ALBANY — Medical marijuana is about to see major growth in New York.

The state Department of Health announced Tuesday it has licensed five new companies to join the five existing firms that grow and sell medical marijuana products for thousands who take part in the strictly regulated state program.

The new companies are New York Canna, Fiorello Pharmaceuticals, Valley Agriceuticals, Citiva Medical and PalliaTech NY.

In May, the department said it was preparing to issue new licenses within a month, giving conditional approval to the five companies that were formally approved Tuesday.

The announcement comes as the previously "registered organizations," as they are known, were due for renewal of their licenses, which expire after two years.

Health Commissioner Dr. Howard Zucker said in a statement that adding the new companies "will make it easier for patients across the state to obtain medical marijuana, improve the affordability of medical marijuana products through the introduction of new competition, and increase the variety of medical marijuana products available to patients."

As of Tuesday, 25,736 patients were registered for the program. More than 1,100 doctors also have signed up to certify patients.

The addition of the new operators is a dramatic expansion of the program's physical footprint. Under state law, each company can operate up to four product dispensaries, which would bring the statewide total to 40 if all companies fully build out over time.

Still, retail locations have been centered in more densely populated areas. The New York metro area has seven dispensaries spread from Suffolk County on Long Island through New York City and north to Westchester County.

In Albany, two dispensaries remain open after Etain closed its Warehouse District shop in favor of opening a Manhattan location last month. Etain offers home delivery in the Capital Region.

One Capital Region dispensary is being added with the expansion. Fiorello will open a Saratoga County location, though co-CEO Eric Sirota declined in an interview to identify the company's location. He said all of the company's facilities will be in medical buildings.

The company also is planning a Glenville production facility at the former Navy depot building in the Glenville Business and Technology Park.

Other counties that will see their first dispensaries include Dutchess and Chemung. Brooklyn and Staten Island also are poised to see dispensaries open.

Expanding physical reach is seen as key to expanding awareness about the program.

"For the additional entrants, certainly ourselves, the focus is going to be expanding the number of registered practitioners," Sirota said. "We believe that's a huge hurdle in terms of expanding the program."

Both Sirota and Valley President Erik Holling said their companies plan to work on educational initiatives for patients and physicians in hopes of boosting the program's standing.

"It's the reach of it," Holling said. "You're able to now effectively double in size the program and the amount of people that we can reach out to. I hope that each of the ROs will have a significant investment in the education portion and the reach of getting out to all four corners of the state. It's tough if you're only one. But if you're 10, it makes it a lot easier and is a lot more manageable and palatable, both financially as well as effortwise."

The prospect of expansion and new competitors has been a source of controversy within the existing medical marijuana industry. The New York Medical Cannabis Industry Association, on behalf of four of the five original companies, sued the state in April to try to stop the issuance of new licenses. The association claimed that not only would DOH be overstepping its legal authority by issuing more than five licenses, it would imperil the nascent industry because demand for medicine does not warrant doubling of the supply market.

DOH swiftly rebuffed such arguments.

Association spokesman Patrick McCarthy reiterated on Tuesday that the problem with the program has never been supply, it has been demand.

"We are confident this process will continue to play out in the courts and we will be successful," McCarthy said.

He added that companies look forward to continuing to reach out to patients and practitioners.

The original companies have had a rough go of it financially since the program officially went live in January 2016.

Earlier this year, data showed that roughly half of all patients registered for the program were repeat buyers, further constricting the ability to sell medicines at a high volume. Among oft-cited reasons for depressed customer counts is high cost (insurance coverage is not obtainable for medical marijuana). As such, some companies have turned to offering discount programs.

"I completely understand why 1 through 5 wanted to keep it as 1 through 5, but the program necessitates this and this public and the patients necessitate it," Holling said. "We have a great team of investors and personnel to really be able to effectively make wise decisions financially and at the same time have the long-term financial wherewithal to know that it's not an overnight success, it takes time."

The program has undergone other changes that have been touted as helping boost patient counts. In particular, the introduction of chronic pain as a qualifying condition led to a relative boom in patients. DOH said Tuesday that 10,744 patients have become certified since chronic pain was added in March.

The state also has made public a list of consenting doctors, nurse practitioners and physician assistants who are registered to certify patients for medical marijuana.

State lawmakers also have sought to expand the program, and in June passed legislation that would add post-traumatic stress disorder to the list of qualifying conditions.

That bill has yet to hit Gov. Andrew Cuomo's desk. It's unclear how he would act on it.

mhamilton@timesunion.com • 518-454-5449 • @matt_hamilton10