OBJECTIVES: To assess the effectiveness and cost-effectiveness of hospice-based palliative care for cancer patients compared to usual hospital care in cancer centers across Kazakhstan from societal perspective.

METHODS: 182 family caregivers were recruited, 104 in a hospice group and 78 in a control (palliative units). Patients’ state of health and family caregivers’ burden were measured using Palliative Outcome Scale and Zarit Burden Inventory on 14th day of the inpatient palliative care. Direct and indirect medical costs as well as family caregivers’ out-of-pocket expenses associated with the care has been collected. The cost-effectiveness analysis was conducted by calculating the difference between mean cost of treatment related to the difference in outcomes. Uncertainty around the cost-effectiveness estimates was explored by generating 10,000 resamples using bootstrapping.

RESULTS: At 14 days, patients’ mean quality of life was 2,4 points better (95% CI: 0,06 – 4,9) in the hospice group compared to the control. Family caregiver burden was 4,6 points better in the hospice group (95% CI: -0,26 – 9.3). Mean treatment costs over 14 days were $31 lower for the hospice group (95% CI: $29 - $32). The cost-effectiveness plane graphically showed that the hospice case is cost-effective in 80% of scenarios.

CONCLUSIONS: We demonstrated that hospice-based palliative care for people with terminal cancer is beneficial for the Kazakh healthcare system and the society overall, while providing cost savings.