Medical Access and Reimbursement in Singapore

Currently classified as a strictly controlled substance under Singapore's Misuse of Drugs Act with no authorised medical use outside approved clinical research. The Central Narcotics Bureau (CNB) lists psilocybin/psilocin and psilocybin-containing mushrooms as controlled/plants that contain controlled drugs; possession, consumption, importation or trafficking is subject to severe criminal penalties under the Misuse of Drugs Act. # #.

Currently classified as a strictly controlled substance under Singapore's Misuse of Drugs Act with no authorised medical use outside approved clinical research. MDMA (Ecstasy) is listed among controlled/Part I substances and is policed by CNB; there is no approved medical framework or routine clinical reimbursement for MDMA‑assisted therapy. # #.

Esketamine nasal spray (SPRAVATO®) is a registered, prescription-only therapeutic product in Singapore and may be used in specialist psychiatric settings for the registered indications. The Health Sciences Authority (HSA) approved SPRAVATO® (registration SIN16033P) on 27 Oct 2020 for Treatment‑Resistant Depression (in combination with an oral antidepressant) and subsequently approved an additional indication for acute short‑term treatment of certain severe depressive episodes (indication approval entry dated 08 Dec 2021). SPRAVATO® is to be administered under clinical supervision with post‑dose monitoring and is subject to product labelling and usage safeguards in its product information. # #.

Regulatory/administration context: SPRAVATO® is prescription‑only and intended for administration under supervision in hospital/clinic environments; HSA product information specifies blood‑pressure monitoring and post‑administration observation requirements and that the product should be supplied only to specialist psychiatric services. The Ministry of Health (MOH) and HSA require controlled‑drug handling and record‑keeping for such products. #.

Reimbursement/access nuance: SPRAVATO® is an HSA‑registered medicine, but routine public reimbursement/subsidy for SPRAVATO® is not universally published as an entitlement; access typically requires treatment at specialist centres and payment terms are set by the treating hospital/clinic and the patient's insurer. Where patients seek SPRAVATO®, funding may be via private insurance (case‑by‑case) or out‑of‑pocket unless a particular hospital/clinic has a specific subsidy arrangement. Explicit nationwide public reimbursement for SPRAVATO® (e.g., standard MediShield or national subsidy policy) is not documented on HSA approval pages; providers or payors should be contacted for specific coverage policies.

Ketamine is a controlled drug in Singapore and is policed by the Central Narcotics Bureau; however, it is an established anaesthetic and is used in licensed medical settings. The CNB provides the legal framework and penalties for possession and trafficking of ketamine. #.

Medical/therapeutic context: The Ministry of Health (MOH) has acknowledged the medical use of ketamine formulations for severe depression in clinical contexts; a MOH statement notes that a ketamine nasal spray was approved by the HSA in October 2020 for administration together with other oral antidepressant therapy for treatment of depression, and that safeguards require supply to hospitals/clinics providing specialist psychiatric services with controlled‑drug handling and monitored administration. This establishes a medical pathway under strict supervision rather than unrestricted outpatient self‑administration. # #.

Reimbursement/access nuance: Routine public reimbursement for off‑label ketamine infusions or unregistered ketamine protocols is not standardised and is typically determined by the treating institution and the patient's insurer; many ketamine infusion services operate on a private/out‑of‑pocket basis and are subject to institutional clinical governance and supply licensing under HSA/Hospital rules.

Currently classified as a strictly controlled substance under Singapore's Misuse of Drugs Act with no authorised medical use outside approved clinical research. CNB's guidance and the plants‑list explicitly identify DMT (and multiple DMT‑containing plants such as Psychotria viridis and Banisteriopsis caapi / ayahuasca components) as controlled; importation, possession or consumption is criminalised except in properly authorised research contexts. # #.

Currently classified as a strictly controlled substance under Singapore's Misuse of Drugs Act with no authorised medical use outside approved clinical research. 5‑MeO‑DMT and related substituted tryptamines are treated as controlled/subject to the Misuse of Drugs Act; there is no authorised therapeutic pathway or reimbursement for 5‑MeO‑DMT outside regulated research. # #.

Currently classified as a strictly controlled substance under Singapore's Misuse of Drugs Act with no authorised medical use outside approved clinical research. There is no recognised clinical‑use framework or approved product registration for ibogaine in Singapore; possession or use is criminalised unless specifically authorised for research. # #.

Ayahuasca (the plant brews/plant components that contain DMT/MAO‑inhibiting plants) and constituent plants are listed by CNB as plants that contain controlled drugs (DMT) and therefore are illegal except in properly authorised research. There is no authorised medical/therapeutic access pathway or reimbursement for ayahuasca outside approved clinical trials. #.

Currently classified as a strictly controlled substance under Singapore's Misuse of Drugs Act with no authorised medical use outside approved clinical research. CNB explicitly lists peyote and mescaline‑containing plants as controlled; there is no legal medical access or reimbursement pathway for mescaline outside authorised clinical research. # #.

Currently classified as a strictly controlled substance under Singapore's Misuse of Drugs Act and/or captured under the New Psychoactive Substances controls; there is no authorised medical/therapeutic use or reimbursement for 2C‑class phenethylamines outside approved clinical research. CNB's NPS materials and the Misuse of Drugs Act schedule cover synthetic phenethylamines and NPS monitoring/enforcement. # #.