Norway - Country Commercial Guide
Healthcare Technologies
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Norway spends 8.1% of GDP on healthcare, placing it among the top healthcare spenders in the world.  That amounts to USD 47 billion in total, or USD 8,637 per citizen in 2022.  The state-run healthcare system, covering 85% of total healthcare costs, is striving for technological advances and organizational improvements in a climate of budget constraints, a rise in chronic diseases and an aging population.  The health and social welfare system in Norway is mostly publicly financed, primarily through a national insurance tax and payroll contributions.  The national insurance, or social security, is a collective insurance plan to which all in Norway belong.  Citizens requiring medical treatment in Norway are guaranteed medical care and user fees are limited – no one pays more than about USD 250 per year for public health services. 

Estimates from the public health authorities and trade associations indicate that the total Norwegian market for medical and dental equipment and supplies is over USD 2 billion.  Public health care authorities are estimated to account for about 90% of the purchases of medical equipment, whereas private (non-publicly funded) purchases account for the remaining 10%.  About half of the medical equipment is sold to Norway’s public hospital trusts, which account for approximately 94% of all hospital stays.   The national government is responsible for hospital and specialty care which is administered through the four Regional Health Authorities.  The Municipalities are responsible for providing primary, preventative, and nursing care.  In the specialist health service, the four health regions jointly own the Norwegian Hospital Procurement Trust (Sykehusinnkjøp HF). In the period 2020–2022, it delivered 2,700 procurements with a total value of approximately USD 6.4 billion where 80% of the procurements were for a health trust. In terms of value, national procurements accounted for two-thirds.


ROADMAP - The health industry:  In August 2023, the Norwegian government released a roadmap with the aim to promote and strengthen the health industry in Norway.  The health industry is one of Norway’s growing industries with great potential for increased for further growth.  The interaction and affective cooperation between the public and private sector were highlighted as a key to success in achieving the goals.  The roadmap presents 12 focus area: testing and piloting; clinical trials; clusters; health technology and personalized medicine; access to and use of data; production of pharmaceuticals; research, education, innovation, and commercialization; international research and innovation collaboration; intellectual property rights; capital; public procurement, export.

Health data and Cancer Registry of Norway:   Norway has extensive health registries that have been built up over a long period of time.  Access to and management of health data will become increasingly important for the development and use of services, medical devices, pharmaceuticals, and health and welfare technologies.  The Health Data Service was established in 2021 to facilitate access to and contribute to increased use of health data. From March 15, 2023, the service has become the decision-making authority for applications for access to data from the Cancer Registry of Norway, the Norwegian Health Archives Registry and the national health registries managed by the Directorate of Health and the Norwegian Institute of Public Health.

New Hospital Projects:  There are several new hospital construction and modernization projects underway in Norway with an estimated cost of USD 8.8 billion.  The hospital projects will invest in new technologies and digitalization of workflows to increase productivity and efficiency gains.  The new hospitals are to be equipped with state-of-the-art medical equipment, robotics & logistics systems, smart building technologies and waste management systems. There will be opportunities for U.S. companies that have innovative products or services related to medical devices, operating room equipment, medical imaging, medical furniture, patient monitoring systems, transport, and logistics systems.

Medical Devices:  Aging demographics and a government commitment to maintaining and improving the country’s high standard of healthcare will continue to drive investment in new medical technologies. The market for medical device in Norway is expected to grow at a 2021 – 2026 CAGR of 4.4% in local currency terms which will take expenditure to USD 2.3 billion.  Norway has one of the highest medical devices spending per capita rates with a heavy reliance on imports. The United States is the leading national supplier of medical consumables, diagnostic imaging, orthopedics, and dental equipment in Norway.

Pharmaceuticals: The Norwegian pharmaceuticals market grew to USD 4.2 billion in 2022, an 8.2% increase in NOK and +1.1% in USD terms from the previous year.  The modest growth in recent years is attributed to the government’s restrictive policy in fixing prices and reimbursement, and the patent expiry of several high turnover brands.  The generic pharmaceuticals market has grown significantly in recent years and accounts for 49% of the market, and with the introduction of the “step price scheme,” aimed at further reducing the price of generic medicines, this is a trend set to continue.  In the future, the entry into force of European Regulation (EU) 2021/2282 on health technology assessment (HTA) will bring important implications.  The most important is the introduction of EU-level joint clinical assessments (JCAs) that will start to become applicable for different medicine categories between 2025 and 2030.  The new procedure will impact all centrally authorized medicines and some medical devices and may serve as the basis for national value assessments and price negotiations.

Digital Healthcare:  With a rapidly aging population, an increase in chronic disease and increasing healthcare costs, the Norwegian government has stated that telemedicine, e-health, and welfare technology are national priorities as they are very important tools in the successful implementation of the key Integrated Health Care Reform.  The authorities are implementing electronic patient journals/EPJs, and have successfully launched e-prescriptions, a national health portal where citizens will be able to have access to their digital health information. Telemedicine is seen as an important part of future acute medical care, radiology (work-sharing among hospitals) with specialist consultations within the ear-nose-throat field (video conferencing); specialist consultations in dermatology (e.g. video conferencing and still picture technology); and cardiography (e.g. heart rhythm/sound comparisons).  Also, clinical information systems, home care and personalized health systems, services for remote patient monitoring, systems for integrating local-, regional-, and national health information networks, represent significant potential for U.S. companies.  However, there are some barriers to entry, such as a requirement for local language, privacy and data protection concerns, standardization and interoperability issues, and reimbursement issues.   

U.S. companies are estimated to supply around 30% of Norwegian purchases of medical equipment.  High end, quality products and a tailored marketing approach are key factors for U.S. companies in penetrating the Norwegian market.  The perceived reliability and quality of a product, together with information received from health care providers and from relevant certifying bodies and professional associations in Norway constitute the most significant factors in a purchasing decision for Norwegian buyers and end-users of medical equipment.  Due to very limited domestic production, Norway relies heavily on imports of medical equipment and increases in market demand are likely to be met by imports.    

Equipment to be sold in Norway must be registered with the Norwegian Directorate of Health, and must have EU approval (CE Mark).  Norway participates in the EU internal market through the EEA Agreement (European Economic Area) and has the same rights and obligations as EU member states in regulation of medical devices.  The EU’s revised Medical Device Regulation (EU) 2017/745 went into effect in May 2021. This Regulation harmonizes the rules for placing on the market and putting into service medical devices and their accessories on the Union market thus allowing them to benefit from the principle of free movement of goods and intends to take into account guidance developed for medical devices at international level to promote the global convergence of regulations contributing to a high level of safety protection worldwide, and to facilitate trade. Norway applies EU product requirements, methods of conformity assessment, and duty rates for U.S. imports.  Norway spends an estimated USD 7 billion annually on its hospitals, and there is an attractive market for innovative, high quality medical and dental equipment.

Large public tenders can be found at the Norwegian Doffin website and the Tenders Electronic Daily database where tenders that are covered by EU public procurement law have to be published. 

A tender’s database has been developed by the U.S. mission to the EU, featuring all European public procurement tenders that are open to U.S.– based companies since the European Communities is a party to the GPA.