Why Norway brand drugs are cheaper
It’s cheaper because Norway sets one price for the drug. Every hospital and pharmacy pays that (or a cap under it). In the US, each insurer and PBM bargains a rebate off a high list, and the sticker stays high.
National tender / LIS
How it works
Norway bargains as a country. Hospital drugs are tendered. The reimbursement list (LIS) sets what the system will pay. Launch without a deal means you do not get the volume of a national service.
Why it holds
Take-it-or-leave-it with one buyer. RAND: US brands 4.17× Norway — Norway is about 24¢. They still infuse. They do not let a PBM keep a rebate theater on a high list, and they do not let a 340B chair multiply it.
The invoices
See RAND drugs. 30-day list prices: CMS 2023, Inflation Reduction Act round 1.
Twenty brands — US sticker vs Norway
Ranked by the US number. 30-day list is CMS 2023 (Inflation Reduction Act round 1). Infusion doses are our hospital commercial bill. Norway column is that US sticker × this country’s RAND brand index. Gross list, not rebates. Even after a US rebate haircut, RAND says brands stay more than 3×.