1 Maj 2007 Pricing and Reimbursement in Denmark
2 Contents Introduction3 1. Pricing of pharmaceuticals5 1. 1 Pricing in the pharmaceutical industry5 1. 2 Pricing and wholesal
3 Pricing and reimbursement in Denmark Introduction In this paper we describe the current Danish pricing and reimbursement reg
4 Figure 1. Distribution of turnover in the Danish pharmaceutical market 2006 35 56 1 8 Hospital pharmacy Private pharmacy, Rx
5 1. Pricing of pharmaceuticals Having said that Denmark is tough concerning measures to curb cost it on the other hand should
6 There are currently no restrictions on the pricing of OTC products, neither the pharmacyonly products nor the products which
7 The aim of this agreement was to secure a predictable and restrained growth in public health insur ance expenditure for reim
8 Under special circumstances the Danish Medicines Agency could allow that a company exceeded the price that followed from the
9 not exceed the price which has been announced to the Danish Medicines Agency when applying for general reimbursement. During
10 1. 2 Pricing and wholesalers The wholesale market for pharmaceuticals for humans in Denmark is dominated by 23 full line wh
11 Pharmacy retail priceconsumer price DKK 10. 00 1. 25 PPP 0. 088 PPP 8. 59 Including VAT 1. 4 VAT State Taxation In Denmark,
12 directly, but prices are indirectly affected through the system of total gross profit agreements between the Ministry of th
13 2. Reimbursement system 2. 1 Health insurance systems The Danish healthcare services are primarily public but a growing pri
14 2. 2 Reimbursement of pharmaceuticals In accordance with the National Health Act the regions administrate reimbursement of
15 Pursuant to S. 144 1, reimbursement is provided for the purchase of prescription drugs for which the Danish Medicines Agenc
16 The Danish Medicines Agency takes decisions concerning reimbursement status for each product after application from the com
17 if there is a risk that the product will be used for purposes which cannot expect to be reim bursed by the authorities e. g
18 Companies who disagree with the decisions taken by the Danish Medicines Agency can file a complaint to the Ministry of the
19 needs. Logically this regulation means that any product not granted general reimbursement is referred to this default categ
20 but actually according to the Danish Medicines Agency most individual reimbursement li cences are lifelong. This means that
21 Table 4. Reimbursement rates 2007 Annual expense per person for re imbursable pharmaceuticals before subtraction of reimbur
22 prescribed by a GPphysician on a prescription whether the pharmaceutical is entitled to reimbursement or not. 2. 10 Adjustm
23 Table 5. Illustration of working of reference price system reimbursement group with 3 products Product Price of the product
24 average prices were suspended during the period of the price cap from November 2000 until June 2001 and in June 2001 follow
25 Until 1997 the rule was that when prescribing a pharmaceutical covered by the substitution scheme the GPphysician could cho
26 In addition to this system the pharmacies are obliged to report each sale of pharmaceuticals to another central database ru
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1 Maj 2007 Pricing and
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2 Contents Introduction3 1. Pricing of pharmaceuticals5 1. 1 P
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3 Pricing and reimbursement in Denmark Introduction In this pa
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4 Figure 1. Distribution of turnover in the Danish pharmaceuti
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5 1. Pricing of pharmaceuticals Having said that Denmark is to
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6 There are currently no restrictions on the pricing of OTC pr
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7 The aim of this agreement was to secure a predictable and re
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8 Under special circumstances the Danish Medicines Agency coul
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9 not exceed the price which has been announced to the Danish
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10 1. 2 Pricing and wholesalers The wholesale market for pharm
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11 Pharmacy retail priceconsumer price DKK 10. 00 1. 25 PPP 0.
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12 directly, but prices are indirectly affected through the sy
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13 2. Reimbursement system 2. 1 Health insurance systems The D
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14 2. 2 Reimbursement of pharmaceuticals In accordance with th
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15 Pursuant to S. 144 1, reimbursement is provided for the pur
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16 The Danish Medicines Agency takes decisions concerning reim
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17 if there is a risk that the product will be used for purpos
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18 Companies who disagree with the decisions taken by the Dani
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19 needs. Logically this regulation means that any product not
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20 but actually according to the Danish Medicines Agency most
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21 Table 4. Reimbursement rates 2007 Annual expense per person
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22 prescribed by a GPphysician on a prescription whether the p
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23 Table 5. Illustration of working of reference price system
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24 average prices were suspended during the period of the pric
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25 Until 1997 the rule was that when prescribing a pharmaceuti
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26 In addition to this system the pharmacies are obliged to re
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