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: 5.605 million

GDP: USD 324.872 billion

Currency: Danish Krone

Language: Danish

Summary                         

Healthcare is an important part of 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% of healthcare expenditure is publicly financed, mainly through taxes. The remaining 16% are financed primarily through patient copayments. 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”: http://sum.dk/English/Healthcare-in-Denmark-An-Overview.aspx                                           

Market Entry

Main arguments for choosing to bring your healthcare business to Denmark 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 whereas larger installations and 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) is a great resource: https://www.lif.dk/. The Danish-Swedish Life Sciences cluster’s portal http://www.mediconvalley.com/ is also an excellent source of information, which in addition to providing facts and figures, also maps the entire industry and its players in both countries (covers biotech and medtech too). For information related to medtech, the industry association Medicoindustrien publishes industry reports and maintains a good database of members, including distributors: https://www.medicoindustrien.dk/. Denmark is strong in clinical areas such as diagnostics (in vitro and radiology), gastroenterology, orthopedics, cardiology, surgery, drug delivery, vascular surgery and wound care. 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.

The Ministry for Business & Growth has recently developed a national strategy to make the Danish Life Sciences sector the best in class: https://em.dk/nyheder/2018/03-02-ny-vaekstplan-skal-bane-vejen-for-dansk-lifescience-i-verdensklasse. The organization Healthcare Denmark will carry out a lot of the new initiatives: https://www.healthcaredenmark.dk.  

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% of local production is exported. Many international players also have significant R&D presence and activities in Denmark 

Current Demand

The Danish healthcare sector is generally interested in being on the forefront technology-wise, and strives to offer its citizens the best healthcare possible. At the same time, there is a big drive to deliver healthcare at a lower cost and in a more efficient manner. There is a particular focus on technologies that minimize costs at the same time as they provide better patient outcomes or better patient experiences.

Denmark is currently investing in a new hospital infrastructure. This includes 8 larger “super hospitals” (highly digitalized), a couple of greenfield building projects and renovation/improvements of existing hospitals. The project began in 2010 and will continue until 2020 at the cost of approximately 7 billion USD. Expected investments in health IT amounts to almost 3 billion USD. Progress can be followed at http://www.godtsygehusbyggeri.dk/. 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.

The Danish municipalities and Regions, in collaboration, are also currently focused on national implementation of telemedicine for COPD patients, and the Ministry of Health has recently published its national strategy for precision medicine, which is expected to gain momentum. 

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: https://laegemiddelstyrelsen.dk/en/devices/registration-and-marketing/ 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

Barriers are generally low, but companies may experience strong local competition and a need for commitment to the market in order to get a share. 

Procurement & Tenders

Procurement is in most instances tender based and found at https://www.udbud.dk or on TED. Treatments and medicines provided at public hospitals are free for patients and paid for by the regions. The pharmaceutical procurement service, Amgros: http://www.amgros.dk, owned by the five regions, purchases 99% 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. The organization SKI manages many of the public tenders, including medtech and health IT, makes framework agreements with suppliers, and makes sure they adhere to EU directives: https://www.ski.dk.

Trade Events

eHealth Observatory

October 2–3, 2018

Nyborg, Denmark

www.2018.e-sundhedsobservatoriet.dk

 

WHINN (Week of Health and Innovation)

October 9–11, 2018

Odense, Denmark

www.whinn.dk

     

Bio Europe

November 5-7, 2018

Copenhagen, Denmark

https://ebdgroup.knect365.com/bioeurope/

 

Lægedage 2017 (Doctor’s Fair)

November 12-16, 2018

Copenhagen, Denmark

https://www.plo-e.dk/om-laegedage

     

SCANDEFA (Scandinavian Dental Fair)

April 4-5 2019

Copenhagen, Denmark

www.scandefa.dk

 

World Conference on Lung Cancer

December 8–11, 2019

Copenhagen, Denmark

https://www.iaslc.org

     

Health & Rehab Scandinavia 2020

Copenhagen, Denmark

www.health-rehab.dk

   

U.S. Commercial Service Contact Information

Name: Sabina Kroigaard

Position: Senior Commercial Specialist

Email: Sabina.Kroigaard@trade.gov

Phone: +45 33 41 72 02          

Best Practices

  • Health IT solutions – innovative value-based solutions
  • Biotech & Pharmaceuticals – particular interest in precision medicine
  • Medical Devices – mainly cutting edge technology

Market Size

Healthcare spending (including investment)

≈ 15 billion USD

... as percent of GDP

10.8%

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

N/A

... of which spent on pharmaceuticals/consumables

6.6% (2016)

Hospitals, Procedures, Healthcare Professionals

Number of hospitals

59

…Public

40

…Private

19

Number of hospital beds

14,871

... available beds per capita

2.5/1000 (2015)

Number of surgical procedures

21,197 per 100,000 population (2015)

Physicians

24,000 (2014)

…of which surgeons

3,326 (2014)

...of which pediatricians

420 (2014)

Dentists

4,438 (2009)

Demographics

Population

5,604,948 (2017)

Life expectancy men/women

77.1/82.1 (2017)

Infant mortality

3.9 deaths / 1,000 live births (2017 est.)

Percent of population older than 65

19.1%

...projection, 2030

22.5%

Annual deaths

53,261 (2017)

…caused by Cancer

15,780 (2016)

……prevalence of Prostate Cancer

4,464 diagnosed annually, 36,026 live with the disease (2015)

...caused by Heart Disease

6,959 (2016)


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