Private pharmacies threaten to suspend direct payment system from August 1

Tunisia's private pharmacies are threatening to suspend the "tiers payant" system, a direct payment scheme for healthcare, starting August 1. The Private Pharmacy Owners' Union announced on Thursday, July 16, 2026, that the system will be halted if the National Health Insurance Fund (CNAM) does not settle all its financial and contractual commitments to pharmacists by that date.

The syndicate's statement highlighted a growing tension between healthcare providers and the CNAM over unpaid dues. The "tiers payant" system allows patients to pay only their portion of the medical costs upfront, with the insurance fund covering the rest. Its suspension would place a greater immediate financial burden on patients.

This ultimatum signals a critical juncture in the relationship between the CNAM and private pharmacies. The union's action underscores the financial strain on these businesses and their determination to secure timely payments for services rendered. The coming weeks will be crucial in determining whether a resolution can be reached before the August 1 deadline.