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Healthcare Resource Guide: Norway

 

Norway Statistics

Summary
Market Entry

Current Market Trends

Main Competitors

Current Demand

Registration Process
Reimbursement

Barriers

Trade Events

CS Contact

Best Prospects

Capital: Oslo

Population: 5.2 million

GDP*: $488bn

Currency: NOK

Language: Norwegian

Summary

Norway is one of the wealthiest countries in the world and this is reflected in its expenditure on medical care for its citizens. With the exception of the U.S. and Switzerland, Norway spends more of its GDP (10% / USD 38 billion) on healthcare than any other country in the world, USD7200 per citizen per annum. The state-dominated medical 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 disease and an aging population. By 2030, there will be 40% more senior citizens in Norway than today.

The health and social welfare system in Norway is predominantly publicly financed,

primarily through a national insurance tax. Citizens requiring medical treatment in Norway are guaranteed medical care and user fees are limited – no one pays more than about USD150/year for public health services.

Costs by services, 2014 Health expenditure, by function of care, time and contents

Estimates from the public health authorities and trade associations indicate that the total Norwegian market for medical and dental equipment and supplies reached over USD 2 billion in 2015. Public health care authorities are estimated to account for about 90% of the purchases of medical equipment. About half of the medical equipment is sold to hospitals.

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.

Market Entry

Finding a local representative with established contacts with the public authorities is the key to success for a new-to-market U.S. company. The availability of technical service also plays an important role. Most communication is Norwegian so it is an advantage to have a local representative knowledgeable about of the current market conditions.

Current Market Trends

There is a major health reform underway, the Integrated Health Care Reform, that is attempting to address some of the challenges the Norwegian healthcare services face. Issues include the inadequate coordination of services covering patient needs, too few initiatives aimed at limiting and preventing disease, changing demographics with an increase in chronic and complex illnesses. The aging population and increase in chronic diseases represents an extra burden for the healthcare system and the government has signaled that nursing and care for the aged must be given higher priority, as well as an increasing use of outpatient-based care at hospitals in an effort to rationalize. In addition, technological advances and organizational improvements are prioritized to get healthcare costs under control and meet future challenges, so there is a strong on healthIT solutions such as EPJ, tele and cloud based medicine and systems for integrating local/regional/national health information networks.

Main Competitors

Norway relies heavily on imported medical equipment. The major third-country suppliers of medical equipment are Germany, Denmark, Switzerland, Sweden, the United Kingdom, and Japan. The Nordic countries have traditionally had close contact and cooperation in several healthcare related areas over the last decades. Norwegian companies have also had a preference for participating in and seeking trading partners through European, and in particular German, trade events.

Current Demand

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 a national priority as they are very important tools in the successful implementation of the key Integrated Health Care Reform of 2012. The authorities are implementing electronic patient journals/EPJ’s, 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) and 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/national health information networks represent significant potential for U.S. companies. However, there are barriers to entry such as requirement for local language, privacy and data protection concerns, standardization and interoperability issues, and reimbursement issues.

Promising sub-sectors for U.S. suppliers of medical equipment include; surgical instruments and equipment, diagnostic apparatus, ultrasound, orthopedic equipment, monitoring instruments and equipment, laboratory/pathology instruments and equipment, digital x-ray systems and customized ICT equipment.

Registration Process

Equipment to be sold in Norway must be registered with the Department of Health and Care Services http://www.regjeringen.no/en/dep/hod/Subjects/Pharmaceutical-products/medical-devices.html?id=86835, and must have EU approval (CE Mark) http://export.gov/eu/index.asp. 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. Norway applies EU product requirements, methods of conformity assessment, and duty rates for U.S. imports.

Reimbursement

The Norwegian Health Economics Administration (Helfo) is a sub-ordinate institution directly linked to the Norwegian Directorate of Health.

Officially, “Helfo is responsible for direct payments to various health service providers, individual reimbursement for certain medicines, dental services and health services abroad.” In addition, Helfo is manages and oversees the regular General Practitioner (GP scheme) (fastlege), which entitles one to have a regular GP, and issuance of The European Health Insurance Card (Europeisk helsetrygdkort).

Barriers

Through the EEA Agreement (European Economic Area), Norway participates fully in the EU internal market and its efforts to establish common product requirements and methods of conformity assessment. Norway has the same rights and obligations as EU member states in regulation of medical devices. All medical devices must have pre-marketing approval and bear the CE mark confirming conformity with the essential requirements of EU/EEA directives, Medical Device Directive (93/42/EEC), Active Implantable Medical Devices (90/385/EEC) to be sold in the EU internal market.

Procurement & Tenders

Large public tenders are to be found at the Norwegian site http://www.doffin.no and the TED (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 US 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.

Trade Events

Most Norwegian distributors will attend established international trade shows like Medica, Germany, but also HIMSS, BIO, GNYDM etc. in the U.S.

Government Links:

 
U.S. Commercial Service Contact Information

Name: Ms. Britt Hestenes

Position: Senior Commercial Specialist

Email: Britt.Hestenes@trade.gov

Phone: +47 21 30 85 12

Best Prospects

  • Health IT & Telemedicine
  • Welfare technology
  • Innovative, cost saving medical equipment

Healthcare spending (including investment)

as percent of GDP

9.7

as a percent of GDP spent on inpatient services (including long-term care)

2.9

as a percent of GDP which spent on pharmaceuticals/consumables

1.1

as a percent of GDP spent on outpatient services

2.2

Hospitals, Procedures, Healthcare Professionals UN:

Number of hospitals

 

Public

64

Private

11

Number of hospital beds

19 519

available beds per capita

3.3

… of which in general hospitals

11535

… of which in specialized clinics and rehabilitation centers

7984

Number of surgical procedures

30 394

Physicians

27 519/ 4.42 per 1000

… of which surgeons

750

… of which pediatricians

323

Dentists -

4500

Demographics

Population -

5 265 158

Life expectancy men/women

Total population: 81.8

Male: 79.8

Female: 83.9

Infant mortality

2.5 deaths/1 000 live births

Percent of population older than 65

15 per cent

Annual deaths

8.1 deaths/ 1 000 population

… caused by heart disease

28.5

… caused by cancer

27.2


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