Changed reimbursement for medicines for depression and anxiety as of 5 March 2012

07 October 2011

With effect from 5 March 2012, the reimbursement is changed for certain medicinal products for treatment of depression and anxiety (antidepressants and anxiolytics). Based on the Reimbursement Committee's recommendation, the Danish Medicines Agency has decided that in future the general rule is that treatment with inexpensive medicines (e.g. sertraline and citalopram) must be attempted before reimbursement can be granted for more expensive medicines (e.g. escitalopram, duloxetine, pregabalin and agomelatine).

Background to the changes

The price of medicines used for depression and anxiety varies greatly, and there is general consensus among doctors that treatment with inexpensive medicine is just as good as expensive medicine for most patients. There is also general consensus that some depression or anxiety patients are so vulnerable that a switch to a less expensive medicine can entail great risk of relapse.

Who is affected and how?

The majority of patients treated for depression and anxiety use inexpensive medicines. They do not face any changes.

Patients who are in treatment with one of the more expensive medicines should generally switch to a less expensive medicine in order to retain the public reimbursement for their treatment. If a patient has already tried to use an inexpensive medicine unsuccessfully (insufficient effect or side effects), he or she can continue treatment with the more expensive medicine and maintain the public reimbursement. This also applies in other exceptional cases, based on a doctor's overall assessment of the patient's mental condition. In both cases, however, the doctor must write "tilskud" (reimbursement) on the prescription.

Along with their patients, doctors in Denmark must, by 5 March 2012, decide whether to switch to another treatment.

Read more

Here you can read more about the changes:

Is it still possible to get reimbursement for depression and anxiety treatment?

Which medicines are affected by the reimbursement change?

Overview of current and future reimbursement status of medicines for depression and anxiety (Excel file, opens in a new window)

What are the financial implications?

Why is a review of reimbursements necessary?

The Danish Medicines Agency's decision - letters sent to companies (in Danish only)

Letter of 30 September 2011 to general practitioners and specialists in Denmark (PDF file in Danish, opens in a new window)

Information sheet for citizens on the reimbursement change for medicines for depression and anxiety (PDF file in Danish, opens in a new window) - for pharmacies to hand out to affected patients