Dramatic courtroom scene depicting Swedish court's ruling against regions for illegal Cosmic contract addendums, with symbolic fines of 10 million kronor each.
Dramatic courtroom scene depicting Swedish court's ruling against regions for illegal Cosmic contract addendums, with symbolic fines of 10 million kronor each.
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Court rules Cosmic addendum illegal – million fines for regions

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The Administrative Court of Appeal in Gothenburg has ruled that addendum agreements to the Cosmic contract for nine regions, including Region Dalarna, violated the law. Each region must pay 10 million kronor in procurement penalty fees following Tuesday's ruling. The Competition Authority prevailed after the Administrative Court had acquitted the regions.

The Administrative Court of Appeal in Gothenburg issued its ruling on Tuesday against nine regions in the Sussa collaboration, including Region Dalarna, Blekinge, Gävleborg, Halland, Norrbotten, Sörmland, Västerbotten, Västernorrland, and Örebro. In 2022, the regions signed addendum agreements to the original 2016 Cosmic contract, where Cambio won the procurement for the journal system. After delays, the regions opted for a new agreement with extended delivery time instead of claiming compensation from Cambio, which the Competition Authority deemed fundamentally altered the procurement and constituted illegal direct procurement. The Competition Authority began investigating in summer 2023 following a tip. The Administrative Court in Karlstad acquitted the regions in autumn 2025, but the Court of Appeal overturned the decision, imposing 10 million kronor per region—the maximum possible fee at the time of the claim. Court president Johan Sanner stated: “De har varit så pass stora så att det inte längre är samma avtal som leverantörerna hade att ta ställning till när upphandlingen annonserades. Det är en otillåten direktupphandling. Ett typfall som man ska se allvarligt på.” Cambio has previously committed to covering the fines. Elin Norén (S), chair of the regional executive in Dalarna, said: “Det vi behöver göra först nu är att läsa domen och sätta oss tillsammans med de andra Sussa-regionerna och komma fram till om vi ska överklaga till högsta förvaltningsdomstolen, eller inte.” Moderates in Region Dalarna criticize the S-led majority that signed the agreement in 2022 despite warnings from the region's lawyers.

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Discussions on X focus on criticism of the nine regions for breaking procurement laws in the Cosmic addendum deal, with the Gothenburg Administrative Court of Appeal imposing 10 million SEK fines each. Users highlight taxpayer costs, lack of personal accountability for officials, and some allege connections to former PM Göran Persson via Cambio's ownership. Sentiments are overwhelmingly negative, decrying public sector waste.

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Illustration of Cambio Healthcare executives paying Region Dalarna's fines for the Cosmic procurement scandal, with disapproving Konkurrensverket observer.
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Cambio to pay Region Dalarna's fines in Cosmic case

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Nine regions, including Region Dalarna, avoid paying 10 million kronor fines each for the illegal procurement of the Cosmic journal system. Supplier Cambio Healthcare will cover the costs per prior agreement. Konkurrensverket criticizes the arrangement but will not act in this case.

All regions in the Sussa collaboration, including Region Dalarna, are appealing a Kammarrätten ruling imposing 10 million kronor fines each. The ruling concerns a supplementary agreement on the Cosmic system. The regions are deemed to have erred in the handling.

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In the ongoing Sussa Cosmic contract saga, regions including Region Dalarna are appealing the Kammarrätt's recent decision to uphold million-kronor fines (10 million SEK each) over a supplementary agreement for the Cosmic journal system. After winning in administrative court, they lost on Konkurrensverket's appeal. 'We believe we are right,' says Sofia Jarl (C).

A woman in Dalarna died waiting for surgery on an aortic aneurysm after delayed care. Region Dalarna assesses the incident was partly caused by the switch to the Cosmic journal system in October 2025. The region is filing a Lex Maria report.

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Region Dalarna's regional council has decided to allocate up to 30 million kronor extra to the care choice for child and youth psychiatry (BUP) in 2026. The investment aims to retain care providers. The opposition warns that the funds will not solve the root problems.

Criticism of the Cosmic journal system is growing at Falu hospital. The women's clinic and orthopedic clinic have reported the region due to increased stress, longer waiting times, and risks to staff and patients. One demand is to reinstate Take Care.

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Region Dalarna plans to invest 10 million kronor to strengthen cancer care across the county. The allocation forms part of the 2027 budget proposal.

 

 

 

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