First health economic analyses associated with clinical guidelines released in Denmark

The Danish Healthcare Quality Institute (Sundhedsvæsenets Kvalitetsinstitut, DHQI) was established in January 2025, replacing the Health Technology Council and the Regions’ Clinical Quality Development Programme. The Institute comprises three overarching focus areas that aim to ensure patients receive high and uniform quality treatment across the country and the best possible health outcomes for the resources invested.

One of DHQI’s key tasks is to support professional communities in the development and updating of clinical guidelines. In December 2025, DHQI published a document clarifying the DHQI Council’s methodology for health economic analyses related to clinical guidelines and decision-making. 

DHQI prepares health economic analyses of selected recommendations in clinical guidelines developed by professional communities. Based on the evidence review within the guideline and the supplementary health economic analysis, the DHQI Council decides whether it agrees or disagrees that a proposed recommendation can be implemented nationwide. Where the Council agrees with implementation, it supports uniform implementation of the guideline recommendation across the country and across professional societies. In cases where the Council disagrees with implementation, a dialogue must take place between the Council and the author group to determine what will instead be offered to patients.

The steps in the process are outlined below:

• Development of a professional recommendation by the health professional environments (e.g., professional societies and multidisciplinary groups);
• Identification of potential health economic consequences (in connection with the development of the guideline) by the professional environment; 
• Screening and assessment of the need for health economic analysis by DHQI;
• Health economic analysis conducted by DHQI, focusing on effectiveness and costs, supplemented by an overall perspective that includes considerations of patient consequences and organizational impact;
• Consideration by the DHQI Council of the guideline recommendation from the professional environment and the associated health economic analysis, including the broader perspective;
• DHQI Council decision: agreement or disagreement with implementation of the professional society’s recommendation;
• Publication and dissemination: the Council’s decision is first communicated to the author group and subsequently published together with the health economic analysis. DHQI also shares the decision with relevant stakeholders to support implementation and follow-up.

Furthermore, in December 2025, DHQI released its first two health economic analyses associated with clinical guidelines.

The DHQI Council concluded that prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) for staging high-risk prostate cancer appears to be a precise, gentle, and resource-efficient method that can improve treatment decisions at a relatively modest additional cost. The Council therefore agrees that the recommendation for PSMA-PET/CT in the guideline “Imaging in prostate cancer” from the Danish Prostate Cancer Group (DaProCa) should be implemented nationwide.

The DHQI Council also assessed hyperthermic intraperitoneal chemotherapy (HIPEC) as an adjunct to interval surgery for ovarian cancer stages III and IVB. It was concluded that the intervention is associated with additional costs and provides a clinical benefit in terms of both quality of life and survival. The Council agrees that the recommendation in the guideline “Ovarian cancer – Intraperitoneal chemotherapy and HIPEC” from the Danish Gynecological Cancer Group (DGCG) should be implemented nationwide.

The full details in Danish can be found here and here.

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