Opportunities for Improvement
Recommendation
Participation in lung cancer screening trials and studies may enable policymakers to determine whether screening is
appropriate for Norway. Norway has not participated in an evidence based approach on lung cancer screening.
Rationale
Indicator 6: We did not find any indication that Norway has conducted a lung cancer screening study or trial. Workshop
participants noted that results from the NELSON trial will be reviewed to assess opportunities for implementation in Norway.
Recommendation
Decreasing the time between EMA approval and reimbursement of new treatments is important to provide Norwegians with
the latest innovations in care. Earlier access to new treatments through clinical trials and compassionate use programmes can
help in the short term.Rationale
Indicator 13: Workshop participants cited the challenging gap between EMA approval and reimbursement in Norway. Access to
clinical studies and compassionate use can help to alleviate some of the pressure in the short term. Longer term it is important
to ensure that medications are available—in a financially sustainable manner—as soon as reasonably possible after they have
been approved. Failing to do so can create a two-tiered system whereby only those who can afford to pay for the medication
obtain access.Recommendation
A national plan for quality assurance for diagnosis and a centralised programme for diagnostic services could improve care in
N o r way.
Rationale
Indicator 8: Workshop participants recommended that Norway move towards greater centralisation of diagnostic and surgical
services coupled with a decentralised programme to allow patients to receive treatment near their homes. For health systems
servicing a decentralised population, such a hub and spoke model offers many potential benefits.Recommendation
Involvement of patient organisations in national assessments of disease and policy development can help to build consensus.
Rationale
Indicator 7: A specific lung cancer patient organisation exists in Norway, but there is no evidence that patients were represented
in clinical guideline development. Involving patients in the development of clinical guidelines can 1) help to identify issues
that may be overlooked by health professionals, 2) influence the development of recommendations from a patient and carer
perspective, and 3) emphasise the importance of including shared decision making. A defined structure for obtaining patient
involvement is key, and workshop participants suggested that the Norwegian Medical Agency is developing a new system to
increase the role of patient organisations in public procurement.Opportunity 1
Opportunity 2
Opportunity 3
Opportunity 4