The market for hospital medicine in Denmark

Abstract

Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised. 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital medicines more than doubled -accounting for almost 40% of the total Danish pharmaceutical market in 2009. Price increases however - although positive and higher than in the pharmaceutical retail sector - were only moderate. The majority of the expenditure growth was due to an increase in utilisation and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run.

Balancing inclusiveness, work incentives and sustainability in Denmark

“…for scans; Holstein, 2014), the development of private hospital activity remains limited. Also, contract prices for hospital medicine are confidential and practitioners cannot choose the most cost-effective treatments (Hostenkamp, 2012). Transparency on prices and an obligation to prescribe the cheapest treatment can help to contain costs.…”

An OECD analysis of health spending in Norway

“…11. For example, a much higher proportion of total pharmaceutical expenditure relates to hospital pharmaceuticals in Denmark compared with Germany (Hostenkamp, 2011)…”