Background Advance care planning is emphasised in UK policy on end of life care, featuring in the end of life care strategies for England, Wales, Scotland and Northern Ireland, and in a range of associated quality markers and targets. Aimed at improving the appropriateness and quality of care, advance care planning is also often considered a means of controlling health spending at the end of life.

Aim We aimed to review and summarise economic evidence on advance care planning.

Methods A systematic review of academic literature since 1990.

Results There are no published cost-effectiveness studies. We identified 18 relevant studies. These vary considerably in terms of intervention, study design, sample, setting and so forth. They are focused primarily on health care savings, usually associated with reduced hospital care.

Discussion In this presentation, I discuss the published studies, consider the research challenges facing those who undertake economic evaluation of advance care planning or advance care planning initiatives and offer some thoughts on ways forward.

Conclusion It is important to develop further evidence on the economic implications of advance care planning, not just to contain costs but to allocate resources in ways that are efficient and equitable and ensure the most appropriate investment in end of life care services.