Global Health Priorities - Ole-Frithjof Norheim
Global Health Priorities is an interdisciplinary research group situated at the Department of Global Health and Primary Care at the University of Bergen. The group consists of a team of cross-disciplinary researchers and professionals dedicated to study the ethics and economics of priority setting in global health.
The Bergen Centre for Ethics and Priority Setting (BCEPS) was established in 2019 with funding from the Bill & Melinda Gates Foundation, Trond Mohn Foundation, Norad and the University of Bergen. BCEPS has continued its expansion with activities in Ethiopia, Zanzibar, Malawi, Nepal, Ghana, Tanzania and Africa CDC. The center is also a finalist for a new Centre of Excellence grant from the Norwegian Research Council. BCEPS continues to work on priority setting challenges in Norway. The collaboration with CCBIO on cancer biomarkers, precision medicine and fair priority setting is central to this aim.
The aim of CCBIO is to discover, validate and translate cancer biomarkers, a key component of precision medicine. Norheim’s team is interested in how cancer biomarkers can inform and hopefully improve health care priority setting. How is our ethical thinking about treating people as equals challenged when biomarkers and other individual characteristics stratify patients into smaller and smaller sub-groups, with only some being offered new and potentially life-saving treatments?
The PhD project investigating how cancer biomarkers inform treatment recommendations for new and expensive cancer drugs was completed in 2021. In the first PhD defense open to the public since the corona pandemic started, candidate Eirik Joakim Tranvåg successfully defended his thesis on September 24, 2021.
Recent important results
One of the articles in the dissertation was published in BMC Medical Ethics in May. In “Precision medicine and the principle of equal treatment: a conjoint analysis” Tranvåg and coauthors surveyed Norwegian cancer doctors’ stated preferences towards priority setting between cancer patients and found that biomarker status was perceived as relevant in the decisions. Another part of the dissertation will be published in the forthcoming Springer series book by CCBIO’s ELSA team. In a book chapter, Tranvåg and Roger Strand discuss important ethical and societal perspectives on priority setting and personalized medicine.
The increasing amount of new and expensive cancer drugs entering the market offer opportunities, but also challenges. With often marginal effect and unreasonable and confidential pricing, these drugs will impose a heavy burden on our publicly financed health
The team will continue work on priority setting at both clinical- and policy levels. The last article from Tranvåg’s dissertation will be published in 2022. The BCEPS team will also continue to contribute to the ELSA team’s important work to create awareness of the ELSA-related areas in CCBIO. Norheim aims to continue the good dialogue and exchanges with other CCBIO researchers and clinicians.