Executive 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 being 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% is financed primarily through patient copayments. There is a small but growing private hospital and private health insurance sector, led by Aleris-Hamlet, 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 General Practitioners and specialists in private practice. The municipalities are primarily concerned with disease prevention and health promotion, rehabilitation outside hospitals, 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.
COVID-19
As a result of the COVID-19 pandemic, an expected 5% increase in healthcare spending in 2020 is expected (3% above the average annual spending increase since 2015). The pandemic is estimated to have cost the Danish public sector $1.7 billion USD in 2020, or approximately 10% of total spending in the Danish Regions.
Although COVID-19 was categorized as a no longer ‘socially critical disease’ in early 2022 and all restrictions lifted, delays in surgical procedures continue to impact patients in Denmark.
Denmark’s well established integrated digital health infrastructure pre-pandemic proved imperative to managing the crisis, quickly and efficiently, and will continue to play an important role in this highly digitalized society.
Market Entry
Denmark offers a high 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 for conducting research through well-developed national registries and biobanks. 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 (it covers biotech and medtech as well). 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 (EMRs) 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 and Growth has recently developed a national strategy to make the Danish Life Sciences sector the best in its 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 many of the new initiatives: https://www.healthcaredenmark.dk.
Market Size
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Healthcare spending (including investment)
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≈ $35.2 billion USD
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… as percent of GDP
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10.0% (2019)
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… of which spent on inpatient services (including long-term care)
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N/A
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… of which spent on pharmaceuticals/consumables
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11% (2019)
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Hospitals, Procedures, Healthcare Professionals UN
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Number of hospitals
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59
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…Public
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40
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…Private
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19
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Number of hospital beds
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13,973
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… available beds per capita
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2.5/1000 (2020)
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Number of surgical procedures
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21,197 per 100,000 population (2015)
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Physicians
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24,643 (2019)
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…of which surgeons
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3,326 (2018)
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…of which pediatricians
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501 (2018)
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Dentists
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4,890 (2018)
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Demographics
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Population
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5,867,412 (2021)
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Life expectancy men/women
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79.6/83.4 (2021)
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Infant mortality
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3.1 deaths / 1,000 live births (2020 est.)
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Percent of population older than 65
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20%
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…projection, 2030
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23%
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Annual deaths
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54,399 (2020)
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…caused by Cancer
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15,777 (2019)
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…caused by Heart Disease
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6,153 (2017)
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Prevalence of Prostate Cancer
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4,580 diagnosed annually, 43,898 live with the disease (2018)
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Main Competitors
Denmark has many local manufacturers that possess shares of 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 at the vanguard when it comes to technology 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 focus on technologies that minimize costs and simultaneously provide better patient outcomes or better patient experiences.
Since 2010, Denmark has invested heavily in hospital infrastructure to include the construction of 8 large “Super Hospitals” and renovation of existing hospitals. The project spans all 5 regions and at its completion in 2025, is expected to have cost more than $7.1 billion. Expected investments in health IT amount 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.
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 European Union
- 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. 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 gain 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
Nyborg, Denmark, www.e-sundhedsobservatoriet.dk
SCANDEFA (Scandinavian Dental Fair)
Copenhagen, Denmark, www.tandfagligedage.dk
Lægedage (Doctor’s Fair)
Copenhagen, Denmark, https://www.plo-e.dk/om-laegedage
Health & Rehab Scandinavia
Copenhagen, Denmark, www.health-rehab.dk
U.S. Commercial Service Contact Information
Name: Maria Norsk Deichmann
Position: Senior Commercial Specialist
Email: Maria.Norsk@trade.gov
Phone: +45 33 41 73 15
