DENMARK
About the data We were not able to collect a large number of responses in this country. Thus, the information presented below is based mainly on a review of the literature and exchanges with the national diabetes association.
Healthcare expenditure profile (2011)2
Key background information: country health system
15%
Total health expenditure per capita: USD 6,647.70 Proportion of government expenditure on health: 16.4%
85%
Health system overview
Public expenditure Private expenditure Out-of-pocket expenditure represents 88.7% of private spending on health
- In the Danish National Health System, responsibility for healthcare is shared between the national, regional and local authorities.3,7 - Medicines and medical devices are provided through a mixed system: products provided by healthcare facilities are publicly procured, while others are supplied by private actors.3,4 Both sectors have to comply with Ministry of the Interior and Health policy, in line with EU regulation.3 A specialised agency ensures the application of those regulations.3,4 - Although a quality-monitoring system seems to be in place,3 quality control is mainly carried out prior to distribution.6
Diabetes prevalence (2011)1
Key diabetes data
IDF Atlas
National Data
7.5% of 20-79 year-olds
Official records: 250,000 people Including 10% people with type 1 diabetes
Diabetes care procedure
- For people with type 1 diabetes, prescriptions are provided by specialists; for people with type 2 diabetes, by GPs. - Prescribers, along with diabetes nurses and social workers are the main points of diabetes information and advice. - Diabetes products are dispensed mostly at healthcare facilities or pharmacies. Some local authorities delegate the delivery of certain medical devices to private contractors.6
Presence of products at national level
• At least one product from each of the surveyed categories was reported authorised for sale and effectively present in the country.6
Availability
Guidelines and specific prescription criteria
• Denmark has national guidelines for diabetes care.1 o For people with type 2 diabetes, treatment guidelines have been integrated into a care path programme to ensure continuity and inclusivity of care.6 • According to national guidelines, insulin pumps may be prescribed to people with type 1 diabetes who, for example, do not meet their treatment target with multiple daily insulin injections, despite following treatment recommendations. People with type 1 diabetes with hypoglycaemia unawareness or night hypoglycaemia, as well as children facing difficulties with injections, may also be offered this therapy.6,9 o Only specialists can prescribe insulin pumps.9 • Metformin is the first line of pharmaceutical treatment for people with type 2 diabetes.6 o Some newer diabetes medicines (that were not included in this survey like GLP-1 agonists) also follow specific prescription requirements.6
Use
• Prescription and use is regulated through reimbursement.3 • The National Quality Register allows close monitoring of prescription practices.6
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