The Icelandic, Norwegian and Danish flags

Photo: Anne-Li Engström

Iceland, Norway, and Denmark have just announced yet another joint Nordic tendering procedure. Because of global problems with increasing resistance to antibiotics, this time the countries have included specific criteria to combat such resistance.

Iceland, Norway, and Denmark are struggling to secure supplies of certain medicines. This is particularly a challenge for older drugs. Therefore, for the third time, the procurement organisations in the three countries have announced a joint Nordic tendering procedure aimed specifically at older, well-known medicines facing supply challenges. In addition to evaluating price and security of supply, we have also focused on the environment, including criteria to combat increasing resistance to antibiotics.

In accordance with supplier wishes, we have used as a foundation an international standard to combat antibiotics resistance. The international standard makes it easier for suppliers to operate in a global medicines market.

The criteria can reward suppliers with a higher evaluation score for their tenders for being, or planning to be, certified in accordance with the Antibiotic Manufacturing Standard by AMRIA (the Antibiotic Manufacturing Standard Industry Alliance), or another equivalent standard.

– We have decided to focus on requirements for antibiotics because the Nordic countries want to help combat increasing resistance. We also hope that the countries can use the same criteria in their national tendering procedures. It is easier for suppliers to contribute sustainability when they face the same criteria in the different markets they operate in,” says Tommy Juhl Nielsen, divisional director, Sykehusinnkjøp HF, Norway.

Suppliers have been cooperative

The new environmental criteria were presented to suppliers as early as June 2023, when the Nordic Pharmaceuticals Forum invited suppliers to a meeting about our common criteria draft. The countries drew up the final criteria based on this meeting.

Subsequently, in late 2023, suppliers were invited to participate in individual online meetings with the three countries. In these meetings new suppliers were taught about the process for participating in the joint Nordic tendering procedures, and experienced suppliers were able to contribute input for the procedures.

– We very much appreciate the great interest from the industry in helping to promote the sustainability agenda. Without their commitment and goodwill, we would not have come as far as we have. I do, however, also think that we’re all aware that we have to go further to support both national and international goals for our environment and climate, says Flemming Sonne, CEO of Amgros, Denmark.

Iceland hopes to have more agreements

This time, the countries have announced three procedures, of which two include antibiotics. The procedures cover a total of fourteen medicines. Four of the medicines were not included in previous joint Nordic tendering procedures.

These medicines were selected based on the extent to which they were supply critical in the three countries, or whether there have historically been few suppliers on the market.

– We’ve now expanded the range of medicines to include in the joint Nordic tendering procedures, and we hope that this will also result in more drug agreements being reached for Iceland. We also hope that this can help improve the security of supply of medicines for Iceland, says Hulda Harðardóttir, project manager, Landspitali, Iceland.

The deadline for tenders is April 30th, 2024. The new agreements will take effect on April 1st, 2025.


The AMRIA alliance has developed an antibiotic manufacturing standard.

AMRIA is an alliance consisting of more than 100 companies and organisations from the pharmaceutical industry, with the common goal to find sustainable solutions that can curb the development of antimicrobial resistance.

Certification under the AMRIA Antibiotic Manufacturing Standard documents that an independent third party has verified that a supplier has implemented measures to combat resistance to antibiotics.

Today, only the British Standards Institution (BSI), certifies that suppliers comply with the AMRIA Antibiotic Manufacturing Standard.

Read more about the AMRIA here [].

The 14 medicines covered by the three tendering procedures are:

  • Ampicillin
  • Piperacillin and tazobactam
  • Cefuroxime
  • Gentamicin
  • Ciprofloxacin
  • Vancomycin
  • Metronidazole
  • Ondansetron
  • Hydrocortisone
  • Fluconazole
  • Aciclovir
  • Methotrexate
  • Paracetamol
  • Meropenem
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