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Cited by 108Palliative Care and End-of-Life IssuesPalliative and Oncologic CareHealth Systems, Economic Evaluations, Quality of Life

Cost analysis of medical assistance in dying in Canada

Open access
Trachtenberg, Aaron J., Manns, Braden·2017·Canadian Medical Association Journal
DOI 10.1503/cmaj.160650PMC PMC5250515
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Abstract

BACKGROUND: The legalization of medical assistance in dying will affect health care spending in Canada. Our aim was to determine the potential costs and savings associated with the implementation of medical assistance in dying. METHODS: Using published data from the Netherlands and Belgium, where medically assisted death is legal, we estimated that medical assistance in dying will account for 1%-4% of all deaths; 80% of patients will have cancer; 50% of patients will be aged 60-80 years; 55% will be men; 60% of patients will have their lives shortened by 1 month; and 40% of patients will have their lives shortened by 1 week. We combined current mortality data for the Canadian population with recent end-of-life cost data to calculate a predicted range of savings associated with the implementation of medical assistance in dying. We also estimated the direct costs associated with offering medically assisted death, including physician consultations and drug costs. RESULTS: Medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million and $138.8 million, exceeding the $1.5-$14.8 million in direct costs associated with its implementation. In sensitivity analyses, we noted that even if the potential savings are overestimated and costs underestimated, the implementation of mdedical assistance in dying will likely remain at least cost neutral. INTERPRETATION: Providing medical assistance in dying in Canada should not result in any excess financial burden to the health care system, and could result in substantial savings. Additional data on patients who choose medical assistance in dying in Canada should be collected to enable more precise estimates of the impact of medically assisted death on health care spending and to enable further economic evaluation.

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  1. The Way Forward Integration Initiative. Cost-effectiveness of palliative care: a review of the literature. Ottawa: Canadian Hospice Palliative Care Association.

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Authors
Trachtenberg, A. J., & Manns, B.
Affiliations
University of Calgary (CA)
ORCID
Venue
Canadian Medical Association Journal
Publisher
CMA Joule Inc.
Published
2017-01-23
Volume
189
Issue
3
Pages
E101-E105
ISSN
  • 0820-3946 (ISSN-L)
  • 1488-2329
DOI
10.1503/cmaj.160650
PMC
PMC5250515
OpenAlex
W2580102468
Cited by
108
References
13
Citations by year
2026: 6 · 2025: 9 · 2024: 9 · 2023: 7 · 2022: 8 · 2021: 8 · 2020: 6 · 2019: 12 · 2018: 39 · 2017: 4
FWCI
15.64
Type
journal article
Language
en
Open access
Locations
  • Canadian Medical Association Journal (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Institute for Clinical Evaluative Sciences
  • Ontario Ministry of Health and Long-Term Care
  • Alberta Innovates
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
medical assistance in dying, assisted dying, health care costs, cost reduction, end-of-life care costs, physician consultation, drug costs, cost neutrality, health care spending, Canada
MeSH terms
Aged, Aged, 80 and over, Canada, Chronic Disease, Cost-Benefit Analysis, Health Expenditures, Female, Humans, Male, Middle Aged, Quality of Health Care, Cost Savings, Health Care Costs, Evidence-Based Medicine, Euthanasia, Active, Voluntary

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