Tough priorities are inevitable in all countries' health services. These choices create winners and losers, even as budgets gradually increase. Should low-income countries give higher priority to preventing and treating cardiovascular diseases and cancer if this means fewer resources for maternal and child health? Should Norway prioritize new and expensive gene therapy for rare diseases or strengthen services for people with mental disorders? Determining whether such priorities are fair requires ethical judgment and medical and economic evaluation.
BCEPS+ aims to develop new methods and a new ethical framework for efficient and fair distribution. We collect data health and income in a large model for an entire population. We then study the impact of different priorities on the level and distribution of health and income over time. In this way, we will develop new methods for the economic evaluation of health interventions. These experiments will then help us understand and develop a better ethical framework for prioritization in health that takes into account both fair distribution and efficiency. We will also collect data and measure the effect of measures to reduce inequality in health through large randomized controlled studies. Overall, new knowledge, new methods and an improved ethical framework will help us to convey relevant knowledge to decision-makers nationally and internationally. BCEPS+ leads The Disease Control Priorities Project (DCP4) which will publish relevant evidence and new recommendations on prioritization.
BCEPS+ aims to become an internationally attractive center for young researchers, with innovative PhD courses, international exchange between UiB and top universities and good career opportunities. A majority of our students go on to academic positions or take on leadership roles in health and health 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. BCEPS+’s foundational research 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. To close these gaps, BCEPS+ is organised around four work streams: 1. Innovative Methods to evaluate the impact of interventions on both health and income. 2. A “Rationing Lab” to determine the impact of alternative ethical frameworks on population health and income. 3. Equity Impact Studies using analytic epidemiologic designs. 4. Core Analytics for Disease Control Priorities. 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. BCEPS+ is poised to become a world-leading research environment that will attract and train new talent for years to come.