Changes in reimbursement for cardiovascular medicine as of 13 July 2009

The Reimbursement Committee and the Danish Medicines Agency have reviewed medicinal products for the treatment of cardiovascular disease (‘antihypertensives’) in order to assess whether they meet the criteria for public reimbursement. We have made a decision to eliminate the general reimbursement for some of the medicinal products and make the reimbursement for others conditional. The rest of the cardiovascular medicinal products will maintain their general reimbursement.

Along with their patients, the general practitioners in Denmark have six months to find the correct treatment before the reimbursement reform for cardiovascular medicinal products enters into force on 13 July 2009. For most patients, there will be no need to change their treatment. Either the medicine prescribed to them today will continue to be eligible for reimbursement, or there may be good reasons for the general practitioner to apply for continued reimbursement for the patient’s medicine. However, a change in reimbursement of this magnitude could create uncertainties for some patients and general practitioners.

“Some critics might say that we have compared apples and oranges – that we are mixing things up,” says Steffen Thirstrup, Chief Medical Officer at the Danish Medicines Agency. He continues:

“As I see it, we are comparing apples with apples and oranges with oranges. We have reviewed the individual medicinal product groups and chosen to grant reimbursement for the least expensive among medicinal products with equal efficiency. And to stay with the fruit metaphor: If the apples correspond to the different types of medicine with the same effect, we have now recommended those apple species which are least expensive to the consumer and to the public sector.”

One of the factors characterising this group of medicinal products is that these medicinal products often treat a risk rather than a disease. On the other hand, there are many advantages. The medicinal products protect patients against myocardial infarctions and cardiac arrest and also reduce the risk of cerebral thrombosis and cerebral haemorrhage. And many more Danes should be treated for hypertension.

“Overall, this reform will result in the least expensive among equally effective medicinal products being chosen,” says Steffen Thirstrup.

Why is this reform needed?

Which medicinal products are part of the reform?

How can you continue to be granted reimbursement?

What are the financial implications?

Decisions by the Danish Medicines Agency - letters sent to companies

Monitor the trends in consumption of cardiovascular medicines

Danish Medicines Agency, 19 January 2009, updated on 9 June 2009