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Arendalsuka: – We need to attract the big companies

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Norway needs more big companies to deliver on the Mission on Cancer.

The European Union has launched the Mission on Cancer with the goal to improve the lives of 3 million Europeans. In the recent meeting Fremtidens kreftbehandling during Arendalsuka, key experts and politicians gathered to discuss the implications of this for Norway. See the meeting here. See the meeting here. 

“With missions, we need to mobilise all resources in society towards a common goal. This is a new way to work and it challenges the established system. It is a historic investment from the EU; they are leaving no stone unturned in the fight against cancer,” said Astrid Bjerke, strategic adviser for the Norwegian Cancer Society.

A Norwegian Cancer Mission Hub has already been set up in Norway by several stakeholders, including Cancer Society, Oslo Cancer Cluster, The Research Council, The Norwegian Health Directorate, the Cancer Registry of Norway, and more.

“Norway is a part of the Mission on Cancer and this is important both for the ministry and from political leadership. EU has seen that we have to work together in the area of health. It is important that Norway is a part of this, because it also gives us possibilities.

“We have a great health service and fantastic health data, which we need to take better advantage of. We have a high degree of knowledge and fabulous research environments, as well as a population with a high degree of trust. Many positive things are happening, but we need to attract the big companies and their competence,” said Cathrine Lofthus, Secretary General of the Ministry of Health and Care Services.

Successful industry collaborations

Idar Kreutzer, director of The Confederation of Norwegian Enterprise (NHO), gave several historic examples of how Norway has built industries based on public-private collaboration, such as water power and the oil industry.

“We were impressed when we saw the power of the development of vaccines during the pandemic, which was a real collaboration between authorities, researchers and industry – with impressive results! The health industry is already exporting for more than NOK 20 billion per year, but the potential is even larger and Norway has perfect conditions to grow a health industry,” said Kreutzer.

One example of a current collaboration between academia and industry is the Oslo Cancer Cluster Innovation Park, which is expanding and has recently signed a lease agreement with the global company Thermo Fisher Scientific.

“We are doing many of the right things in Norway from basic research to patient treatment, but we need to look at the whole ecosystem. We built this ecosystem in miniature around the Radium Hospital, because this is where most of the cancer patients come through and most cancer research is done. It has been a difficult journey, but we have a very exciting pipeline with several up-and-coming companies and promising treatments,” said Jónas Einarsson, CEO of Radforsk Investment Fund and founder of Oslo Cancer Cluster.

Is there political will?

There seemed to be broad political consensus around the Cancer Mission among the politicians at the meeting.

“Missions and the EU’s work in this area is a part of our new cancer strategy and we have to collaborate on this, as well as collaborate with the EU. The mission concept is nothing new. It is first and foremost about achieving collaboration between the health service and the industry. Our cancer strategy will lay the basis for this: to gather all resources around a common goal,” said Even Røed, the Labour Party (Norway).

“We need to replace the income from oil and gas with new industries, which need to have large potentials. All Nordic countries have managed to make their health industries grow. Now we have the opportunity in Norway. The health service, academic milieus and industry are already gathering momentum, but there is a lack of political will. Norway has joined the Mission on Cancer, but how will it be implemented in Norway? There needs to be political will to build the health industry,” said Alfred Bjørlo, the Liberal Party (Norway).

“This is a really exciting method, to involve civil society, industry and academic milieus. I am most concerned about this being politically anchored. Will we see it when the new Cancer Strategy is presented? Will we see the Minister of Health together with the Minister of Industry and a representative from the European Union? Will we be connected to the Europen Union, or will this be a Norwegian hobby project, where we don’t take advantage of the big advantages we have?” asked Kristoffer Robin Haug, Green Party (Norway).

 

The meeting was organised by Oslo Cancer Cluster, the Norwegian Cancer Society, Legemiddelindustrien LMI, MSD Norway, Janssen Norway and AstraZeneca Norway. Thank you to our collaboration partners!

 

Making every day count

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Cancer patient Silje Morild Helland spends all her time searching for better treatments.

“I want to spend my time doing this. It is not just my life, but many people’s lives. We all want to be here for our loved ones. I have made friends who have the same diagnosis and several of them are not here anymore. People are dying while waiting for important medicines.”

Silje was diagnosed with breast cancer while pregnant in 2015. Since then, she has tried all the treatments that are available to her in Norway. Now, her current treatment is losing effect and Silje feels she has a responsibility to search for more options, since many other cancer patients cannot.

“I think it is problematic that breast cancer patients are assessed according to the average age of the entire patient group. It is said we are too old for the new treatment to be cost effective. It is too expensive in relation to how old we are on the group level, but I am not too old,” Silje said.

Silje told her story at the meeting Fremtidens Kreftbehandling – Hver Dag Teller, Eller? during the Norwegian political festival Arendalsuka. The meeting was organised jointly by Oslo Cancer Cluster, LMI, the Norwegian Cancer Society, Astra Zeneca Norway, Janssen Norway and MSD Norway.

Watch the meeting here:

Is this even legal?

The lawyer Geir Lippestad explained at the meeting that the system called Nye Metoder has been given the legal mandate by publicly appointed officials to decide which medicines will be approved in Norway.

“We do not have any case law or Supreme Court decisions concerning Nye Metoder. This is because it is not possible for patients to appeal decisions that have been made. This is not completely unproblematic. In an open society, the right to appeal is a guarantee for legal safety. This is something we need to debate politically. It is very unusual that there is not a bigger legal framework to appeal.”

Calling for a mission on cancer

Sigrid Bratlie, special advisor in the Norwegian Cancer Society, told the audience about recent advances in the cancer field.

“We are at a breaking point in the development of knowledge and technology. Two areas that are moving especially fast are personalised medicine and immunotherapy.”

Bratlie explained that future cancer treatments will be defined by four characteristics. The treatments will be more personalized and more influenced by advanced technologies. They will be given more in combination with one another, and clinical studies will be an integrated part of standard treatment.

“To realise the potential we have in Norway, we need to invest and set ambitious goals. The European Union has launched a Cancer Mission with the goal to improve the lives of 3 million people by 2030. The USA has the Cancer Moonshot to reduce the death rate from cancer by at least 50 percent over the next 25 years.”

Steinar Thoresen (Merck), Sigrid Bratlie (Kreftforeningen) and Truls Vasvik (Labour Party) discussed access to new cancer treatments. Photo: Sofia Lindén / Oslo Cancer Cluster

What is Norway doing?

Sigbjørn Smeland, Head of the Cancer Clinic at Oslo University Hospital, and Steinar Thoresen, Senior Medical Consultant Merck Oncology and Medical Director NordicRWE, introduced the new initiatives for precision cancer medicine in Norway.

One of them is IMPRESS, a national study where patients with metastatic cancer who have exhausted all treatment options get a chance to try another treatment based on the cancer’s genetic mutation.

Another initiative is CONNECT, a public-private consortium driving the implementation of precision medicine in Norway. Several companies in CONNECT have agreed to contribute pharmaceuticals to the IMPRESS study.

“Precision medicine is one of the pillars of the cancer treatments of the future. We must organise ourselves differently. It requires a closer collaboration between industry and academia. We are looking at the individual patient, instead of groups of patients, which gives us a different type of knowledge base,” Smeland explained.

Steinar Thoresen complemented:

“The industry has gone from being a part, to becoming a partner. For the first time we have a shared risk between private and public. This can be a framework for future payment structures. People have started to say ‘Look to Norway’ and we have no time to lose. We need to collaborate to get more clinical studies, to get more drugs into IMPRESS and to make use of Norwegian health data.”

The politician Truls Vasvik from the Norwegian Labour Party (Arbeiderpartiet) was also at the meeting.

“We need to work together with industry to succeed. We need to establish a system that can handle the extremely rapid changes in cancer treatment. We also need to think new about price models. We have a focus on cancer right now, because many are getting ill, and the development is going extremely fast.”

Silje Morild Helland does not think the system is good enough. If she can’t get new treatment in Norway, she plans on travelling abroad, like many other Norwegian cancer patients already have.

Fremtidens kreftbehandling frokostmøte 2022

Challenged politicians about cancer

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Where are the Norwegian political ambitions for cancer treatment? We need more public-private collaboration on cancer.

Breakfast and political conversations on cancer are the hallmark for our meeting series Fremtidens kreftbehandling. On 21 April 2022, health officials, politicians, patient spokespeople and industry representatives met to discuss the future of cancer treatments. They all agreed: we need more public-private collaboration on cancer.

As introduction, Ketil Widerberg, general manager of Oslo Cancer Cluster, presented the results from a recent survey by Kantar of the Norwegian population’s views on health policy. The survey showed a majority want more modern cancer treatments with less side effects at public hospitals. They want the same treatment options as in other Nordic countries. They also think the public health service should pay for cancer treatments that work.

“We believe cancer can go from being a deadly disease to a disease people live well with, but we can’t get new treatments to the patients if the public and private sector don’t work together,” Widerberg said. “When we build roads, we assess the economy on a broader scale than when we assess new treatments. Is this really the kind of politics we want?”

A cancer revolution underway

The people’s wishes are clear, but how can doctors offer more modern treatments to their patients? In the first panel discussion, Anne Karin Rime, president of the Norwegian Medical Association, Jan Frich, deputy CEO of the South-Eastern Regional Health Authority, and Ingrid Stenstadvold Ross, general secretary of the Norwegian Cancer Society discussed how patients can gain access to precision medicine, which means the right treatment to the right patient at the right time.

“We are living in a kind of cancer revolution. There are many extremely promising treatments on the way, especially in precision medicine,” Stenstadvold Ross said. “The current system assesses the cost and effect of a treatment by looking at an average patient group. For lung cancer, it will typically be 60-plus men with a history of smoking, but if I developed lung cancer, my characteristics wouldn’t fit this description.”

Rime argued that these new, revolutionary medicines have made the doctor’s job more complicated.

“The role of the doctor has changed from deciding the best treatment for the patient. Now the doctor also needs to think about society as a whole: what can we afford to treat? It is extremely difficult for a doctor to know there are treatments or diagnostics that may help the patient, which they can’t offer,” said Rime. “Diagnostics become more important now and offering genetic tests to all patients to identify which treatment will work.”

Frich agreed that more precise diagnostics is the solution.

“The key to personalised treatment is good diagnostics,” Frich commented. “The last two-three years, much has happened in personalised medicine. We have created a national plan for advanced diagnostics and set aside resources for this. An infrastructure for precision diagnostics is being built. The CONNECT collaboration with the pharmaceutical industry work on a large clinical study called IMPRESS, which is supported with NOK 60 million from the regional health authorities.”

Make your voice heard

The system needs to change so that patients can take part in the cancer revolution. Gloria Traina is a PhD and advisor at the Specialist Health Section in the Norwegian Ministry of Health and Care Services. They are working on a Strategy for Personalised Medicine to be launched before 2023.

“There has been some success getting precision medicine to Norway and there are many new initiatives, including InPred, IMPRESS and CONNECT. We now see there is a need for a revised strategy,” Traina explained.

More public-private collaboration

While the new strategy materialises, patients are still waiting for access to better treatments. In the debate, politicians were challenged to declare their ambitions for Norway.

”I want to see more political vision. The European Union has launched a Cancer Mission, the goal is to improve the lives of 3 million people by 2030. What are Norway’s ambitions?” Stenstadvold Ross asked.

“We need to look at how we rig the decision-making systems, for example by involving clinicians and patients, how we attract clinical studies and how we implement personalised medicine,” Karl Kristian Bekeng from the Labour Party (Arbeiderpartiet) said. “When it comes to collaboration on new technologies and new medicines, there should be a lot more public-private collaboration. This should not be a replacement of the public health service, but an improvement of the public health service.”

Sylvi Listhaug from the Progress Party Association (Fremskrittspartiet) criticised the decision-making system.

“I think many patients – and the population as a whole – question why Norway is so late in implementing new medicines that can save lives and give better quality of life. I also think there are many desperate doctors, who see there are medicines that can give their patients a better life, which they can’t offer. The way we do this in Norway is completely out-dated. It doesn’t work. We are putting forward a new bill to Parliament now to change the whole system,” Listhaug announced.

Hege Edvardsen, senior adviser in LMI, represented the pharmaceutical industry in the debate and challenged the politicians to become more hands-on.

“We see that political decisions do not agree with what is actually delivered in the health service,” said Edvardsen, “It is important to strengthen the public-private collaboration. We have done a lot in oncology, but we are still struggling to get access to new treatments and we are lagging behind other Nordic countries. We need to consider the entire ecosystem when we talk about these things. If we wish to increase the number of clinical studies and attract research investments to Norway, we must also become better at solving the access part.”

The meeting also included mingling between the participants and the audience, which sparked further conversations and reflections. The debate will continue in our communication channels and at our next meeting during Arendalsuka at Clarion Hotel Tyholmen on 18 August 2022 (08:00-09:30). We hope to see you there!

Watch the meeting here (in Norwegian):

 

 

This meeting was a collaboration between Oslo Cancer Cluster, Norwegian Cancer Society, LMI, AstraZeneca, Janssen and MSD.

logos of organising partners

 

Man on podium talking with sticker saying "cluster collaborations"

The Future of Cancer Treatment

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What is the The Future of Cancer Treatment all about?

The seminar series The Future of Cancer Treatment (Fremtidens kreftbehandling in Norwegian) usually has two yearly events, always about new possibilities in cancer treatments, and how Norway can be better equipped to keep up with the rapid developments in precision medicine.

It started as a political meeting in 2015, during a political festival in the southern Norwegian town Arendal. The last seminar was also held in Arendal, 18 August 2021.

You can watch the latest Arendal-event on our YouTube channel: 

A collective effort

The series is a collaboration between Oslo Cancer Cluster, Association of the Pharmaceutical Industry in Norway (LMI), the Norwegian Cancer Society (Kreftforeningen), and the three pharmaceutical companies MSD, AstraZeneca, and Janssen.

Why have the same six partners worked together on the same subject for six years? Part of the answer is the collaboration itself.

The collective effort of hosting these seminars has value to everyone involved. For Oslo Cancer Cluster, facilitating collaborations between members is one of our main functions as a research and industry cluster. In addition, we have a role as a changemaker, in which we aim to improve the framework conditions for cancer innovations in the Norwegian health industry and raising expertise. The Future of Cancer Treatment allows the cluster to act as a changemaker and bring members with common goals together.

At the forefront of cancer care

Behind each seminar, there is of course a great deal of planning. Mattis Dahl Åmotsbakken, Associate Director Policy and Communications at MSD Norway, is one of the permanent members of the planning group, together with the other voices quoted in this article.

“The collaboration between this truly cross-functional team ensures innovative ideas that always are at the forefront of cancer care, constructive exchange and learning for everyone involved, as well as a solid output that both attracts and generates interest among a broad variety of stakeholders,” said Åmotsbakken.

He added that a mature cluster is a well-fitted frame for these kinds of collaborations.

“The fact that Oslo Cancer Cluster is a well-established and experienced cluster ensures efficiency, continuous and profound insights into healthcare policies and a solid perception among stakeholders that output from Oslo Cancer Cluster’s collaborative activities is of high quality and solution minded. The cluster’s accumulated experience and position in the cancer care domain coupled with the continuous generation of innovative ideas make the cluster a unique arena for collaboration and development of actionable solutions to further ameliorate the Norwegian health care system,” said Åmotsbakken.

The common interest

Hege Edvardsen, Senior Advisor at LMI, underlines the variety of audiences the seminars are designed to reach.

“This meeting series is arranged by partners deeply invested in bringing the future of cancer therapies to Norwegian patients, specifically through clinical studies, but also in general. The collaboration ensures that we are looking at this issue from all perspectives, since the meetings are targeted to researchers, clinicians, politicians and government bodies, and also to patients and their next of kin,” said Edvardsen, and added:

“The partnership behind this meeting series is in itself an example of how private-public partnerships can help us challenge each other, build culture and collaboration and together press forward a topic of common interest.”

Astra Zeneca is the second industry partner in the series, and Line Walen, Head of Governmental Affairs at AstraZeneca Norway, has been part of the meeting series planning group for a couple of years.

“The group has a common interest in making effective treatments available for patients and to put focus on obstacles, and suggestions for solutions. It is great to come together among patient organisations, clusters and companies to work towards a common goal on important topics. We hope this seminar series will continue in the years to come, and that this will be a good contribution to the debate on how to make new and effective treatments accessible for the patients who need them,” said Line Walen.

Cancer on the political agenda

The third and final pharmaceutical company involved in the series is Janssen Norway. Marthe Brovold Løberg, Communication and Public Affairs Manager at Janssen, has been part of the planning group since the start in 2015. She said:

“Janssen is very proud to be a collaboration partner in this well-established political meeting series that has highlighted important issues since 2015. We all have a common goal; to secure the best possible cancer treatment, now and in the future, and our focus is to enable fast and equal access to innovative treatment in Norway. Janssen wishes to be a part of the solution for cancer patients. To achieve this, collaboration is key,” said Marthe Brovold Løberg.

Thomas Axelsen, head of the political department at The Norwegian Cancer Society, also part of the planning group, added that cross sectoral collaboration is important for a patient organisation.

“This meeting series has been a great arena for the Norwegian Cancer Society to find common ground and raise important issues together with other actors in a field that is of enormous importance to cancer patients. Even though we sometimes have different perspectives and incentives, most of the time we share a common end goal – and finding together across sectors is both important and necessary for us to succeed at creating better cancer care,” said Thomas Axelsen, and added:

“The most important thing we want to achieve is putting cancer on the political agenda and creating a meeting place where different sectors can come together and offer solutions to existing problems. We want the politicians who attend our meetings to leave with more knowledge, and new input that can lead to needed political action. To some extent I think we have succeeded at this so far.”

Why Arendal

Arendalsuka, the political festival in the southern Norwegian town Arendal, taking place in August, has become an important arena for those who want to improve aspects of Norwegian society and politics. Oslo Cancer Cluster has participated several years to meet key players and accelerate the development of cancer treatments.

There was a natural pandemic pause in Arendalsuka in 2020 but in 2021 the town was once again the hub of politics and organisations for a week in mid-August, and The Future of Cancer Treatment hosted an open breakfast seminar about health data – from politics to clinics.

 

About Cluster Collaborations

In an article series called Cluster Collaborations, we want to highlight the fruitful collaborations in the cluster, underlining the very essence of what Oslo Cancer Cluster is all about, from cancer research to cure.