The Union of Community Pharmacists of Tunisia (SPOT) announced the suspension of the third-party payment system, following the failure of negotiations with the National Health Insurance Fund (CNAM).
The decision was made public Monday via a press release posted on the union’s social networks. It occurs in a context of institutional blockage and lack of reaction from the authorities concerned.
Breakdown of negotiations with CNAM
SPOT claims that the decision follows the unilateral cessation of discussions by the CNAM. According to the union, a first round of negotiations, held on November 21, nevertheless resulted in a draft joint declaration described as constructive.
However, the second meeting scheduled for November 28 was not organized. The draft text would have been rejected without official justification, a behavior that the union describes as a clear breach of the commitments made during previous discussions.
Lack of legal framework and reimbursement delays
The SPOT national office justifies the suspension of third-party payment by several structural factors. He mentions in particular the absence of a clear legal framework governing the system, the chronic delays in reimbursements due to pharmacists, as well as the absence of financial guarantees governing the system.
The union also emphasizes that no reaction was recorded from public authorities a week after the announcement of the measure, describing the situation as worrying in a matter directly affecting the functioning of the health system.
Implicatement of government authorities
SPOT explicitly calls into question the Presidency of the Government as well as the Ministries of Social Affairs and Health, which it accuses of inaction despite repeated warnings. He now claims to place full responsibility for the consequences of the suspension of the system on these institutions.
The union declares that it refuses to continue to assume the role of financier of the system, believing that pharmacists can no longer serve as “lenders” in the face of policies deemed unsuitable.
Faced with what it describes as a structural weakening of the profession, SPOT indicates that it remains open to reintegration of the third-party payment system. This would, however, be conditional on the establishment of concrete legal and financial guarantees, aimed at simultaneously protecting patients, pharmacists and the balance of the health system.
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