Establish private health insurance and assistance Central collection point for drug discounts (ZESAR)

11.03.2011 17:50

Since the beginning of the year, the legally introduced drug discounts have also been valid for privately insured people. For this purpose, the Association of Private Health Insurance and the sponsors of the aid have founded the joint venture ZESAR - Central Office for the Billing of Drug Discounts GmbH - in Cologne.

In the future, ZESAR will assert the new discount claims against drug manufacturers for the 43 member companies of the PKV Association and the approximately 11,000 aid agencies in Germany. The company, based in Cologne, began operations on January 1, 2011. The first employees were hired and the technical infrastructure for recording, particularly in the aid offices, was implemented. Collection of the discounts is expected at the beginning of the second quarter. According to the “Law on the Reorganization of the Medicines Market” (AMNOG), insured persons pay the full price of the medication at the pharmacy and receive the agreed reimbursement in the same way from their aid agency or the private health insurance company.

ZESAR GmbH then demands the statutory manufacturer's discount of 16 percent from the pharmaceutical companies. For reimbursement, it is mandatory that pharmacies include the pharmacy code on the prescription. ZESAR then returns the discounts achieved to the insurers and aid agencies. According to legal requirements, the discounts are used exclusively to reduce premiums or to stabilize premiums. In the area of aid, the discounts serve to reduce expenditure and thus ensure the level of aid provided by the federal and state governments. The industry expects that the savings for private health insurance and aid will amount to around 300 million euros per year. ZESAR's managing directors are Christian Hälker for the PKV Association and Joachim Schmidt from the Finance Ministry of North Rhine-Westphalia for the aid.