Is Palliative Care Cost-Effective? A Systematic Review of the Literature

Abstract

Palliative care improves the quality of life for patients; however, its value-for-money is not yet established. The objective of the present study was to identify and critically assess published studies which investigate the cost-effectiveness of palliative care. A defined strategy was applied; the identified records were assessed with specific inclusion-exclusion criteria (PICO). Methodological quality of the included studies was assessed with the Drummond checklist. An electronic search was conducted in PubMed, SCOPUS, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, from January 2010 up to December 2022. A narrative synthesis approach was used. From a total of 3857 records, 21 studies were included in the analysis. Almost half (n = 10) the studies were conducted along randomized controlled trials, while the most common setting was home-based palliative care (n = 9). Quality of life was the most commonly assessed outcome (n = 14), measured almost exclusively in Quality-Adjusted Life Years (n = 13). In more than half of the included studies (n = 13), palliative care was found to lead to improved outcomes, while 3 studies did not find any difference in outcomes between comparators. Also, palliative care yielded lower costs in 13 studies and increased costs in 5 studies. Overall, 11 studies concluded that palliative care was a cost-effective intervention. The results of the review indicate that palliative care has the potential to be a cost-efficient allocation of healthcare resources or, at least, a cost saving approach. However, the need for a commonly aligned methodological framework still remains.