Suspension of the "Tiers Payant" System in Tunisia
The Tunisian Pharmacists' Union (Spot) recently announced the immediate suspension of the "Tiers Payant" system, citing the failure of negotiations with the National Health Insurance Fund (Cnam). Due to non-payment of outstanding amounts, the Spot is suspending all third-party payments (Apci, ordinary illness, etc.).
Background
The annual sectoral agreement has not been renewed, according to Emna Abbes, Deputy Secretary-General of the Spot. The "Tiers Payant" system allowed citizens to pay only 30% of the costs, with the remaining amount covered by the Cnam and paid directly to the pharmacy. Abbes explains the process: "When dispensing the prescription and filling out the care bulletin, we are paid in full, and the patient recovers their share from the Cnam."
Debt and Pharmacy Numbers
The value of the Cnam's debt to pharmacists is estimated to be around 200 million dinars, says Emna Abbes. She notes that there are approximately 2,500 pharmacies in Tunisia, with around 1,200 of them having an agreement with the Cnam.
Demands and Goals
The union is demanding payment of the outstanding amounts, as well as a clear regulatory framework for pharmacies, including coverage of dietary supplements and other services. The ultimate goal is to ensure the long-term viability of Tunisian pharmacies.
Readiness to Reintegrate
The union states that it is willing to reintegrate into the system as soon as legal and financial guarantees are provided, emphasizing that this measure aims to protect the healthcare system and patient safety, rather than penalizing citizens.
