Insights from Recent Site Visits in Norway

04. June 2024


Recent site visits have highlighted the dynamic and collaborative efforts of the ASCERTAIN project in advancing precision cancer medicine (PCM) and health technology assessments (HTA) in Norway.

On April 12th, PhD student Yansi Wu presented initial findings from our Structured Expert Elicitation (SEE) project to the CONNECT group, a consortium focused on overcoming barriers in PCM. This was followed by a visit to the Norwegian Medical Products Agency (DMP) on May 2nd, where the ASCERTAIN team engaged with key stakeholders to discuss innovative health technologies and cost-effectiveness modeling. Both events provided invaluable feedback and fostered productive discussions, reinforcing our commitment to integrating diverse perspectives into our research and development initiatives.

Stakeholder feedback from the CONNECT group and the Norwegian Medical Products Agency

On April 12th, PhD student Yansi Wu at the University of Oslo (ASCERTAIN Work Package 5) presented initial findings from our Structured Expert Elicitation (SEE) project to the CONNECT group. CONNECT is a public-private consortium aimed at driving the implementations of precision cancer medicine (PCM) by addressing key obstacles (e.g., single-arm trials) and piloting novel solutions (e.g., SEE). This meeting unites representative stakeholders from the Norwegian university hospitals, pharmaceutical and technology companies (Association of Pharmaceutical Industry in Norway), patient organizations (the Norwegian Cancer Society), and the Norwegian HTA agency (the Norwegian Medical Products Agency).The study was partly funded by CONNECT and is a collaboration with Oslo Economics.

During this meeting, Yansi shared findings from ASCERTAIN’s exploration into the use of Structured Expert Elicitation (SEE) in evaluating the cost-effectiveness of Selpercatinib for non-small cell lung cancer (NSCLC) patients in Norway. Given an increasing reliance on single-arm trials within PCM, SEE holds potential in offering alternative methodologies of effectiveness evaluation, an endeavor that could significantly impact decision-making processes within PCM. The presentation focused on SEE as a viable tool in the pilot case of Selpercatinb for NSCLC and its potential to aid healthcare economic evaluations.

We received invaluable feedback and suggestions from the patient representatives, the industry, and the HTA agency. The patient organizations were concerned about the transparency and credibility of SEE. They were particularly interested in understanding which experts contribute to our elicitations, how these individuals are selected, and their levels of expertise. This insight encourages us to ensure that our SEE framework is both open and structured to earn trust and support from patient groups eagerly awaiting new PCMs.

Similarly, the industry and the HTA agency showed great interest in the structural integrity and validity of the model we presented. They sought clarity on the conclusions drawn from our project and were curious about SEE’s potential role in real-world applications. Their perspective is crucial as they prioritize tangible outputs that can influence healthcare decision-makings.

Overall, aligned with the overarching goal of the ASCERTAIN project, the CONNECT meeting was a cornerstone event for gaining direct input from diverse stakeholders. It offered us diverse perspectives on how to tailor further development of our project to meet the needs and expectations from the industries, HTA agencies, and patent groups.

Decision-makers, mingling and productive discussions – our site visit to DMP

Stakeholder engagement visit to the Norwegian Medical Products Agency on May 2nd, 2024

ASCERTAIN aims to meet the needs of patients, physicians, manufacturers, regulators, and payers. A recent site visit to the Norwegian Medical Products Agency (DMP – Direktoratet for medisinske produkter) provided a great opportunity for the Oslo team to exchange knowledge with health authorities and decision-making stakeholders on their needs and perspectives on our project.

The afternoon started with mingling followed by an introductory round of all participants from DMP, the Norwegian Hospital Procurement Trust (NHPT), and the ASCERTAIN team from the University of Oslo. Afterwards, DMP and NHPT presented their organizational structure and gave a brief spotlight on some of their recent work with clinical sub-groups in assessments. Eline Aas then gave a general introduction to the ASCERTAIN project and to the specific tasks conducted by the Oslo team. She introduced the concept of use cases, which was then illustrated in presentations by two of ASCERTAIN’s PhD students in Oslo. First, Pia Henkel presented her project on next-generation sequencing-based diagnostics in oncology. Subsequently, Yansi Wu presented his project on structured expert elicitation and single-arm trials applied to non-small cell lung cancer. Especially the timing of the expert elicitation assessment sparked a lively discussion on the challenges related to single-arm trials in health technology assessment. Our presentations were rounded off by Emily Burger, who introduced our quality assurance framework for ASCERTAIN cost-effectiveness modeling. Based on previously sent-out questions, the audience then shared their thoughts on the needs and challenges of assessing innovative health technologies, and on the concept of global models.

Our two main takeaways from this discussion are as follows. First, improving access, one of ASCERTAIN’s main objectives, was not always understood as access to products, but also as access to high-quality decisions. Second, the idea of global models was perceived positively, especially when enabling decision-makers to work with data inputs rather than finished models. Overall, we received both critical and encouraging feedback on our work. The productive discussions helped us to better understand the perspective of healthcare decision-makers and payers involved in health technology assessment. As such, we aim to conduct more of these visits and discussions with decision-makers in other countries, and continuously implement their insights into our work.

Photo: Emily Burger

For more information on the Department of Health Management and Health economics from the University of Oslo please visit their website here.