Pharmacie d’officine: 3 mois pour appliquer une nouvelle mesure, et 10 mois de négociations sans rien obtenir

Zitouni Imounachen 14/02/2024 556

Si la décision d’exonérer les médicaments de la TVA est une décision louable qui a été saluée par l’ensemble du secteur pharmaceutique, sa mise en application pose plus d’une question et risque de mettre en difficulté les différents acteurs du secteur, et plus particulièrement le pharmacien d’officine dont la situation est déjà critique. La rentrée

Si la décision d’exonérer les médicaments de la TVA est une décision louable qui a été saluée par l’ensemble du secteur pharmaceutique, sa mise en application pose plus d’une question et risque de mettre en difficulté les différents acteurs du secteur, et plus particulièrement le pharmacien d’officine dont la situation est déjà critique.

La rentrée en vigueur de cette mesure sans discussions préalables, met le pharmacien d’officine face à plusieurs problématiques. Tout d’abord, elle l’oblige à écouler tous les médicaments à 7% de TVA, ce qui représente environ la moitié de son stock total, en à peine 3 mois ! Mission quasiment impossible, surtout pour les petites et moyennes pharmacies ou les médicaments à faible rotation sont nombreux. La seconde problématique qui découle de la première concerne le sort des produits non écoulés au 31 mars. Car ce n’est pas au pharmacien d’officine, déjà en difficulté économique, de supporter les effets collatéraux de la mise en place précipitée de cette nouvelle mesure.

La disponibilité des médicaments en pharmacie sera aussi affectée, car pour pouvoir écouler le stock des produits avec l’ancien prix, les pharmaciens travaillent avec un stock minimal, en général un produit de chaque référence, ce qui contraint les pharmaciens à commander au fur et a mesure et les patients à faire plusieurs allers-retours à l’officine afin d’avoir leur traitement. De même, la coexistence des anciens et des nouveaux prix est une source d’incompréhension et de confusion chez les patients. Car ces derniers ont du mal à comprendre qu’ils puissent se procurer un médicament avec le nouveau prix dans une pharmacie et une deuxième boite avec l’ancien prix dans une autre pharmacie.

Hormis Ces désagréments d’ordre pratique, les pharmaciens se posent des questions par rapport à la légalité de délivrer des médicaments avec un prix plus élevé que celui publié dans le bulletin officiel. Et ce d’autant plus que le délai de 3 mois octroyé pour écouler le stock est un accord strictement oral, et dont on ne trouve aucune trace écrite (à notre connaissance), ce qui n’a aucune valeur légale.

Pour faire face aux problématiques engendrées par la mise en place de l’exonération de la TVA sur les médicaments, les industriels et les grossistes, qui ont le mérite d’avoir de véritables représentativités, ont bien défendu leurs intérêts auprès du ministère de tutelle. Quant à la pharmacie d’officine, qu’on peut qualifier aujourd’hui de profession orpheline, aucune discussion ou négociation n’a eu lieu entre la tutelle et les représentants de la profession.

La question que tous les pharmaciens se posent aujourd’hui est pourquoi ils sont considérés comme les parents pauvres de la chaîne de soins et du secteur du médicament et ne sont jamais consultés même sur les questions qui les touchent directement? La réponse est certes complexe mais s’articule autour de deux éléments principaux. Le premier est interne à la profession et concerne la défaillance de nos instances professionnelles. Censées être une force de proposition et de pression, celles-ci sont devenues des coquilles vides pour ne pas dire de véritables faires valoir. Leur silence strident et leur inefficacité à toute épreuve émanent certes, en partie, de leur incompétence, mais surtout de la situation d’illégalité ou ils se sont empêtrés. Cette illégitimité les fragilise vis à vis de la tutelle et en fait des interlocuteurs affaiblis et non fiables.
Quant au deuxième élément de réponse, force est de constater que la pharmacie d’officine est considérée comme le maillon faible de la chaîne de soins au Maroc. Malgré les grandes difficultés que vit cette profession et malgré les Sit in et la grève générale du 13 avril, dix mois de discussions avec la tutelle n’ont pas suffi à obtenir un seul acquis palpable pour la profession. Pire, le pharmacien se retrouve face une nouvelle problématique, celle de la mise en place de l’exonération de la TVA des médicaments sans aucune discussion préalable, qui risque de lui coûter très cher.

L’inefficience des représentants de la profession couplée à la surdité de la tutelle poussent les pharmaciens de base à s’organiser autrement pour défendre leur profession. C’est ainsi qu’une série d’initiatives ont été entamées, notamment la création d’une coordination entre les pharmaciens de la base lors des journées de Fès qui a eu lieu les 05 et 06 janvier, et ce afin d’essayer de dynamiser les centrales syndicales sérieuses et d’arrêter l’hémorragie que subit la pharmacie d’officine.

Enfin, le pharmacien d’officine est un acteur de santé essentiel de la chaîne de soins. Il est impossible d’avoir une offre de soins de qualité sans pharmaciens d’officine forts. Affaiblir ce maillon de la chaîne revient à affaiblir toute la chaîne. Ailleurs, on l’a compris, et on a, non seulement renforcé leurs acquis, mais on a élargi leur champ d’action en leur octroyant de nouvelles missions. Espérons que les négociations qui ont débuté il y a presque un an aboutiront enfin à des résultats concrets sur le terrain, et dépasseront le cadre des promesses, afin d’apaiser une profession en crise et d’offrir à nos concitoyens une meilleure prise en charge.

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