Today, SPOT is implementing its decision to suspend the third-party payment system for CNAM policyholders. From December 8, pharmacies will no longer dispense medicines covered by third-party payment, until further notice.
This radical measure comes after the accumulation of debts of the CNAM towards pharmacies, the absence of clear contractual guarantees after the negotiations, as well as a deep financial crisis in the entire pharmaceutical chain – from wholesalers to pharmacies.
Reasons given by pharmacists
SPOT explains its decision for several reasons:
- The non-payment of debts owed by the CNAM to pharmacists, which endangers the financial viability of pharmacies.
- The absence of a “clear vision” or “official commitment” resulting from the negotiations, making the continuation of the agreement between pharmacists and CNAM uncertain.
- A general deterioration of the medicine distribution chain, with wholesalers and suppliers themselves in difficulty, threatening the entire supply of medicines.
The union is calling in particular for clarification of the legal framework governing pharmacies, urgent measures to stabilize distribution, and exceptional financing for the CNAM via the future 2026 finance law.
What this changes for policyholders today
- CNAM policyholders will now have to pay the entire cost of medications at the pharmacy — third-party payment is suspended until further agreement.
- Reimbursements, if maintained, will be deferred or will be subject to another mechanism, as long as the CNAM’s debts have not been settled.
- This situation could complicate access to care for many citizens, particularly the most vulnerable, the chronically ill or people living in rural or disadvantaged areas.
Consequences for the pharmaceutical system
SPOT warns that if the situation persists, several pharmacies – particularly in interior areas – risk ceasing activity, which would threaten access to medicines.
The breakdown of third-party payment could lead to a major crisis in access to basic care, worsening social inequalities and further weakening the public health system.
SPOT calls for urgent intervention from the public authorities to quickly settle CNAM’s debts to pharmacies; clarify the legal framework for private pharmacies; put in place exceptional financial support to guarantee the continuity of the medicines chain; and guarantee the right of citizens to access essential treatments.
Pharmacists say they are ready to resume the third-party payment service as soon as financial and legal guarantees are provided. But without a quick solution, the country faces a major crisis.
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