LEADING ARTICLE PharmocoeconomiCS 1997 Dec; 12 (6): 627-636 1170-7690/97/0012-0627/$05.50/0 ©Ad is International Lmited All r1ghts reserved The Danish Approach to Standards For Economic Evaluation Methodologies Anita Alban, 1 Marlene Gyldmark, 1 Arne Vesth Pedersen 2 and Jes Sogaard3 1 Danish Institute for Health Services Research and Development, Copenhagen, Denmark 2 The Funen County Health Secretariat, Odense, Denmark 3 Center of Health Services Research and Social Policy, University of Odense, Odense, Denmark Summary Standards for economic evaluation have now been proposed in several coun- tries. The background for this article is a report commissioned in 1994 by the Danish health authorities (the National Board of Health and the Danish Ministry of Health) on the state of the art of economic evaluation: are the methods ready to be used for systematic decision-making in the Danish healthcare sector? The themes of this article are the attitude towards economic evaluation of medical technologies and healthcare services in Denmark, the areas for application and the desirability and feasibility of a standard set of methods for conducting eco- nomic evaluations. In addition, the current state of methodologies in economic evaluation is briefly outlined. On the background of a roundtable discussion of interested parties, the Danish health authorities have decided to introduce economic evaluation of new phar- maceutical products, on a voluntary basis for 2 to 3 years, when application has been made for public reimbursement. It is a general trend in healthcare systems that the pressure for documentation of effectiveness and cost effectiveness is increasing. This develop- ment is demonstrated by the emergence, in many countries, of databases with information on cost as well as outcome and the increased political in- terest in supplementing the decision process with information on cost effectiveness. In Australia, guidelines for economic appraisals used in reim- bursement decisions related to new drugs were in- troduced in 1993,[11 and Canada produced similar guidelines in 1994.l 2 l Information on new political initiatives travels fast among researchers and decision-makers who constantly search for new ways to achieve effi- ciency in the health service. The Australian and Canadian experiences are studied carefully and with great interest. Denmark is no exception to this trend. In 1994, the Danish Board of Health and the Danish Ministry of Health asked a group of health economists to prepare a document on the state of the art of economic appraisal, explaining to the authorities how economic appraisals may be help- ful tools in reimbursement decisions and the poten- tial problems in implementing economic evalua- tions in the decision-making process regarding reimbursement classifications of specific drugs. This article will describe the Danish approach to standardising economic evaluations to an inter- national audience and aims to inform and create debate among interested parties in the field. The article includes an introduction to the pres- ent situation in Denmark: the state of the art of economic appraisal is briefly described, followed