Aims: To identify agreed best practice for health economic
evaluation in palliative and end of life (P&EoLC) research.

Methods: We used the MORECare Transparent Expert
Consultation approach to conduct consultation workshops
with experts in health economics in P&EoLC research.
Prior to workshops participants were sent overviews
of pertinent issues in health economics in P&EoLC.
Following workshop presentations and discussion,
nominal group techniques were used to produce candidate
recommendations. These were subsequently rated online
by participating experts. Descriptive statistics were used
to permit analysis of consensus and rated importance.
Narrative comments were collated.

Results: The workshop comprised 28 participants making
27 recommendations. The top three recommendations were:
1. The need to develop robust methods for assessing
outcomes which take into account preferences and the
way these change over time.
2. Researchers should give consideration to the implications
of decisions on the equitable distribution of care.
3. Costing should be from the societal perspective and as
well as statutory services include costs of other formal
care (e.g. hospices and third sector) and informal care
unless a clear rationale for using a different perspective
is provided.
The main area which failed to reach consensus were on the
use of Quality Adjusted Life Years (QALYs) and whether
individual opportunity costs should be used to measure the
costs of informal care.

Conclusions: When designing studies in P&EoLC it is
recommended that outcome measures are responsive over
time and costings should come from a societal perspective
taking into account the equitable distribution of care. More
research is needed given the lack of consensus in this area
so that future recommendations can be made.