While New Zealand’s Medicinal Cannabis Scheme (MCS) has successfully established a domestic production sector, reduced prices and provided alternatives to illegal supply, there may also be unintended negative consequences. These were the findings of an analysis of the MCS since implementation in 2020. The analysis found that the quarterly supply of medicinal cannabis products has increased fourteenfold since implementation, with most products now THC-dominant rather than CBD and in the form of dried cannabis flower rather than oral liquids/oils. Prices of products have declined to be comparable with the illegal market. While specialised private cannabis clinics have expanded patient access, inequities persist due to expense, disproportionately affecting Māori and those on lower incomes.