In summary, a hospital in Germany compares to a profit centre, whereas in Denmark it is more a social institution. Germany has over 200 health insurances compared to only one in Denmark. The German healthcare system is notable for two essential characteristics: 1) the sharing of decision-making powers between states, the federal government and self-regulated organisations of payers and providers; and 2) the separation of SHI (including the social LTCI) and PHI (including the private LTCI). SHI and PHI use the same providers.

Hospitals and physicians treat both statutorily and privately insured patients, unlike hospitals in many other countries. Private insurances have some influence on the German market, whereas they play a minor role in the Danish market.

The share of ICT in Denmark is a lot higher, which ensures better control of processes and easier monitoring of patients.

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Identification of market access barriers

Getting access to an ecosystem that knows the healthcare sectors and has clear market access strategies supported by relevant partners, services, tools and methods, is very valuable for Danish and German companies. The following information on market access barriers in Germany and Scandinavia is based on the report ‘Identification of market access barriers – work package 6.1 (WP 6.1)’ of the Access & Acceleration project. The report presents the results of qualitative interviews and workshops with partners from different institutions and companies (e. g. medical device manufacturers and software development companies). Aiming to describe reasons for market access barriers in Scandinavia and Germany as well as resulting challenges, the report evaluates various barriers to entry for the Scandinavian and German healthcare market for innovative products. It also considers market trends, target groups, sales channels and possible cooperation with users and buyers. Workshops and interviews were performed in Denmark and Germany: 29 persons participated in total.

Barriers regarding the Medical Device Regulation and national legislation

  • Complicated tender process and high demand for evidence-based products in Germany
  • Legislation and structure of the Technical Aids Register (German: Hilfsmittelverzeichnis) in Germany

Barriers regarding the different structure of the healthcare system

  • In Denmark, the success of German suppliers of larger units depends very much on the tender outcome/price agreements
  • Legislation and structure of the Technical Aids Register in Germany
  • In Denmark, there is an open innovation environment, however, Denmark struggles with scaling
  • The German market is not interested in new innovative ideas because of a weak reimbursement system
  • Different healthcare systems mean different financial incentives in terms of treating patients

Barriers related to language

  • In Germany and Denmark, relevant information is only available in the national language (e. g. Technical Aids Register, documents on tender processes)
  • Germans prefer to speak in their native language
  • Lack of knowledge on tender processes across borders

The next step will involve identifying strategies which facilitate the companies’ access to the crossborder
market entry, and to develop new strategies and tools for overcoming the listed market access
barriers. Therefore, a roadmap for market access strategies will be developed.


Videos on market entry into Germany

German Market for health & care technologies
The Link provides insights into the German Health Care market. It is a recording from an event in March 2019. The language is English.

Part 1 until 1:50,40 provides insights into the following questions:

  • What are the challenges in the German health and social care system?
  • How open is the German care market for health technologies?
  • What solutions have the greatest opportunities?
  • What are the trends in the German healthcare market?
  • What is the reimbursement model in Germany?
  • What do you need to consider when entering the German market?

Part 2 1:50,40 – 2:42,20 refers to Long term care insurance, nursing homes and outpatient care

Under the project Digital health & care 4.0 you find a series of 4 webinars from 2019 that bring a lot of examples for

  • strategies to enter the German market
  • Selling on the German market
  • motivating German health care to invest and
  • Market entry

All webinars are available for free after registration.
Additional material is available.