The implementation of medicinal cannabis in Panama has once again entered a phase of both anticipation and uncertainty among patients. Although the Ministry of Health (Minsa) announced modifications to the decree regulating Law 242 of October 13, 2021, on medicinal cannabis—including the future availability of the product in authorized pharmacies—patient organizations maintain a cautious stance, as key elements for full implementation are still missing.
An important change was the elimination of the closed list of diseases for which the use of medicinal cannabis was permitted. This step was welcomed, as science is dynamic, and a rigid list could hinder patients' access to scientific advancements. With this adjustment, any authorized doctor will be able to issue a prescription for a patient with a clinically validated condition to consider cannabis as a viable alternative.
Another change announced by the Ministry of Health was the elimination of the mandatory course that doctors had to take to prescribe medicinal cannabis. While some see this as a simplification, experts warn it could create inequalities between patients with access to a trained physician and those without. The responsibility for choosing a competent doctor now falls more on patients.
The participation of private companies is also part of the process. According to Minsa, five companies already have operating licenses, and three have licenses for controlled substances. However, the ultimate responsibility for ensuring quality lies with the State, as regulations for enforcement are already in place.
The national director of Pharmacies and Drugs assured that the products will be available “soon.” But the real concern is not the date, but the cost. “The cannabis we will have access to is imported, and logically, it will be more expensive than that produced in Panama, and local production will take a few more years,” warned Pinzón. This means the first patients could face high prices, limiting access for low-income individuals.
The most essential missing element is a patient registration system. Without it, pharmacies cannot dispense medication, and doctors cannot formalize prescriptions, even if the product arrives. Registration is a key component for user identification, therapeutic monitoring, and prevention of diversion.
Enma Pinzón, a patient with rheumatic and musculoskeletal diseases, points out that medicinal cannabis is a therapeutic alternative supported by scientific evidence. In her case, it has provided significant relief from chronic pain without the organ damage that NSAIDs can cause. “For patients with rheumatic and musculoskeletal diseases, like myself, it provides relief from chronic pain, without the damage to organs, such as the kidneys, that NSAIDs can cause,” she said.
In summary, real implementation is not yet guaranteed. A fully functional system is needed, including an enabled registry, clear training, affordable pricing, and strict oversight.
