Madar (Tunis) - Tunisia's syndicate of private pharmacy owners announced on Friday, October 30, 2026, that it is suspending the third-party payment system for patients insured by the National Health Insurance Fund (CNAM) from Sunday, November 1, Tunisian news site Webdo reported.
In practice, insured patients will have to pay for their medicines directly at pharmacies, pending new arrangements, and then go through the applicable reimbursement procedures.
In a statement, the syndicate attributed the decision to what it called the CNAM's persistent failure to honour its contractual commitments and the lack of concrete solutions to keep the service running. It said it had waited until the end of this week in the hope of a settlement, without result, and recalled that its national bureau had warned the CNAM and other parties on October 19 that the system could not continue unless contractual obligations were met and dues paid.
According to the syndicate, private pharmacies are under growing financial strain from payment delays, tax pressure and supply difficulties, amid persistent shortages. It also criticised unresolved structural problems in the profession, including the non-application of the texts that govern it.
The syndicate said it had written to the CNAM to coordinate the handling of insured patients' files and ease their access to medicines after the suspension. Official information on the new procedures will be shared as soon as it is received, it said, regretting the disruption the situation could cause to access to care.
