Alternative agreements

Amgros has been using alternative agreement models for several years. These ensure that patients have access to new, expensive and innovative medicines. We apply a number of principles for using alternative agreement models. Among other things, these principles ensure that all suppliers are treated equally.

Alternative agreements at Amgros are agreements that apply instruments other than a flat discount.

Alternative agreements help reduce uncertainty when the Danish Medicines Council assesses whether a new drug is to be taken into use as a possible standard treatment at Danish public hospitals. This could be because of scant data at the time of approval. The various agreement models deal with different types of uncertainty.

Alternative agreement models can ultimately help secure patients access to new, innovative products in Denmark.

Amgros applies a number of principles for using alternative agreement models. Among other things, these ensure that we treat suppliers equally.

We have set the principles by listening to our suppliers and by talking with colleagues from other countries: and by always comparing the costs and benefits of new agreement models.


Contracts established by Amgros following a decision by the Danish Medicines Council are usually based on a flat discount. This means that we receive the same discount on all the packages of medicines we buy. Alternative agreements are agreements that apply other instruments than a flat discount.

In general, there are two types of agreement model: financially based agreement models and volume-based agreement models. List of models for alternative agreements (only available in Danish).

Amgros assesses whether an alternative agreement can be relevant from case to case.

An alternative agreement must be as simple as possible and entail as little administration at clinics as possible. If possible, it should be managed within the existing logistical and payment systems.

An agreement should never restrict competition in the market, either in the short term or in the long term.

In dialogue with the supplier, Amgros will decide which alternative agreement model can be used in a specific case.

In parallel with this, working with hospital pharmacies and relevant clinical departments, Amgros will make a technical assessment of how we can design an alternative agreement. This is to ensure that we can manage the agreement in practice.

No matter which model is chosen, the Danish Medicines Council always decides whether it can recommend a new medicine or extension of indication as a possible standard treatment at Danish public hospitals.

Amgros usually draws up agreements and terms and conditions in Danish.


Any supplier wanting to establish an alternative agreement model can contact Amgros and arrange a meeting to discuss the agreement. We will hold the meeting after the Danish Medicines Council has received and approved the final application (day 0).

If the agreement involves ATMP (Advanced Therapy Medicinal Products), it is possible to hold a meeting before this time. This is because these products entail a large number of elements that can be incorporated at an early stage in implementation at Danish hospitals.

Before the meeting between Amgros and the supplier, we will ask the supplier to complete this document: Preparation for dialogue on alternative agreement (only available in Danish).

After the meeting, the supplier will send a revised proposed alternative agreement to Amgros, if the supplier wants to continue the process.

Amgros will assess whether to negotiate further on the basis of the revised proposal. If we continue, we will involve relevant persons from the Danish Medicines Council and hospital pharmacies, for example.


Amgros has prepared a list different models for alternative agreements. The list has some good ideas for suppliers and will help them prepare for their dialogue with Amgros.

List of models for alternative agreements (only available in Danish).


Alternative agreements

New pharmaceuticals and negotiations

If a new medicine is to be considered as a standard treatment at Danish public hospitals, the Danish Medicines Council has to assess and recommend it first.

Alternative agreements


Danes are living longer. And we can treat more diseases, because new and better drugs are entering the market all the time. This is good. But it’s expensive. Therefore, it is important that we are at the forefront of market developments.