Health technology assessment in Denmark: strategy, implementation, and developments.

OBJECTIVES The mainly tax-paid healthcare system in Denmark is decentralized with three defined policy and management levels. Health technology assessment (HTA) as a concept was introduced in the beginning of the 1980s. Significant implementation only happened when the first national strategy for HTA was developed by relevant stakeholders and issued as an official document in 1996. The introduction and the further development are described. METHODS The Danish Institute for HTA was established in the National Board of Health in 1997 with responsibility for coordination and production of HTA. A local government reform from 2007 provides several new challenges to HTA and its coordination. RESULTS An external evaluation in 2003 indicated that HTA was widely disseminated and that HTA results were benefitting political, administrative, and clinical decision making at all levels of the healthcare system. CONCLUSIONS The first national strategy for HTA, the broad HTA model covering four elements: Technology (clinical aspects), Patient, Organization, and Economy, and the development and introduction of mini-HTA as a tool for HTA-related activities in institutions and municipalities are major contributions to international HTA.