Reimbursed Care Access in Mayotte

Currently classified as a strictly controlled substance under French national drug‑scheduling law and listed among substances treated as stupéfiants; there is no authorised medical use outside approved clinical research. Clinical research may be possible only after ANSM and ethics committee authorisation under the French Public Health Code and EU CTR. # #

Currently classified as a strictly controlled substance under national drug scheduling laws in France, with no authorised medical use outside approved clinical research. Any medical/therapeutic use in Mayotte would require formal ANSM/ethics and CTIS approvals for clinical trials. #

Esketamine (Spravato) is the enantiomeric nasal preparation that has been subject to regulatory review in France. The Haute Autorité de Santé (HAS) evaluated SPRAVATO and concluded that, for the indication assessed (rapid reduction of depressive symptoms in adults with a moderate to severe episode of major depressive disorder when co‑administered with an oral antidepressant), the Committee judged the clinical benefit insufficient to justify public funding coverage under France’s reimbursement system. This HAS opinion means that broad public (Assurance Maladie) reimbursement was not granted in the assessment published by HAS. Prescribing and use in France (and therefore in Mayotte as a French department) remain tightly regulated: if SPRAVATO is used it must be prescribed by a psychiatrist and administered in appropriate clinical settings with monitoring. #

Regulatory and access nuance: Spravato has been evaluated and marketed in some jurisdictions, but the HAS opinion specifically addresses public reimbursement in France; local uptake in hospitals or private settings may still occur subject to marketing authorisation status and institutional procurement rules, and individual centres must follow ANSM/HAS guidance on safety, monitoring and training. Clinical use must follow the product’s regulatory marketing authorisation and any special monitoring obligations. #

Ketamine is a controlled substance in France but is an established authorised medication for anaesthesia and analgesia and is used clinically in hospitals. In psychiatry, intravenous or subcutaneous ketamine protocols are used off‑label for treatment‑resistant depression in specialized hospital or clinic settings; such uses are organised within hospital practice, and funding/reimbursement depends on the care setting (inpatient hospital care or specific outpatient hospital procedures may be reimbursed under the French system, while private, ambulatory off‑label administrations may not attract standard outpatient drug reimbursement). The ANSM and French public health texts recognise that certain substances (including ketamine) are subject to control but may be permitted for medical use; any psychiatric use outside marketing authorisations is off‑label and must be conducted under physician responsibility and institutional protocols. # #

Regional note: Mayotte, as a French department, applies the same national regulatory framework (ANSM, Code de la santé publique) and hospital governance as metropolitan France; availability of hospital‑based ketamine psychiatric programs may be limited by local healthcare infrastructure on the island, so practical outpatient access can be constrained despite legal medical permissibility.

Currently classified as a strictly controlled substance under national drug scheduling laws in France, with no authorised medical use outside approved clinical research. Use or possession is subject to criminal sanctions except when explicitly authorised for ANSM‑approved research. #

Currently classified as a strictly controlled substance under French national drug scheduling law with no authorised medical use outside approved clinical research; possession, distribution and use are prohibited except within regulated trials. #

Currently classified as a strictly controlled substance under national drug scheduling laws in France and has no authorised medical use outside approved clinical research; any therapeutic or ritual use is unlawful except in approved clinical trials. #

Preparations containing DMT (such as ayahuasca) are treated under France’s stupéfiants framework and are illegal for general use; there is no authorised therapeutic pathway outside regulated clinical research. Importation, possession or administration can be prosecuted unless part of an authorised scientific protocol. #

Mescaline is included among controlled hallucinogenic substances under French law and is not authorised for medical therapy except in the context of approved clinical research; otherwise possession and supply are criminal offences. #

Synthetic phenethylamines of the 2C‑family are controlled as new psychoactive substances or listed as stupéfiants in France; there is no authorised medical use and access is limited to ANSM‑approved research. Criminal sanctions apply for possession, distribution and manufacture outside authorised research. #