Favorable coverage decision for robotic-assisted surgery in Norway

Norway has a national framework for introducing new health technologies within the specialist health service, known as the "New Methods" framework. This framework mandates a national or hospital-based health technology assessment (HTA) for all innovations before funding approval.

Since 2022, robot-assisted surgery for prostatectomy (indication IV), hysterectomy (indication V), and rectal resection (indication VI) have been under evaluation within the "New Methods" framework. 

In October 2024, the National Institute of Public Health (NIPH) published several health technology assessment reports. Based on HTA results, on March 17, 2025, the Decision Forum for New Methods made a positive coverage decision for robot-assisted prostatectomy, hysterectomy, and rectal resection in cancer indications, providing the following conclusions: 

• Robotic-assisted surgery may continue to be used for the treatment of prostate, rectal and uterine cancers;
• Hospitals utilizing robotic-assisted surgery must maintain a sufficient patient volume in prostate surgery, rectal surgery, and/or hysterectomy due to cancer. This ensures that robotic capacity is primarily allocated to these three conditions, which have been subject to method assessment;
• Until sufficient documentation of positive effects is available, the use of robotic-assisted surgery for conditions beyond the prostate, rectum, or uterus should be limited to university hospitals. This restriction aims to support professional development in areas with limited patient volumes;
• The medical directors of the Regional Health Authorities are tasked with following up on this decision as part of the mandate to reassess treatment methods. Particular attention should be given to the organizational, preparedness, and resource implications of robotic-assisted surgery in hospitals. Health Authorities must monitor complication rates, comparing robotic-assisted surgery with conventional surgery;
• The medical directors will appoint an interregional working group to develop a strategic plan, including the need for further method assessments, capacity planning, and broad-based competence. Until this plan is available, regions should evaluate the need to procure new surgical robots. The working group will report to the interregional medical directors’ meeting.

See the full details in Norwegian here, here, and here.

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