed method.

Who pays: it depends on the region

Reimbursement is set by each region and autonomous province through its own laws or resolutions, the ministry guidance says. Some regions pay for specific conditions and set their own rules; elsewhere the patient pays in full.

Before your appointment, ask the local health authority (ASL) which indications your region covers and whether the prescription must come from a specialist or a hospital clinic to qualify. Price per gram at the pharmacy varies with the product and the preparation; SCFM's own production price was €6.88 per gram before VAT, according to a 2024 trade report.

CBD oil is not cannabis terapeutica

CBD products sold in shops are not medicines. A June 27, 2024 ministry decree that lists oral CBD compositions among prescription medicines has been frozen in court since December 2025, when the Council of State suspended the ruling that upheld it; in August 2026 the same court referred the case to the EU Court of Justice. See our Italy overview for the wider rules and what happens outside the medical system. If symptoms worsen or you have side effects such as confusion, palpitations or mood changes, contact your doctor.