Patient Access (ATU)

Workflow steps

1. Patient Need
   France provides medicinal cannabis access through the ATU (Autorisation Temporaire d'Utilisation) framework for products not on the authorized list, and standard prescription for products that are. The pilot program ran 2021–2024 and converted to permanent status in 2024.
   • Specialist physician evaluation
   • Qualifying condition documented
2. Specialist Physician Evaluation
   Patient evaluated by a specialist physician (pain, neurology, oncology, etc.). General practitioners cannot initiate medicinal cannabis prescriptions.
   • Specialist physician consultation
   • Qualifying condition diagnosis
   • Treatment history documented
   • Informed consent obtained
3. Product on authorized list?
   If the prescribed product is on ANSM's authorized list, standard prescription applies. If not, the ATU pathway is required.
4. Standard Prescription
   Product is on ANSM's authorized list. Specialist physician prescribes; dispensing at hospital pharmacy (expanding to community pharmacies).
   • Specialist prescription
   • ANSM-authorized product
   • Hospital or community pharmacy dispensing
5. ATU Application — Autorisation Temporaire d'Utilisation
   Named-patient framework for products not on the authorized list. Physician submits ATU application to ANSM on behalf of the patient.
   • ATU application to ANSM
   • Clinical justification
   • Product not on authorized list
   • Physician-named patient
6. ATU approved?
   ANSM reviews the ATU application. Processing time varies; may request additional clinical documentation.
7. Dispensing — Hospital pharmacy initially, expanding to community
   Medicinal cannabis dispensed to patient. Hospital pharmacies were the initial dispensing point; expansion to community pharmacies underway as the program transitions to permanent status. Prescriber hierarchy: ANSM → hospital/community pharmacist → specialist prescriber → patient.
   • Hospital or community pharmacy
   • Prescription or ATU authorization on file
   • Narcotic dispensing register
8. Patient Receives Medication ✓
   Patient receives medicinal cannabis. Follow-up with prescribing specialist required. ATU renewals may be needed for ongoing treatment.