Most Countries Where CBD Is Approved for Epilepsy Still Can't Afford or Access It | Research

The takeaway

An ILAE global survey found that while 32 countries have approved cannabinoids for epilepsy, 72% report them unaffordable and 56% report them difficult to access — and 63% of surveyed countries haven't approved them at all.

Epilepsy specialists, health policy researchers, patient advocacy organizations, and families affected by drug-resistant epilepsy.

What the researchers found

Of 86 responding ILAE chapters (68% response rate), only 32 countries had regulatory approval for cannabinoids in epilepsy, with 21 approving only CBD. Among approved countries, 23 (71.8%) reported cannabinoids unaffordable and 18 (56.2%) reported them difficult to access. Unapproved cannabinoid products were available over-the-counter in 34 countries.

Why it matters

Even where cannabinoids are legally available for epilepsy, most patients can't access or afford them. Meanwhile, unregulated products are filling the gap in 40% of countries, raising quality and safety concerns for patients with drug-resistant epilepsy.

The numbers in context

86 of 126 ILAE chapters responded (68%). 32 countries approved cannabinoids for epilepsy. 21 of 32 approved only CBD. 71.8% in approved countries report them unaffordable. 56.2% report them difficult to access. 54 countries (62.7%) have no approval. 34 countries (39.5%) have unapproved OTC products. 47 countries report traditional cannabinoid-containing plant products.

How the study worked

Survey conducted by the ILAE Plant-Based Therapy Task Force through its chapters from June to December 2023. 86 of 126 chapters (68%) responded. Responses were screened and analyzed using pre-set criteria for availability, accessibility, and affordability.

What this study cannot tell us

Survey-based, relying on chapter representatives' knowledge. 32% non-response rate may introduce bias. Snapshot from 2023, and availability is changing rapidly. Cannot capture patient-level access experiences.

How to read the evidence

Large-scale global survey with 68% response rate from the authoritative ILAE network, providing the most comprehensive global access data available.

When this study was published

Published 2025, survey data from June–December 2023.

The bigger picture

CBD for epilepsy is one of the most evidence-based uses of cannabinoids in medicine, with FDA and EMA approval. Yet this survey reveals that regulatory approval alone is not enough — affordability and access remain massive barriers, and nearly half the world's ILAE chapters want advocacy help.

Questions still open

What policy interventions would most effectively improve cannabinoid affordability for epilepsy? Could generic CBD formulations address cost barriers? How can quality be ensured for the unregulated products already being used in 34 countries?

Common questions

Is CBD available for epilepsy everywhere?

No. Only 32 of 86 surveyed countries have approved cannabinoids for epilepsy. Even where approved, most countries report them unaffordable (72%) or difficult to access (56%). Over-the-counter unapproved products are available in 34 countries.

What about generic CBD for epilepsy?

The survey highlights affordability as a major barrier, suggesting that generic or subsidized formulations could dramatically improve access. Currently, 49% of responding countries expressed need for ILAE advocacy to improve cannabinoid accessibility.

Read the original research

Availability and affordability of cannabinoids for epilepsy treatment across different geographic settings-A survey from the ILAE Plant-Based Therapy Task Force.

Epilepsia, 66(12), 4639-4653

View on PubMed ↗Publisher’s paper ↗

Citation

Vinayan, Kollencheri Puthenveettil; Asadi-Pooya, Ali Akbar; Jyotsna, Aruna Setumadhava; Kumar, Nithya N; Elsas, Siegward-M; Johannessen Landmark, Cecilie; Matsabisa, Motlalepula; Mesraoua, Boulenouar; O'Callaghan, Finbar; Thiele, Elizabeth; Zhang, Chunbo; Riney, Kate. (2025). Availability and affordability of cannabinoids for epilepsy treatment across different geographic settings-A survey from the ILAE Plant-Based Therapy Task Force.. Epilepsia, 66(12), 4639-4653. https://doi.org/10.1111/epi.18622