BCEPS Centre of Excellence

The information below is taken from the project description submitted to the Research Council of Norway in the Centre of Excellence application process.

Centre of Excellence Research Goals

As a Centre of Excellence, BCEPS will develop new methods and a new ethical framework that can be applied at all levels to achieve fair and efficient priority setting in health. It will build on its applied research in Universal Health Coverage decision support to become a world-leading Centre for Ethics and Priority Setting in Health. The 10-year perspective of a Centre of Excellence will enable the experienced team of researchers to undertake the foundational research necessary to achieve this goal.

Foundational research is needed to clarify how ethical principles can better guide priority setting for health and well-being. The planned workstreams have the potential to achieve ground-breaking results.

Secondary Objectives:

1. Create an advanced population health model which includes impact on level and distribution of health and income, and propose new methods that incorporate these elements into economic evaluation of health interventions.
    
2. Develop a new ethical framework for priority setting in health that integrates both fair distribution and efficiency.
    
3. Develop and evaluate cutting-edge research designs and analytic strategies to measure the equity impact of interventions in randomised controlled trials and observational epidemiologic studies.
    
4. Apply the new methods and generate new evidence and recommendations for essential health services that satisfy both fairness and efficiency considerations.

Resource Scarcity, Priority Setting and Rationing Policy

Resource scarcity in health care is unavoidable and a cause of premature deaths and excess morbidity. All countries ration health services, often through market forces or ad hoc mechanisms that typically favour the well off.

One question is who should have priority access to new technologies, e.g. COVID-19 vaccines? Rationing creates winners and losers. Determining whether a rationing policy is fair requires ethical evaluation. Combining better methods to evaluate the distribution of health care resources with refined ethical frameworks will help decision makers develop fairer and more impactful policies.

Foundational Research

Foundational research at the Centre of Excellence will address four major research gaps: 

a) Current economic evaluation methods do not combine the impact of interventions on both health and income distributions

b) While ethical frameworks can inform evidence generation and policy decisions, those that exist do not integrate concerns for fairness efficiency

c)The impact of health interventions on equity is rarely adequately measured in randomised controlled trials or other epidemiologic studies

d) Fragmentation makes it difficult to provide evidence-informed recommendations for priority setting that integrate both fairness and efficiency.

Four workstreams will aim to close these gaps. Led by researchers renowned in their fields, these work streams will generate ground-breaking results that will emerge from these new methods and new ethical framework for fair and efficient priority setting in health.

SFF Workstreams

1. Rationing Lab to determine the impact of alternative ethical frameworks on population health and income (led by Professors Ole F. Norheim & Ezekiel Emanuel)
    
2. Rationing Lab to determine the impact of alternative ethical frameworks on population health and income (led by Professors Ole F. Norheim & Ezekiel Emanuel)
    
3. Equity Impact Studies using analytic epidemiologic designs (led by Professors Ingvild F. Sandøy & Halvor Sommerfelt)
    
4. Core Analytics for Disease Control Priorities (DCP4) (led by Professors Ole F. Norheim & David Watkins)