Spain’s Ministry of Health has initiated a substantial regulatory shift with the September 2025 publication of a draft royal decree designed to operationalize medical cannabis under a tightly controlled framework. This long-awaited move positions Spain to join other major European markets with a formal medical cannabis program governed by its central authority, the Agencia Española de Medicamentos y Productos Sanitarios (AEMPS). Below, we break down the decree’s structure, its rollout timeline, who can prescribe and dispense, product forms covered, and the broader implications for businesses and patients.
Key Dates and Rollout Timeline
The draft royal decree was released for public consultation at the end of September 2025. Final approval is expected in early 2026, with implementation likely phased over 6–12 months to allow for licensing, infrastructure, and training for prescribers and pharmacies.
- Q3/Q4 2025: Public consultation and EU regulatory notification. Stakeholder input invited.
- Q1 2026: Anticipated adoption and official publication of the Royal Decree.
- Mid to Late 2026: Stepwise rollout, starting with prescriber registration, AEMPS licensing, and opening of eligible hospital pharmacies for dispensing.
For the latest status and official documents, visit the AEMPS Medical Cannabis section.
Who Can Prescribe?
Restricted Prescriber Pool
The draft decree limits prescription authority almost exclusively to hospital-based specialists and physicians practicing within the national health system (SNS). General practitioners and private-clinic doctors will not be able to prescribe, marking a significant contrast to more liberalized regimes like those in the UK.**
- Eligible prescribers include: oncologists, neurologists, pain specialists, and select other hospital-based professionals.
- Prescriptions are restricted to specific indications with substantial clinical evidence—such as chronic pain from cancer, certain refractory epilepsies, spasticity in multiple sclerosis, and some palliative care scenarios.
This approach is intended to ensure tight clinical oversight and minimize diversion.
Dispensing Points: Hospital Pharmacies Only
Medical cannabis will be dispensed exclusively through hospital system pharmacies. Unlike Germany or the UK, community pharmacies and private clinics are excluded at launch.
- Hospital pharmacy teams will handle preparation of standardized cannabis products, labeling, and patient counseling.
- Initial priorities will center on in-patient and specialty outpatient care. Broader pharmacy access—a model seen in Germany post-2024 reforms—is not planned in the first phase.
This limits point-of-sale options for patients and establishes a highly centralized distribution chain.
Spain’s policy focuses on standardized master formulas and preparations registered with the AEMPS. The decree specifies:
- THC and/or CBD extracts are eligible, provided they meet pharmaceutical standards. Raw flower and unregistered full-spectrum products are excluded.
- Dosage forms will include oral oils, capsules, and potentially oral sprays—inhalable forms or smoking products are not expected to be permitted in the initial phase.
- Only products manufactured under EU-GMP (Good Manufacturing Practices) or equivalent standards are eligible, whether produced domestically or imported.
Learn more about product standards via the Forbes coverage on Spain’s decree.
AEMPS Licensing: Production, Distribution, and Compliance
Producers: EU-GMP Is Mandatory
Licensing for cultivation, production, and wholesale will be strictly regulated by AEMPS.
- Only entities registered and approved by AEMPS—meeting stringent EU-GMP criteria—may supply the medical cannabis market.
- This opens limited opportunities for existing Spanish producers (primarily those with research/export expertise), as well as international EU-GMP-compliant suppliers.
Distributors and Pharmacies
- Distribution is confined to channels directly linked to the SNS and hospital pharmacies.
- Spanish community pharmacies and private facilities remain outside the system initially. Future revisions may adjust these rules.
- Import licensing for EU-GMP products will also be administered by AEMPS, as seen in Germany’s medical cannabis framework.
Compliance, Tracking, and Patient Safeguards
Prescription and Dispensing Controls
- Electronic prescription and tracking will be mandatory, linking hospital IT with AEMPS’ central database.
- Pharmacovigilance: Prescriber and pharmacist reporting of outcomes, side effects, and adverse reactions is a core requirement.
- Labeling and packaging must comply with pharmaceutical norms—dosing, storage, expiry, and warnings are tightly regulated.
Patient Implications and Possession Rules
- Medical users must have a valid prescription and may only possess/transport prescribed quantities.
- Home cultivation is not permitted under the draft decree.
- Product selection and dosage are determined by hospital doctors only.
How Spain Compares: Germany and UK Contrasts
Germany (Post-2024 Reforms)
- Germany’s medical cannabis access was expanded as part of broader reforms, now allowing dispensing via community pharmacies and to a wider range of medical providers.
- Broader product range (including dried flower) and more liberal import rules provide a larger market.
- Spain’s model is notably more restrictive at launch, limiting both patient and business access.
United Kingdom
- Prescriptions largely private-sector and clinic-based—including via telemedicine, with broad doctor eligibility.
- The private prescription model creates greater access for patients with financial resources but less insurance coverage compared to Spain’s SNS-based program.
- Both Spain and the UK use EU-GMP standards but diverge sharply on prescriber and pharmacy dispersion.
Opportunities and Challenges for Businesses
EU-GMP Producers
- Spain’s policy provides clear incentives for EU-GMP-certified businesses, with minimal space for informal or non-pharmaceutical operators.
- Domestic and international suppliers will need to work closely with AEMPS to qualify for tenders or supply contracts.
Distributors
- Limited distribution opportunities at launch, focused on hospital-linked wholesalers. Future regulation could expand this, but stakeholders should prepare for a slow onboarding.
Spanish Pharmacies
- Hospital pharmacies will need additional training and upgraded facilities to handle cannabis preparations. Community (retail) pharmacies may need to wait for subsequent regulatory phases.
Stay informed on regulatory amendments and rollout phases at AEMPS and industry associations like Business of Cannabis.
Takeaways for Stakeholders
- The 2025/26 Spanish medical cannabis framework will be among Europe’s most restrictive—at least in early years—but is a seminal step for patients and a signal for future liberalization.
- Strict AEMPS licensing, EU-GMP-only supply, hospital pharmacy control, and limited eligible indications define the new regime.
- Businesses: Now is the time to engage with AEMPS and start compliance preparations for future licensing and product registrations.
- Patients: Expect highly centralized access, with prescriptions only from hospital specialists and limited product forms available.
Regulatory requirements are evolving. For detailed compliance support, ongoing license monitoring, and expert industry research, visit CannabisRegulations.ai and streamline your path to Spain’s changing cannabis market.
