Spanish Supreme Court admits appeal to expand access to medicinal cannabis in pharmacies

The Spanish Supreme Court admitted, this January, the appeal filed by the General Council of Pharmacists' Associations (CGCOF) against provisions of Royal Decree 903/2025.

The action questions the Spanish government's decision to limit the dispensing of cannabis-based medicines exclusively to hospital pharmacies, excluding community units (street pharmacies) from the process. 

The proceedings were confirmed after publication in the Official State Gazette (BOE) on January 2, although the legislation remains in force and without suspensive effect until the final decision.

Legal and health arguments

The pharmacists' central challenge is based on the Law of Guarantees and the rational use of medicines. According to the CGCOF, the exclusion of community pharmacies goes against current legislation.

In a statement, a source from the Council explained the basis of the appeal: “We consider the hindrance to dispensing to be contrary to the Law of Guarantees and, therefore, illegal, since article 3.6 of said law stipulates that the dispensing of medicines must take place in pharmacies, except in very specific situations that do not apply in this case”.

The Andalusian Confederation of Pharmacy Offices (CEOFA), which also filed a similar lawsuit, told Diario Médico that the government's measure was taken “unjustifiably and without technical foundation”. 

The entity emphasizes that pharmacies have the legal capacity and resources for the preparation of compounded medications (magistral formulas) according to the National Formulary.

The current regulations provide exceptions for the delivery of medications outside the hospital setting only in cases of dependency, vulnerability, or significant physical distance. However, patient advocacy groups argue that such measures are insufficient to ensure adequate access.

Current regulations (Royal Decree 903/2025)

While the appeal is pending in the Third Chamber of the Contentious-Administrative Court, the rules established by the Spanish government in October 2025 remain in effect. The model adopts a closed and highly restrictive circuit:

Allowed products: Only magistral formulas (oils and standardized extracts) prepared from inputs registered with the Spanish Agency of Medicines (AEMPS). The natural flower (for smoking or vaporizing) remains prohibited.

Prescription: Exclusive to specialist doctors (neurologists, oncologists, etc.) in a hospital setting. Primary care physicians and private clinics are not authorized to prescribe.

Authorized indications:

- Spasticity in Multiple Sclerosis;

- Severe refractory Epilepsy;

- Nausea and vomiting induced by chemotherapy;

- Refractory chronic pain (oncological or neuropathic).

Recently, the AEMPS formalized the inclusion of standardized THC and CBD oral solution formulas in the National Formulary, a technical step necessary for the implementation of the law, regardless of the judicial dispute over dispensing locations.