Tunisian Pharmacists' Union Announces Decision to Stop Working with "Tiers Payant" System
The Tunisian Pharmacists' Union (SPOT) announced on Monday its decision to stop working with the "Tiers Payant" system, following the failure of negotiations with the National Health Insurance Fund (CNAM) and the inaction of the authorities.
On its Facebook page, the SPOT explained that this decision comes after the CNAM unilaterally broke off negotiations. After a first round of "positive" talks on November 21, which resulted in a draft joint statement, the CNAM refused without justification to hold a second meeting scheduled for November 28 and rejected the project, which the union described as a "flagrant breach of its commitments".
The national bureau of the union justified its decision by citing the lack of a clear legal framework, persistent delays in reimbursements without guarantees, and the total lack of reaction from government authorities a week after the announcement of this measure. It denounced a "grave situation of irresponsibility in a file that directly affects national security".
The union accused the authorities, particularly the Presidency of the Government, the Ministry of Social Affairs, and the Ministry of Health, of inaction despite repeated warnings. It now rejects "full responsibility" on them, stating that pharmacists "refuse to endorse all erroneous policies" and the role of "lender and banker".
Faced with what it describes as a "structural erosion" of the profession, the union says it is ready to reintegrate the Tiers Payant system only when "real legal and financial guarantees" are put in place to protect both the patient, the pharmacist, and the healthcare system.
