Utilization in the Nordic countries of cancer medicines EMA approved 2008/14-2020: does it vary across countries?

Objective: To examine to what extent Norwegian cancer patients have benefited from new cancer medicines EMA approved after 2008 (and 14), as compared to the other Nordic countries. Method: based on sales data provided by IQVIA (for Sweden, Finland and Norway, 2008-2020) and DLIMI (for Denmark, 2015-2021) Results: The analyses provided evidence that there are substantial differences in the uptake of new cancer medicines between the Nordic countries. Denmark sticks out as the country for which has both the earliest and highest uptake of cancer medicines (after 2014). Conclusion: Norway does still have a slower uptake of cancer medicines in the first months after EMA-approval as compared to other Nordic countries, Denmark in specific, though data indicates that the difference is smaller in the period after Q4 2014 as compared to the period before. Norway does though have a more rapid uptake, so hence from approximately the 6th. and 4th. month after EMA approval (for medicines approved after Q4 2014) Norway surpasses both Sweden and particularly Finland, for which both takes longer to reach a plateau in the use. Though the data do not support any conclusions on the reasons for the result-findings, some findings do support different theories on how the structural set-up of the assessment of reimbursement and funding impacts the use, both when, at what pace the uptake rises and possibly on distribution of which medicines are taken into use in each market. Keywords: Malignant disease, cancer, pharmaceuticals, drug utilization, Nordic countries, reimbursement, early access, equity