Boosting access to diabetes medications and reducing national insurance user fees

Reimbursement costs for the diabetes medication Ozempic have risen significantly since 2019, and these costs now account for approximately ten per cent of total national insurance drug costs.

The medication is being used extensively for the treatment of obesity, which is not included in the approved uses for the blue prescription scheme. High levels of demand for Ozempic around the world have resulted in a global shortage of the drug.

Four initiatives from 1 July

‘The government will ensure access to diabetes medication and reduce national insurance user fees. This is why we are proposing four initiatives in the revised national budget that will take effect from 1 July this year,’ says Jan Christian Vestre, Minister of Health and Care Services.

‘The overall effect of these initiatives will be to provide better access to patients who need to use these medications while we also achieve better cost control in terms of national insurance user fees.

Three of the initiatives relate to Ozempic:

• Transition from pre-approved reimbursement to individual grants,
• removal of reimbursement for foreign packaging,
• and rationing in pharmacies.

Proposed legislation relating to medication preparedness

The government has recently announced proposed legislation relating to medication preparedness (in Norwegian), which includes proposals to allow for the introduction of restrictions on the sale and dispensing of medications in pharmacies and from wholesalers in the event that there are issues accessing the drugs in Norway.

Additionally, the government is proposing to allow reimbursements for Rybelsus when this is used due to a shortage of Ozempic. This requires consent from the Storting.

The Norwegian Medical Products Agency has previously implemented initiatives to improve information and to clarify the criteria for reimbursements of blue prescriptions, as well as engaging in price negotiations with the drug manufacturer.

A wider range of diabetes medications

These previous initiatives have not resulted in improved compliance with the reimbursement terms and conditions or brought about improved cost control.

In order to ensure that diabetes patients have access to necessary medication during the current shortages, it is therefore necessary to impose more robust measures.

‘These initiatives will make a wider range of diabetes medications available to the affected patient group, while limiting the need for the use of expensive, foreign-supplied Ozempic,’ says Vestre.

‘Imported medication can cost three to seven times as much as the Norwegian domestic equivalent since the price is set freely by the seller. Rationing in pharmacies will enable us to prioritise those patients who need Ozempic the most.’