Uruguay Considers Integrating Medical Cannabis Into Public Healthcare

Proposal Would Add Cannabis to National Formulary

The Ministry of Public Health is reviewing a framework to list medical cannabis products on ASSE's official drug formulary, enabling physicians within the public system to prescribe cannabis for approved indications without requiring patients to pay retail pharmacy prices. Uruguay's ASSE system covers approximately 1.2 million residents, roughly one-third of the country's population. Patients can already access medical cannabis through licensed pharmacies under the regulatory structure established by Law 19.172 in 2013. But products sell at market rates. No reimbursement.

ASSE-affiliated physicians would write prescriptions for cannabis oils, tinctures, and dried flower products manufactured by state-licensed producers. Patients would obtain these products through ASSE pharmacies at the same subsidized co-pay rates applied to other prescription medications in the formulary. The National Drug Secretariat, which oversees cannabis policy implementation, hasn't released a timeline for a final decision.

Uruguay's 2013 Cannabis Law Created Framework for Medical Access

Law 19.172, enacted in December 2013, established Uruguay as the first country to legalize and regulate cannabis production, distribution, and consumption at the national level. The statute created three legal access pathways: pharmacy sales for adult-use consumers, home cultivation for registered individuals, and medical prescriptions issued by licensed physicians. Medical cannabis products entered the market in 2017 after the Institute for the Regulation and Control of Cannabis (IRCCA) issued cultivation and manufacturing licenses.

To date, IRCCA has licensed four companies to produce medical cannabis products:

• Fotmer Life Sciences
• ICC Labs (now Clever Leaves)
• Dormul
• Symbiosis

These producers supply oils and extracts to domestic pharmacies and export bulk cannabis to international markets, primarily in Europe and Israel. Domestic medical sales have remained limited. IRCCA reported fewer than 8,000 active medical cannabis patients as of December 2025, representing less than 0.25 percent of Uruguay's population.

Integration Would Address Access Barriers Cited by Patient Advocates

Patient advocacy organizations have documented cost as the primary barrier to medical cannabis uptake under the current system, with monthly treatment expenses ranging from 2,500 to 6,000 Uruguayan pesos (approximately $60 to $145 USD) for standard-dose oil formulations. By comparison, ASSE co-pays for formulary medications average 150 to 400 pesos per prescription. The disparity has limited adoption among lower-income patients who qualify for cannabis therapy under IRCCA's approved indications, which include chronic pain, epilepsy, multiple sclerosis, and palliative oncology care.

Dr. Raquel Peyraube, a Montevideo-based physician and medical cannabis researcher, has stated publicly that integration into ASSE would remove the financial obstacle preventing many eligible patients from accessing treatment. She serves on the advisory board of the Uruguayan Medical Cannabis Society, a professional association that's lobbied the Ministry of Public Health to include cannabis in the national formulary since 2019.

The proposal under review doesn't specify which cannabis products or formulations would be listed, nor does it detail reimbursement rates for manufacturers. ASSE negotiates drug prices directly with pharmaceutical suppliers through a centralized procurement process managed by the State Health Services Administration.

Decision Carries Implications for Regional Cannabis Policy Models

If approved, Uruguay's integration of medical cannabis into a public health system would set a precedent closely watched by policymakers in Argentina, Colombia, and Mexico, where medical cannabis programs operate under private-market frameworks without government reimbursement. Colombia's Ministry of Health has explored similar proposals but hasn't advanced legislation to include cannabis in the national Mandatory Health Plan (Plan Obligatorio de Salud). Argentina's REPROCANN registry allows patients to access domestically produced cannabis oils, though products aren't covered by the country's social security health system (obras sociales).

Uruguay's Ministry of Public Health hasn't announced a public comment period or stakeholder consultation process. The National Drug Secretariat is expected to coordinate with ASSE administrators and the Ministry of Economy and Finance to evaluate fiscal impact before issuing a recommendation. For full background on this story, see the CannIntel topic hub on Uruguay's medical cannabis program.

The next signal: a formal announcement from the Ministry of Public Health or ASSE regarding formulary inclusion, timeline, and covered products. That decision will determine whether Uruguay's 13-year-old cannabis legalization framework evolves from a market-access model to a publicly subsidized therapeutic program.