Czech Republic

Reimbursed since February 2025 for adults under 65 with non-psychotic treatment-resistant depression after two adequate failed antidepressants (conditions via the state drug agency SÚKL). Insurers can grant exceptional individual reimbursement beyond the criteria — e.g. over-65s — when other options are exhausted.

Prague’s Psyon clinic offers structured ketamine-assisted psychotherapy with partial coverage from seven Czech insurers (VZP, VoZP, ČPZP, ZP MV ČR, OZP, RBP, ZP Škoda) — as far as we know the only insurer-supported KAP in Europe. Indications: depression incl. TRD, anxiety disorders, PTSD, eating disorders; 18+, physician-decided admission.

First EU country with a full legal framework for medical psilocybin, in force since 1 January 2026 — zákon č. 270/2025 Sb. plus implementing decree nařízení vlády č. 552/2025 Sb.: prescribable by qualified physicians in specialised facilities for defined serious conditions after authorised medicines failed. The honest status: NUDZ stated on 23 March 2026 that treatment delivery has not started and no waiting list exists — launch expected in H2 2026. Anyone selling “legal Czech psilocybin therapy” today is operating outside the framework.

Controlled substance, no medical route. NUDZ took part in an international Phase 2 MDMA/PTSD trial (NCT04030169, completed); none recruiting as of July 2026.

Medical: prescription cannabis since 2013, insurance-subsidised since 2020. Non-medical: from 1 January 2026 home cultivation of 3 plants and possession of up to 100 g at home / 25 g in public are legal (reform signed July 2025; no sales, no clubs), alongside the separate psychomodulatory-substances law for low-THC retail.

~20 studies tracked, 6 active — NUDZ (Klecany) anchors the system, Psyon serves as a trial site. Recruiting: PsyPal (palliative care) and Cybin’s CYB003 Phase 3 (Czech sites). Participation is free; screening is strict; never pay for “trial access”