The National Council of the Order of Pharmacists of Tunisia has warned owners of private pharmacies against the continuation of the âthird-party paymentâ regime in the absence of any legal framework, after the expiration of the sectoral agreement linking the profession to the CNAM. The Order brandishes the threat of legal recourse, while the crisis bogs down against a backdrop of massive payment arrears.
The sectoral agreement linking the National Health Insurance Fund (CNAM) to the Union of Community Pharmacists of Tunisia (SPOT) expired on December 31, 2025. Since this date, no contractual framework officially governs the relationship between the CNAM and private pharmacies.
It is in this context that the National Council of the Order of Pharmacists of Tunisia (CNOPT) came out of its reserve to alert the profession to the legal risks linked to the continuation of the activity under the âthird party paymentâ regime, in the absence of any legal basis.
The Order brandishes the threat of prosecution
In a press release, the CNOPT warned pharmacists against any continuation of this mechanism and affirmed that it reserved the right to âresort to all legal meansâ to defend the law and the ethics of the profession.
The Council considers that the current situation places pharmacists in a zone of legal insecurity, likely to incur their professional and financial liability.
Reminder of the legal framework
To support its position, the Order recalls the provisions of Law No. 71 of 2004 relating to the establishment of the health insurance system. Article 11 of this text stipulates that relations between the CNAM and health service providers must be organized within the framework of a framework agreement and sectoral agreements concluded with their representatives.
In the absence of these agreements, the CNOPT considers that the pursuit of the third-party payer does not rest on any solid legal basis.
Despite the firmness of its warning, the Council reaffirms its attachment to the health insurance system as an asset for the Tunisian citizen. He calls on all parties concerned to seek âeffective and lastingâ solutions to the current crisis.
Among the priorities mentioned are the settlement of debts accumulated for the benefit of private pharmacies and the opening of a serious dialogue with representatives of the profession, in a logic of general interest and continuity of the public health service.
SPOT warns of the financial asphyxiation of pharmacies
The Order’s position comes after a decision taken by the CNAM, since last October, to continue the application of the third-party payment system directly with private pharmacies, with the stated aim of guaranteeing the regular supply of medicines to socially insured persons.
This decision, taken outside of any renewed conventional framework, is today at the heart of the standoff between the different parties.
For its part, the Union of Community Pharmacists of Tunisia officially announced, on January 5, the end of the agreement linking it to the CNAM. SPOT justified this break by payment delays exceeding 185 days.
According to the union, this situation has already led to the closure of several pharmacies and the exhaustion of the financial capacities of many others, threatening the balance of the entire sector.
