PMU69 Does the Finose Collaboration Improve Access in Sweden and Norway?

Abstract

In 2017, three Nordic HTA agencies, Finnish Medicines Agency (Fimea), Norwegian Medicines Agency (NoMA) and the Swedish Dental and Pharmaceutical Benefits Agency (TLV), set up a collaborative network named FINOSE with the aim to write joint assessments. This collaboration was not developed for joint decision-making, but to align agreement on relative effectiveness and where appropriate, health economic impact of a new treatment. In June 2020, FINOSE prolonged this collaboration for an additional three years. In this review study, all available completed FINOSE joint assessments were included and compared to the status of national assessments in Sweden and Norway. Until May 2020, three joint assessments have been published: enzalutamide, atezolizumab and betibeglogene autotemcel. NoMA and TLV authored two and three of the joint assessments, respectively. In the joint assessments FINOSE showed concerns regarding the clinical aspects, including small patient populations, immature data and the lack of long-term efficacy. Uncertainty in the economic aspects included treatment duration, quality of life data and achieved health benefit. These concerns were also reflected in TLV’s and NoMA’s national assessments. To complement the FINOSE report, NoMA (enzalutamide and atezolizumab) and TLV (enzalutamide, atezolizumab and betibeglogene autotemcel) reviewed national aspects such as cost analysis, budget consequences and patient estimates for local decision-making. TLV published their local decision simultaneously with the FINOSE report, whereas NoMA’s report came one to three months after FINOSE’s publication. To date, none of the treatments received a positive recommendation. However, betibeglogene autotemcel has been invited as the first treatment undergoing a joint Nordic contract negotiation. The FINOSE reports are used by national agencies to inform their decision-making and provides manufacturers with the opportunity to reduce duplication of submissions. Despite that the treatments did not receive a positive recommendation; it could potentially increase equal and faster access to Nordic patients in future collaborations.