Switzerland’s 2022 reform made medical cannabis legally accessible to any prescriber, yet two years of federal MeCanna data reveal a market still defined by limited scale rather than open access. Beneath that constrained surface the picture is shifting: a patient base broadening beyond pain, and a product mix moving decisively toward flower. As adult-use pilots gather momentum, Switzerland is emerging as one of Europe’s most important medical cannabis markets to watch — even as reimbursement and access remain the binding constraints on its growth.
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Switzerland occupies an unusual position in Europe’s medical cannabis landscape. Prescribing has been legally unrestricted since 1 August 2022, when an amendment to the narcotics ordinance removed the requirement for a federal exceptional authorisation and handed that decision to any physician. Yet the country remains one of the continent’s smaller reported medical markets. The Federal Office of Public Health’s MeCanna reporting system is the only structured, government-run window into what is actually being prescribed, to whom, and with what results — and with two datasets now available, covering August 2022–July 2023 and a second draft spanning August 2023–July 2025, it is possible to read how prescribing has evolved since liberalisation. This article works through that evidence across three dimensions: how much prescribing activity the system actually captures, what conditions are driving reported use, and how the dispensed product mix has changed.
A Reporting System Capturing a Fraction of Prescribing Activity
The clearest signal in the MeCanna data is not what has grown, but what has not. In the scheme’s first year, 924 physicians registered to report cannabis prescriptions, yet only 384 — 41.6% — ever submitted a therapy report. Two years on, the picture has barely moved: just 404 physicians filed any report across the entire 2023–2025 window, and reporting stays concentrated among a small repeat-prescriber group, with 58% of active physicians filing only once. Report volumes tell the same story.
MeCanna logged 724 reports in 2022–2023 and 1,183 across the longer 2023–2025 period — but on an annualised basis that is a decline, from 724 to roughly 592 reports a year. Measured against the ~2,800–3,000 exceptional authorisations granted annually before the 2022 reform, MeCanna is capturing only about one-fifth to one-quarter of expected treatment activity.
The mechanism is well understood: every prescribing doctor is meant to complete a mandatory report that takes around 15 minutes per case, is unpaid, and is widely skipped — a gap Swiss health officials themselves acknowledge. Every MeCanna figure should therefore be read as a floor, not a level. Reported patients numbered roughly 1,065 in 2023–2025 (the Federal Council separately confirmed about 1,200 patients in 2025) — far below the ~10,000 people believed to obtain cannabis medicines through pharmacies, and a fraction of the ~110,000 estimated to be self-treating with cannabis outside formal channels. MeCanna is not a census of the Swiss medical market; it is a reduced, self-selected sample of it.
Patient Reports & Reporting Doctors in Switzerland (2022–2025)
A Patient Base Broadening Beyond Pain
Pain remains the anchor indication for Swiss medical cannabis, but it is no longer the whole story. On a like-for-like reconstruction of the two reporting periods, pain accounts for roughly 74% of patient symptoms in 2023–2025, only modestly down from 77% two years earlier, while sleep disorders rose from 16% to 23% and depression-related symptoms edged up from 9% to 11%.
Patients by Treated Symptom & Underlying Condition (2022–2025)
The shift is sharper by diagnosis. Mental and behavioural conditions — led by ADHD, which jumped from 1.6% to 7.0% of diagnoses — grew from a 4% to an 11% share of the patient base, while multiple sclerosis fell from 7% to 3% and cancer from 12% to 8%. Patients are also presenting with more complex profiles: the share with two or more diagnoses rose from 3.1% to 28.1%, which may reflect a genuinely broadening case mix, better reporting discipline, or both.
This broadening toward sleep and mental-health demand mirrors the trajectory of more mature European markets. It comes with a caveat worth flagging rather than resolving: a 2025 Swiss study found only weak evidence for cannabis in depression, anxiety and ADHD, with roughly one in seven patients reporting side effects. The same shift helps explain why Sativex — purpose-built for MS spasticity — is losing ground, as multiple sclerosis and spasticity lose relative weight in the reported patient base.
Flower Moves From Marginal to Mainstream
The most significant commercial shift in the MeCanna data is in what is actually being dispensed. Cannabis flower rose from 2.0% of reported product forms in 2022–2023 to 26.2% in 2023–2025, while balanced oils and tinctures — the original cornerstone of Swiss magistral dispensing — fell from a combined 54.0% to 40.0%. Finished products, including Sativex, slipped from 19% to 10%, confirming that Switzerland remains predominantly a magistral-prescription market rather than a finished-pharmaceutical one..
The consequences run deeper than labelling. Because flower and resin are vaporised rather than swallowed, inhaled administration climbed from a negligible 2% of the market to 27%, and THC-dominant preparations roughly doubled their share, from 25% to 49%, at the expense of balanced or CBD-containing formulations. Supply is not the constraint: a 2026 manufacturer directory shows extracts still make up around half of listed products against flower’s 35%, broadly in line with demand.
Reimbursement is the constraint. Among the 344 reported treatments with reimbursement status recorded, 85.2% received no cover at all, and nationally only around 70 of the roughly 10,000 patients obtaining cannabis medicines through pharmacies receive any insurance reimbursement — with about 90% of prescriptions fully self-paid. Pricing compounds the problem: a 2026 investigation found the same THC oil priced up to 34 times higher between pharmacies, ranging from CHF 0.05 to CHF 1.76 per milligram.
Medical Cannabis Product Mix in Switzerland (2022–2025)
The Direction Is Clear, Even If the Data Is Limited
Two years of MeCanna data tell a consistent story: Switzerland’s 2022 reform solved legal access to medical cannabis, but not the practical barriers around it. Physician participation has not broadened materially, reimbursement remains the exception rather than the rule, and pricing is opaque enough to vary more than thirtyfold for an identical product. And yet, within that constrained frame, the market is unmistakably changing shape — toward a more diverse patient base and a product mix now led as much by flower as by the balanced oils that once defined Swiss magistral prescribing. Whether this becomes the foundation for something larger will depend less on further growth in prescribing than on reimbursement reform and Switzerland’s adult-use pilots, which had enrolled around 10,400 participants by mid-2025 and continue to feed the country’s CanPG legalisation process — a trajectory now realistically pointing toward 2029–2030. The data is limited. The direction is not.