The Union of Community Pharmacists of Tunisia (SPOT) has confirmed the suspension of the third-party payment system for CNAM affiliates, a decision applied since yesterday at the national level.
The national office mentions the absence of solutions and guarantees regarding CNAM payment deadlines. The union calls on the State to act quickly to avoid a deeper crisis in the pharmaceutical sector.
Suspension implemented, pharmacists out of breath
SPOT reaffirmed, in a press release published at the end of the meeting of its national office, its attachment to the decision to suspend third-party payment, considering that no real progress has been made to resolve the chronic payment delays of the CNAM.
According to the union, this measure, far from targeting citizens, is part of a logic of survival: ensuring the financial sustainability of private pharmacies, preserving the supply chain, and avoiding a disruption in the availability of medicines.
Union officials point out that the delays continue to lengthen: two months in 2015, 80 to 90 days in 2019, 110 days in 2023, more than 120 days in 2024, and now, in certain cases, more than six months in 2025. A shift described as “structural” by the national office, highlighting the impossibility for pharmacies to support more financial pressure.
SPOT nevertheless ensures that it remains willing to re-establish the third-party payment system if serious guarantees and sustainable and transparent financing mechanisms are established.
Urgent appeal to the authorities
In its press release, the union directly calls on the competent authorities to “fully assume their responsibilities” and to intervene quickly to resolve the issue of overdue payments.
For SPOT, the intervening administrations – notably the CNAM and the supervisory structures – bear responsibility for the current blockage, due to a lack of reforms undertaken and sustainable funding. Official correspondence sent for years remained without concrete answers.
Ten years of delays weighing down the system
Since 2015, private pharmacies have been warning of a continued increase in reimbursement times, which has become a major factor in economic instability in the sector. The relationship between the CNAM and pharmacists is regularly marked by tensions, warnings and threats of suspension of third-party payment, often narrowly avoided.
This time, for lack of a solution and in the face of delays considered unbearable, the suspension was applied, opening a new episode in a file which remains one of the most sensitive in the Tunisian health system.
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