In Norway, severity is measured as absolute shortfall: the healthy life years a patient group is expected to lose with current standard treatment, compared with the general population of the same age. Enter the mean age and the undiscounted prognosis from your model.
Severity and threshold values
DMP compares the cost per QALY with an opportunity cost of NOK 275,000 per QALY. Higher severity supports a higher willingness to pay. The threshold values rise in six steps with absolute shortfall, as proposed by the Magnussen group and described in the Ministry of Health and Care Services' 2024 expert group report. DMP confirmed the range of NOK 275,000 to NOK 825,000 per QALY in January 2026:[1, 2, 3]
| Absolute shortfall (QALYs) | Threshold value (NOK per QALY) |
|---|---|
| Below 4 | 275,000 |
| 4 to below 8 | 385,000 |
| 8 to below 12 | 495,000 |
| 12 to below 16 | 605,000 |
| 16 to below 20 | 715,000 |
| 20 or more | 825,000 |
These values are reference points for an overall judgement, not absolute limits. Decision-makers weigh benefit, resource use and severity together, along with uncertainty and budget impact. Severity raises the threshold value; the QALYs themselves are not weighted. DMP does not state a rounding rule at band edges; this calculator places values such as 3.95 in the lower band.[4]
Getting the inputs right
- Age: Use the mean age at treatment start in the Norwegian patient group, consistent with the model and Norwegian clinical practice.
- Undiscounted QALYs: Absolute shortfall uses undiscounted QALYs; the cost per QALY uses discounted costs and QALYs.
- Current norms: Since 1 September 2025, adult submissions using EQ-5D-5L data apply the Norwegian EQ-5D-5L value set and the matching population norms, which this calculator uses. Where HRQoL was collected with EQ-5D-3L, the guideline refers to the Norwegian 3L norms instead.[5]
- Very small patient groups: A separate assessment applies where the group is very small (fewer than about 1 in 100,000 worldwide and about 50 patients in Norway), the absolute shortfall is at least about 30 QALYs and the expected gain is at least about 2 QALYs.[6]
For the full submission process, see DMP and Nye Metoder in Norway.
References
- Direktoratet for medisinske produkter (DMP). Submission guideline (July 2026), chapter 13 [Internet]. Oslo: Direktoratet for medisinske produkter (DMP); [date unknown] [cited 2026 Oct]. Available from: https://www.dmp.no/globalassets/documents/offentlig-finansiering-og-pris/dokumentasjon-til-metodevurdering/submission-guideline-july-2026.pdf
- Ministry of Health and Care Services. expert group report on perspective and priorities [Internet]. Oslo: Ministry of Health and Care Services; 2024 [cited 2026 Oct]. Available from: https://www.regjeringen.no/no/dokumenter/rapport-fra-ekspertgruppe-om-perspektiv-og-prioriteringer/id3025560/?ch=5
- Direktoratet for medisinske produkter (DMP). rapid review of the opportunity cost [Internet]. Oslo: Direktoratet for medisinske produkter (DMP); 2026 Jan [cited 2026 Oct]. Available from: https://www.dmp.no/nyheter/hurtigutredning-av-alternativkostnaden--anbefaler-ingen-midlertidig-justering
- Direktoratet for medisinske produkter (DMP). Priority criteria (resource use, benefit, severity) [Internet]. Oslo: Direktoratet for medisinske produkter (DMP); [date unknown] [cited 2026 Oct]. Available from: https://www.dmp.no/offentlig-finansiering/offentlig-finansiering-av-legemidler-og-medisinsk-utstyr/hva-inneberer-prioriteringskriteriene-ressursbruk-nytte-og-alvorlighet
- Direktoratet for medisinske produkter (DMP). Tools for severity calculation and age adjustment [Internet]. Oslo: Direktoratet for medisinske produkter (DMP); 2025 Sep 1 [cited 2026 Oct]. Available from: https://www.dmp.no/globalassets/documents/offentlig-finansiering-og-pris/dokumentasjon-til-metodevurdering/tools-for-severity-calculation-and-age-adjustment-july-25-1.xlsx
- Direktoratet for medisinske produkter (DMP). Very small patient groups with extremely severe conditions [Internet]. Oslo: Direktoratet for medisinske produkter (DMP); 2024 [cited 2026 Oct]. Available from: https://www.dmp.no/globalassets/documents/offentlig-finansiering-og-pris/dokumentasjon-til-metodevurdering/small-patient-groups-mai24.pdf
Rules reviewed October 2026. This calculator is indicative and independent of the agencies; check the latest official texts before submission.
