Much has changed since organisations from Iceland, Norway, Sweden, Finland and Denmark set up the Nordic Pharmaceutical Forum in 2015. The pandemic has demonstrated that the medicines market is global and fragile - uncertain supply chains and disruption of supplies are now well-known challenges for the Nordic countries. The EU launched a new pharmaceutical strategy in 2020, and this is likely to lead to a revision of the European pharmaceutical legislation in spring 2023. The EU has also established HERA to help secure supplies of medicines during future pandemics. Furthermore, the costs of medicines in Nordic health budgets continue to rise due to demographics and because of new, expensive medicines.
So there is every good reason for the Nordic Pharmaceutical Forum to launch a new joint strategy to set the direction for cooperation over the next few years.
“We’ve spent the past seven years sharing knowledge, identifying opportunities and working together to find common solutions to the challenges facing us all. We’ve been very successful so far, but if we are to continue to keep up with changing times and developments, we have to move even closer together,” says Flemming Sonne, Chair of the Nordic Pharmaceutical Forum and CEO at Amgros in Denmark.
The new joint Nordic strategy focuses on three areas 1) Innovative procurement cooperation 2) Security of supply, and 3) a strong Nordic voice.
By focusing on innovative procurement cooperation, the organisations in the Nordic Pharmaceutical Forum hope that we can help ensure that our patients continue to have access to both new and older medicines. We will also concentrate on making procurement even more environmentally friendly. Therefore, within the focus area Innovative procurement cooperation, the Nordic Pharmaceuticals Forum has decided to work together on the following three areas: 1) New and often promising medicines. 2) Common Nordic tendering procedures. And 3) Horizon Scanning.
“As national procurers of hospital medicines, we’re all experiencing increasing pressure on our budgets due to rising prices for new, often promising medicines. We already have experience with common Nordic price negotiations for these new medicines. In the long term, this may help to ensure patients better access to treatment. We will learn from our experience and continue to work on developing common guidelines for common negotiations,” says Tommy Juhl Nielsen, Director, Pharma Division at Sykehusinnkjøp HF in Norway.
Advanced therapies are also a focus area for the Nordic Pharmaceuticals Forum in the new strategy. Members from all of the countries have seen that it can take a long time to reach an agreement in this area. Furthermore, we expect that advanced therapies will make up an increasing percentage of new medical treatment in the future. Therefore, all the countries, although initially Sweden, Norway and Denmark, will work together and share knowledge about standard terms for ATMPs.
The Nordic countries have already harvested good experience from their joint tendering procedures across borders. Most recently, the countries announced a joint tendering procedure including the environment as a criterion. This led to the award of the European Prize for Innovation & Procurement Excellence in 2022.
The new joint strategy stresses the countries’ clear ambition to contribute to the green transition. And to be recognised as a partner that develops and delivers sustainable and innovative solutions to supply medicines for public healthcare systems.
“The organisations in the Nordic Pharmaceutical Forum have an important task in securing supplies of medicines for public hospitals in the individual countries - this is also one of the main reasons we have done joint tenders together. But the time has passed when supply was only about price, quality and getting the goods to hospitals. Now it’s also very much about sustainability and the environment. Therefore, we’ve decided to make our mark on the green agenda,” said Rannveig Alma Einarsdóttir, Clinical pharmacist and Project Manager, Medicines Committee of Landspítala inIceland.
Horizon Scanning is already an important area for cooperation in the Nordic Pharmaceutical Forum. This has helped us plan processes, prepare for price negotiations with suppliers, and organise our tendering procedures in good time. However, we have also shared our knowledge in this area with countries outside the Nordic community. Amgros and the Swedish regional cooperation model on pharmaceuticals through Region Stockholm have therefore played a key role in establishing the International Horizon Scanning Initiative, which is a collaborative initiative between eight European countries.
This means there is good reason to continue our close collaboration on Horizon Scanning in the new joint Nordic strategy.
“Horizon Scanning is absolutely crucial for ensuring that we have full knowledge about what drugs are on their way to Nordic markets. This helps us to prepare for future negotiations, tells us about when competitors are likely to enter the market, and helps us to organise our tendering procedures. All our organisations should exploit the vast knowledge and unique position the Nordic countries have within Horizon Scanning,” said Marianne Aufrecht-Gustafsson, Senior Legal Advisor in Health and Medical Care Administration (HSF), Stockholm Region in Sweden.
Besides innovative procurement cooperation, Security of supply is the second strategic area in the new strategy for the Nordic Pharmaceuticals Forum. In this context, countries will primarily focus on the difficulties in supplying medicines.
“The Nordic Pharmaceuticals Forum has been extremely good at sharing knowledge about how we can manage routine back-order issues. Clearly, we must continue with this, but we believe that there’s also a lot to learn from sharing knowledge and cooperation about more strategic initiatives to secure supplies of medicines,” says Kerstin Carlsson, Director, HUS Pharmacy, HUS Group, the joint authority for Helsinki and Uusimaa in Finland.
An important element in securing supplies is production of medicines by hospital pharmacies for individual patients. For this reason, the countries also have an ambition to share knowledge further about development and production of these magistral pharmaceuticals.
Initially, the Nordic Pharmaceuticals Forum will establish an overview of all the areas in which the countries currently produce these medicines. In the longer term, the countries hope that it will also be possible to have magistral pharmaceuticals in stock.
The Nordic Pharmaceutical Forum has regularly spoken about the initiatives and results created through the collaboration. This means we have already earned recognition for our efforts in supplying medicines to the public sector. But we must be even more visible.
“We live in a world of rapid development. Where global suppliers, as well as regional and international collaboration fora have an important voice. The Nordic Pharmaceutical Forum must also have a strong voice, so that our interests are heard. Moreover, we must strengthen dialogue with our stakeholders so that we continue to learn from one another,” said Flemming Sonne, Chair of the Nordic Pharmaceutical Forum and CEO at Amgros.
The following organisations have issued the strategy:
- Amgros I/S - Denmark
- Sykehusinnkjøp HF - Norway
- Norwegian Medicines Agency - Norway
- Regional cooperation model on pharmaceuticals with i.e. Region Stockholm and the Swedish Association of Local Authorities and Regions (SALAR) - Sweden
- Icelandic Medicines Agency - Iceland
- Medicines Committee of Landspítala - Iceland
- HUS Pharmacy, HUS Group, the joint authority for Helsinki and Uusimaa - Finland
Innovation & Procurement Excellence Award. The EHPPA (European Health Public Procurement Alliance) and Health Proc Europe are behind the award. Read more about the award received by Iceland, Norway and Denmark here: European award for Nordic environmental criteria - Amgros
HERA (European Health Emergency preparedness and Response Authority).
The mission of the European Health Emergency preparedness and Response Authority is to prevent, detect, and rapidly respond to health emergencies. HERA, created in the aftermath of the COVID-19 pandemic, will anticipate threats and potential health crises, through intelligence gathering and by building the necessary response capacities. When an emergency hits, HERA will ensure the development, production and distribution of medicines, vaccines and other medical countermeasures – such as gloves and masks – that were often lacking during the first phase of the response to the COVID-19 pandemic.
Horizon Scanning provides lists of pharmaceuticals, extensions of indication and pharmaceutical forms that are expected to be marketed in the Nordic countries within the next two to three years.
The International Horizon Scanning Initiative (IHSI) was formed in 2019 to develop and maintain a database with information about new medicines and medical devices that are likely to enter the European market.
The IHSI also secures the development of high-impact reports on the basis of the information in the database (reports on medicines that are expected to have a high impact on budgets or current treatment regimes).
Hospital pharmacies produce magistral pharmaceuticals for the individual patient.
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Karen Torgny
Senior Specialist- Communication
I’m responsible for overall communication at Amgros, including PR. And I help to ensure that we communicate with the surrounding world in an open and engaging manner.