Norway

Norway established in 2013 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. In January 2020, four new mini-HTA projects of medical technologies were launched in Norway: robotic-assisted procedures, ear reconstruction, continuous electroencephalography, among others.

In December 2019, the Norwegian Institute of Public Health released an HTA report regarding the effectiveness of uterine fibroids treatment commissioned by the Centre for joint decision-making to summarize the findings regarding this method. Embolization probably reduces the time that is needed to get back to the activity in comparison to myomectomy and hysterectomy.

In November 2019, the two new mini-method assessments for ankyloglossia and rapid testing for chlamydia and gonorrhea were initiated by Oslo University. After the completion of the assessment procedure, the final reports would be available via a mini-HTA database.

In Norway, the mini-HTA for intraepidermal nerve fiber density in skin biopsy was released in September 2019. The method was determined as efficient and safe. It was recommended to be introduced as part of the clinical routine in the hospital with a two-year follow-up to get enough data regarding the diagnostic volume and financial aspects.

In August 2019, the Decision Forum conducted the meeting towards the funding decisions for new methods, where concluded that prehospital CT ("stroke ambulance") for early diagnosis and treatment of suspected stroke can be used within the framework of controlled studies with a sufficient number of patients. The protocol of the Decision Forum meeting was released on the website of the New Method.

In August 2019, the Norwegian Institute of Public Health has released an HTA report regarding the effectiveness of treatment for localized prostate cancer commissioned by the Centre for joint decision-making to summarize the findings regarding this method. The effectiveness of the several treatment methods is unknown due to the lack of evidence. There is little or no difference in survival after radical prostatectomy compared to low-dose-rate brachytherapy.

In August 2019, the Norwegian Institute of Public Health (NIPH) has released a single technology assessment report for molecular profiling panel – Prosigna aimed to investigate its prognostic accuracy, clinical and cost-effectiveness in patients with breast cancer. It was outlined that it is uncertain to what extent Prosigna contributes prognostic information that turns into better clinical results; conclusions about the cost-effectiveness of Prosigna cannot be made due to the lack of existing information.

In August 2019, the mini-HTA for Tendyne transcatheter mitral valve implantation system was initiated by Oslo University Hospital. The finalized mini-method assessment will be published in the National Database for Mini-HTA.

In July 2019, the Norwegian Institute of Public Health (NIPH) has released a report for the effectiveness of treatment for knee osteoarthritis to summarize key findings from systematic reviews about relevant treatment options to ease the symptoms in patients with arthritis in the knee. It was outlined that self-management education program and physical aids give little or no difference in pain, whereas noncompartmental knee arthroplasty is superior to total knee arthroplasty in pain.

The mini-HTA for internal emergency medicine ultrasound in patients with urgent medical conditions was released in July 2019 in Norway. The method was determined as efficient, safe, and was recommended to be introduced as part of the clinical routine in the hospital.

In June 2019, the Norwegian Institute of Public Health (NIPH) has released an HTA report for prehospital CT for early diagnosis and treatment of suspected acute stroke or severe head injury to evaluate the documentation for clinical efficacy, safety and possible initiation of treatment prior to arrival in hospitals, compared with current hospital practice. Although the mobile stroke unit care increases the number of patients who receive thrombolysis, its efficacy is unknown due to the lack of evidence.

In June 2019, the Norwegian Institute of Public Health (NIPH) has released an HTA report for TAVI in patients with severe aortic stenosis and intermediate surgical risk commissioned by the National System for Managed Introduction of New Health Technologies within the Specialist Health Service in Norway. The cost-utility analysis indicated that TAVI was slightly more effective and more costly than open surgery. These findings can help decision makers appraise the intervention against the official priority setting criteria in health care sector applicable in Norway.