Key topics
There are three key themes describing market access for medical technologies in Denmark:
- Reimbursement: payment mechanism via the DRG-adjusted budget system
- Funding: national recommendations from the Health Technology Council
- Health technology assessment: obtaining recommendations from the national and local HTA bodies
Reimbursement
Denmark uses the Danish DRG system, but hospital revenue from the DRGs accounts for only about 20%. Hospital care is predominantly funded via a global budget mechanism, which is mostly calculated based on actual costs incurred by the hospitals (differences in calculation methodology among regions may exist).
However, all inter-regional care is reimbursed on a case-by-case basis via the DRG system. Therefore, the role of DRG is higher for procedures, which are concentrated only in several hospitals across the country and which provide care for patients from other Danish regions.
DRGs are determined by the combination of a procedure code (SKS) and a diagnosis code (ICD-10). The SKS nomenclature and the Danish DRG system are maintained by the Health Data Authority.
Funding
Denmark has no nationally defined list of health benefits which are guaranteed to the Danish population. Decisions on which treatment methods to use and which new technologies to introduce are made by the hospitals.
Danish regions have a system to collaborate on the introduction of medical technologies and to enable equal access, cost-effective and efficient use of medical technologies in the country. In this framework, technologies are evaluated on the national level by the Health Technology Council, which provides recommendations for the adoption of novel technologies to payers (Regions) and healthcare providers.
Health technology assessment
HTA is performed on the national level (as part of the evaluations by the Health Technology Council) or on the regional and local levels (two organizations have limited activity in the Med Tech space).
Specifics for IVD tests
There is no specific reimbursement framework for in-vitro diagnostic tests. IVD tests are funded using a global budget principle as part of the laboratory funding.
How can MTRC help?
Development of reimbursement analysis (procedure coding, payment mechanism, reimbursement tariffs, policy and HTA considerations)
Development of reimbursement strategy
Development of an application for a procedure code
Development of an application for a DRG change
Adaptation of the global health economic model to the Danish settings
Access to an educational seminar on the Danish reimbursement system
MTRC has experience with more than 143 projects in Denmark
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