This study investigates why, unlike Sweden, Denmark and Norway have decided to establish independent national anti-doping agencies. Starting off from a new institutional perspective, a qualitative comparative method is applied, and this study outlines variables that enable us to explain the differences and similarities of the two approaches. It is concluded that Sweden differs because doping is regarded as a broader public health issue and thus administratively dealt with in an area not only concerned with sport, while Sweden has a tradition of low political interference in elite sport. Despite various differences, the similar solutions chosen by Denmark and Norway are explained by their focus on doping in elite sport, combined with a high political profile in anti-doping. Although one can argue in favour of sport as an example of a world-society culture with a huge institutionalizing impact, this study reveals a space open for national interpretation. Finally, this article discusses future challenges for the two models analysed.