BCEPS Centre of Excellence - Research Goals

^{[Primary Objective]}
The Centre for Ethics and Priority Setting in Health aims to develop new methods and a new ethical framework for efficient and fair distribution of health and income.

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 servicesthat 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.

To close these gaps, the centre is organised around four work streams (see figure above):

Workstreams

1. Innovative Methods to evaluate the impact of interventions on both health and income.
    
2. "Rationing Lab" to determine the impact of alternative ethical frameworks onpopulation 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. The centre is poised to become a world-leading research environment that will attract and train new talent for years to come.