Madagascar

Reimbursed Care Access

Madagascar maintains a restrictive, prohibition-focused approach to classical psychedelics (psilocybin, MDMA, DMT, mescaline, 5‑MeO‑DMT, ibogaine and synthetic phenethylamines), which carry no authorised medical use outside regulated research. Ketamine is widely used and available as an anaesthetic in public and private hospitals; however, newer psychedelic-derived therapeutics such as esketamine (Spravato) do not appear to have a documented national registration or public reimbursement pathway in Madagascar.