End-of-Life Costs in Cancer Patients: A Systematic Review.

Area of Science:

• Health Economics
• Oncology
• Public Health

Background:

• End-of-life care for cancer patients involves significant costs.
• Understanding these costs is crucial for healthcare policy and resource allocation.
• Existing research presents heterogeneity in cost analysis methodologies.

Purpose of the Study:

• To systematically review and identify the costs associated with end-of-life care for oncology patients.
• To synthesize findings from existing literature on cancer patient end-of-life costs.

Main Methods:

• A systematic literature review was conducted across Embase, PubMed, and Lilacs databases.
• Studies published up to March 2024 evaluating end-of-life care costs for cancer patients were included.
• Quality assessment was performed using the Drummond checklist, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Main Results:

• 43 studies were eligible out of 733 retrieved, focusing on various neoplasms (41.86%) and lung neoplasms (18.60%).
• Direct cost analysis was performed in all studies; indirect costs were analyzed in 9.30%. No study evaluated intangible costs.
• Most studies used a payer perspective (74.41%) and macrocosting methodologies (81.39%), leading to significant heterogeneity and limiting resource variability assessment.

Conclusions:

• There is a need for new studies, particularly in low- and middle-income countries, to address indirect and intangible costs.
• A societal perspective is recommended for future research to inform public health policies.
• Developing consistent cost data is essential for transforming towards value-based care and enhancing patient/family value.