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Healthcare Resource Guide: Denmark

Denmark Statistics

Summary

Market Entry

Current Market Trends

Main Competitors

Current Demand

Registration Process

Reimbursement

Barriers

Trade Events

CS Contact

Capital: Copenhagen

Population: 5.7 million

GDP: $264.8 Billion

Currency: Danish Krone

Language: Danish

Summary

                              

Healthcare is an important part to the Danish welfare system (often referred to in the United States as “the Scandinavian model”). A fundamental principle of the system is that all citizens have the right to good health and healthcare on equal terms, regardless of income. Approximately 84 per cent of healthcare expenditure is publicly financed, mainly through taxes. The remaining 16 per cent are financed primarily through patient co-payments. There is a small but growing private hospital and private health insurance sector, with Aleris-Hamlet being the largest private hospital chain in Scandinavia.

The healthcare sector has three political and administrative levels: the national government, the regions, and the municipalities. Denmark is divided into five regions and 98 municipalities that cover at least 20,000 inhabitants each.

The Ministry of Health is responsible for establishing the overall framework for the provision of health and elderly care. This includes legislation on the organization and provision of health and elderly care services, patients’ rights, healthcare professionals, hospitals and pharmacies, medicinal products, vaccinations, maternity care and child healthcare. The legislation covers the tasks of the regions, municipalities and other authorities within the area of health. The regions are responsible for hospital care, including emergency care, psychiatry, and for health services provided by GPs and specialists in private practice. The municipalities are primarily concerned with disease prevention and health promotion, rehabilitation outside hospital, home nursing, school health services, child dental treatment, child nursing, physiotherapy, alcohol and drug abuse treatment, home care services, nursing homes, and other services for elderly people. In addition, municipalities co-finance regional rehabilitation services and training facilities.

For a more detailed description of the structure and statistics for the Danish healthcare sector, we refer to the Ministry of Health’s publication “Healthcare in Denmark”, and the Ministry of Foreign Affairs / Invest in Denmark’s publication “The Heart of Life Sciences for Research & Business”.

                                          

Market Entry

Above-mentioned report by Invest in Denmark lists top 10 reasons for choosing Denmark for your pharmaceutical, medical device or health IT solution. Main arguments are the ease of doing business, flexible workforce and access to talent, good framework conditions and an advanced healthcare sector to test the market. Many are also attracted by the amounts of data available through well-developed national registries and biobanks, for conducting research. This goes for not only those choosing to locate activities here, but also those who enter the market through partnerships.

The sale of medical devices is typically accomplished with a traditional distribution model (Medicoindustrien lists local distributors under their members, http://medicoindustrien.dk/content/medlemmer) , whereas health IT solutions may require a local presence or a strategic partnership with a local vendor.

Pharmaceuticals and biotech companies typically locate or enter into partnerships with Danish scientists who can help them access national data and biobanks.

 

Current Market Trends

Denmark has one of Europe’s strongest pharmaceutical development pipelines.

The Danish Association of the Pharmaceutical Industry (Lif) publishes reports in English annually about the sector. “The Pharmaceutical Industry – A Danish position of strength” for 2016 can we found on the website. The Danish-Swedish Life Sciences cluster’s portal www.mediconvalley.com is also a great resource, which in addition to providing facts and figures, also maps the entire industry and its players in both countries (covers biotech and medtech too). Within medtech, Denmark is strong in clinical areas such as diagnostics (in vitro and radiology), gastroenterology, orthopedics, cardiology, surgery, drug delivery, vascular surgery and wound care. Medicoindustrien describe the strongholds and lists active companies in its publication “Medicobranchen i Danmark”. Denmark is also one of the world’s leading countries in the adoption of health IT. Virtually all primary care physicians have electronic medical records with full clinical functionality. General Practitioners use Electronic Medical Records and Electronic Prescribing to exchange clinical messages using the Danish national MedCom network, which enables communication across sectors. The five regions are each responsible for the EMRs used in their hospitals. Two of the Danish regions, the Capital Region and Region Zealand, have recently acquired and implemented Epic.

The Danish hospital sector is currently undergoing a complete restructuring. An important part of this transformation is the merging of specialized functions into fewer and larger units. As of today, there are around 50 public health facilities with more than 100,000 full-time employees. Over the next decade, approximately 7 billion USD will be invested in 16 new (or renovated) modern hospitals, eight of which will be so-called “super hospitals”. Out of the total budget for new hospitals, USD 1 billion has been earmarked for the procurement of medical equipment and information technology.

 

Main Competitors

Denmark has many local manufacturers that possess fair shares in the global market. Denmark is home to major companies such as Bavarian Nordic, Coloplast, Lundbeck, LEO Pharma, Novo Nordisk, GN ReSound, Oticon, and Widex. About 90 percent of local production is exported. Many international players also have significant R&D presence and activities in Denmark.

 

Current Demand

In 2015, the average life-expectancy in Denmark was 78.6 years for men and 82.5 years for women, which is among the lowest in Europe. The increase in the average life-expectancy can partly be explained by the low rate of flu epidemic in the last period. Yet, the low life expectancy may also be explained by the fact that Denmark’s medicine expenses per capita are among the lowest in Europe. Lastly, lifestyle factors such as high consumption of tobacco and alcohol may help explain the numbers. While these factors negatively affect Denmark’s life expectancy, other characteristics of the population are healthier than average. For example, Denmark’s rate of obesity and diabetes are among the lowest in the OECD.

It should be noted that since healthcare in Denmark is free, Danes are reluctant to spend money on healthcare and treatment themselves. Nevertheless, most Danes are concerned about their health and are willing to spend money on preventive measures including healthy food, dietary supplements, and gym memberships.

 

Registration Process

Medicines

Before sale, medicines, as well as natural medicinal products and strong vitamins and minerals, must be authorized by the Danish Medicines Agency or the European Commission. Information on the application for authorization can be found at: https://laegemiddelstyrelsen.dk/en/licensing/licensing-of-medicines/

Medical Devices

The following parties are required to register with the Danish Medicines Agency, Lægemiddelstyrelsen:

  • Manufacturers of medical devices and in vitro diagnostic (IVD) devices headquartered in Denmark
  • Danish representatives of manufacturers outside of the EU
  • Distributors and importers of medical devices from outside of Denmark
  • Stores specializing in the sale of medical devices and IVD devices

Registration information and forms can be found at the Danish Medicines Agency website and the process may take up to 14 days.

Reimbursement

When buying medicine at the pharmacy with a prescription, Danish citizens receive reimbursement automatically, according to predetermined thresholds. There are three types of general reimbursement. General reimbursement for prescription-only medicines means that all citizens with a prescription will receive reimbursement automatically. Conditional reimbursement for prescription-only medicines means that to be granted a reimbursement, the medicine must be prescribed to a specific patient group or for treatment of specific diseases. And a conditional reimbursement for over-the-counter medicines means that reimbursement is only granted if the person is covered by the reimbursement condition.

Companies can apply for general reimbursement to the Danish Medicines Agency.

 

Barriers

All products sold in Denmark must carry the CE mark. Medical devices and in vitro diagnostic are regulated by EU directives that are implemented in Danish law. The Danish Medicines Agency manages all licensing, registration, labelling and reimbursement issues. Their English website is easy to navigate for the most up to date information: http://www.laegemiddelstyrelsen.dk/en/

 

Procurement & Tenders

 

Treatments and medicines provided at public hospitals are free for patients and paid for by the regions. The pharmaceutical procurement service, Amgros, owned by the five regions, purchases 99 percent of all medicines used in public hospitals.

In the primary healthcare sector, medicines without directly competing products and which have been granted reimbursement are subject to a price-cap agreement between the Danish Association of the Pharmaceutical Industry, the Danish Regions, and the Ministry of Health. If a medicine does have directly competing products, prices are set by 14-day auctions.

Trade Events

SCANDEFA (Scandinavian Dental Fair)

April 27-28 2017, Copenhagen, Denmark, www.scandefa.dk

WHINN (Week of Health and Innovation)

October 10–12, 2017, Odense, Denmark, www.whinn.dk

eHealth Observatory

October 11–12, 2017, Nyborg, Denmark, www.2017.e-sundhedsobservatoriet.dk

Health & Rehab Scandinavia

May 15-17, 2018, Copenhagen, Denmark, www.health-rehab.dk

13th World Congress of Biological Psychiatry

June 18-22, 2017, Copenhagen, Denmark, www.wfsbp-congress.org

The 10th Congress of the European Pain Federation, EFIC

September 6-9, 2017, Copenhagen, Denmark, www.efic2017.kenes.com

Lægedage 2017 (Doctor’s Fair)

November 13-17, 2017, Copenhagen, Denmark, www.plo-e.dk/udstilling

World Conference on Lung Cancer

December 8–11, 2019, Copenhagen, Denmark, www.10times.com/wclc-copenhagen

  

U.S. Commercial Service Contact Information

 

Name: Bjarke Frederiksen              

Position: Head of Commercial Section         

Email: Bjarke.Frederiksen@trade.gov              

Phone: +45 33 41 72 02            

Market Size

Healthcare spending (including investment)

USD 33.7b (DKK 213.6b)

... as percent of GDP

10.6%

... of which spent on inpatient services (including long-term care)

5.2%

... of which spent on pharmaceuticals/consumables

1.1%

... of which spent on investments

See comment

... of which spent on outpatient services

29.5%

Hospitals, Procedures, Healthcare Professionals

Number of hospitals

 

…Public

40

…Private

19

Number of hospital beds

14,871

... available beds per capita

2.61 per 1,000 people

...of which in general hospitals

See table below

...of which in specialized clinics and rehabilitation centers

See table below

Number of surgical procedures

400,267

...of which colonoscopy

172,900

...of which cataract surgery

59,155

Physicians

20,639

…of which surgeons

3,312

...of which internists

N/A

...of which pediatricians

420

Dentists

4,244

Demographics

Population

5,756,170

Life expectancy men/women

78.8/82.8

Infant mortality

3.7

Percent of population older than 65

19.1%

...projection, 2030

22.5%

Annual deaths

52,555 in 2015

…caused by malignant neoplasm of other and unspecified sites

4,767

...caused by ischaemic heart disease

3,779

   

Hospital Beds

By type of care

By hospital ownership

Curative care

14,461

Public

13,922

Rehabilitative care

168

Not-for-profit private

632

Long-term care

242

For-profit private

317


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