In 2013, Norway established a framework, "New Method," for the introduction of innovations into the health care system through either a national or hospital-based health technology assessment. In this framework, all innovations should undergo HTA before being funded.
Surgery for morbid obesity has been evaluated within the "New Method" framework since 2019. In March 2022, the method assessment phase was completed, and the National Institute of Public Health (NIPH) report was published. The following surgical procedures were considered:
- Adjustable gastric band (AGB);
- Sleeve gastrectomy (SG);
- Roux-en-Y gastric bypass (RYGB);
- Distal Roux-en-Y gastric bypass (RYGB);
- Biliopancreatic diversion with duodenal switch (BPD/DS);
- Biliopancreatic diversion (BPD);
- One-anastomosis gastric bypass (OAGB).
On April 25, 2022, the Decision Forum for "New Method" made the following conclusions:
- No recommendation can be made for a preferred surgical procedure in the treatment of morbid obesity based on the complete method assessment;
- Available evidence shows minor or no difference in weight loss, diabetes control, and health-related quality of life when using various surgical procedures for the treatment of morbid obesity;
- Furthermore, it was not possible to determine the comparative effect of different surgical procedures on the risk of early mortality, progression of obesity, and obesity-related comorbidities;
- The cost differences between the various surgical procedures used in Norway are non-significant;
- Further high-quality research is needed to assess the comparative effectiveness of various surgical procedures for the treatment of morbid obesity.
See the full details in Norwegian here.
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