Sweden’s regions are changing course in how they use tripartite negotiations for reimbursement.
The 21 regions, through the authorisation group (fullmaktsgruppen) working with TLV, have agreed to revise their shared positions and principles for tripartite negotiations with pharmaceutical companies. Previously treated more as an exception, regions now describe these negotiations as an important way to secure access to costly but high-need prescription medicines.
What is changing
- More willingness to enter tripartite negotiations, while each request will still be assessed individually.
- Medical need (e.g., few treatment alternatives) remains central, alongside equal treatment of comparable medicines and expectations of price competition.
- Regions will also weigh TLV’s view on whether a medicine motivates increased willingness to pay.
What 2025 showed
Regions say more negotiations were accepted in 2025, helping several medicines (including for rare diseases) enter the benefits scheme. However, negotiations are not a guarantee: 5 of 12 concluded talks in 2025 ended without an agreement or inclusion.
