Suspension of the "Tiers Payant" System in Tunisia
The Syndicat des pharmaciens d’officine de Tunisie (Spot) announced on Monday the immediate suspension of the "tiers payant" system, citing the failure of negotiations with the Caisse nationale d’assurance maladie (Cnam).
Reasons for the Suspension
In a statement published on its Facebook page, the Spot explained that this decision comes after the Cnam unilaterally broke off discussions. The union recalled that after a first exchange deemed "positive" on November 21, 2025, the Cnam refused, without explanation, to hold the second scheduled meeting on November 28.
Justification for the Suspension
The national bureau justified this suspension due to several persistent shortcomings:
- Lack of a clear legal framework
- Delays in reimbursements
- Absence of guarantees for pharmacists
The Spot also denounced the inaction of official authorities, describing the situation as a "grave irresponsibility affecting national security directly".
Willingness to Reintegrate the System
However, the union stated that it is ready to reintegrate the "tiers payant" system as soon as "real legal and financial guarantees" are put in place, ensuring the protection of patients, pharmacists, and the healthcare system. The statement emphasized: "This measure does not aim to harm citizens, but to guarantee the security and viability of the pharmaceutical system, while preserving the dignity and mission of pharmacists in the country."
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