Cocos (Keeling) Islands

Reimbursed Care Access

The Cocos (Keeling) Islands are an external Australian territory and are subject to Commonwealth law and, where applied, Western Australian law; therefore Australian national regulatory decisions (Therapeutic Goods Administration – TGA) and federal reimbursement schemes (PBS) determine legal medical access to psychedelic compounds. In practice this means esketamine (Spravato) is an approved and PBS-listed medicine for treatment‑resistant depression; psilocybin and MDMA are available only under tightly restricted TGA pathways (Authorised Prescriber / tightly regulated supply) and are not generally reimbursed; most classical psychedelics and novel phenethylamines (DMT, 5‑MeO‑DMT, mescaline, 2C‑X), ayahuasca preparations, and ibogaine remain controlled and unavailable outside clinical trials or specific research authorisations. [https://www.infrastructure.gov.au/territories-regions-cities/territories/indian-ocean-territories/cocos-keeling-islands/governance-administration|Australian Government – Cocos (Keeling) Islands governance] [https://www.tga.gov.au/news/news-articles/update-mdma-and-psilocybin-access-and-safeguards-1-july-2023|TGA update on MDMA/psilocybin].