Health economics for palliative care

Abstract

Healthcare costs are escalating due to public demand for, and the increasing availability of, treatment. National frameworks that use economic evaluation as a basis for health technology assessment have been successful at constraining expenditure on low-value treatments primarily by explicitly considering the opportunity cost of new technology adoption or service redesign. At the end of life and in palliative contexts, such methods have not been widely applied and are underdeveloped despite evidence that healthcare costs typically increase with proximity to death. There may be a requirement for the adaptation of standard methods for healthcare resource allocation in this setting, where the goals of care may differ from a curative or preventative context. Health service and financing models may be complex and specific to this setting, with a greater consideration for third-sector provision and informal care. This chapter outlines the core concepts in health economics that are relevant in the planning of palliative services, with specific considerations in the developed and developing world contexts.