Tunisia suspends pharmacy payments over tier-pay dispute
The social affairs minister ordered payments halted until pharmacies end their tier-pay system suspension.
Tunisia's Minister of Social Affairs, Issam Lahmar, ordered a halt to payments owed to private pharmacies on November 5, 2026. This action is a response to the pharmacies' suspension of the tier-pay system, which began on November 1, 2026, due to unpaid debts from the National Health Insurance Fund (CNAM). The minister stated payments will remain blocked until pharmacies resume their participation in the tier-pay system.
The National Council of the Order of Pharmacists of Tunisia (CNOPT) expressed surprise at the minister's declarations, warning that the situation could worsen the ongoing crisis in the medicine sector. The CNOPT stated that the suspension of the tier-pay system by pharmacies was a reaction to persistent payment delays and accumulated debts from CNAM, causing significant financial strain and threatening their operations.
The conflict's consequences extend beyond private pharmacies, potentially destabilizing the entire pharmaceutical sector, including wholesale distributors and manufacturers. The CNOPT highlighted risks to financial balances, jobs, business continuity, and the availability and supply of medicines for patients. The council called for dialogue and sustainable solutions to settle debts and ensure the sector's continued operation.
Why it mattersTunisian citizens relying on the tier-pay system face potential disruptions in medicine availability and continuity of treatment.