Chile
A country where palliative care for advanced cancer is a funded legal guarantee, the counter-case to mandates without money.
8 domains reviewed · 5 high-confidence · 6 dated estimates · 9 material gaps
WHO region: Americas. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 8 of 9
- Hospice: 0 of 4
- Backed by a primary document
- 0 of 9
- Open questions
- 13
- Sources behind this dossier
- 11
- Newest source 2026
Lessons from Chile
- A funded guarantee works for the group it names: advanced cancer coverage reached nearly everyone in need. It also leaves out everyone else, and closing that gap took a separate law in 2021. Eligibility should be defined broadly from the start.106
- Extending the full package to everyone in need was costed at under half a percent of national health spending. Other countries should run their own costing rather than assume palliative care is unaffordable.106
- Consumption rose eightfold while non-medical use in national surveys stayed low. It is the strongest evidence in the register against the diversion fear used to justify restrictive rules, though Chilean clinicians themselves dispute how to read it.107,108
- Central public procurement contained drug price growth better than private reimbursement. A public palliative drug benefit should buy through pooled procurement.109
- A guarantee and a law did not produce faculty. Training has to be funded as its own track.110
- An existing primary care home program for severely dependent people can carry rural end-of-life care when it supplies equipment, medicines and family preparation, though it lacks explicit end-of-life guidance.538
- Publicly funded cancer pain programs can raise opioid availability while national surveys track non-medical use to keep the balance in view.107
Palliative care
Is morphine available in Chile?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
- 1,692 S-DDD per million inhabitants per daySOURCE-CHECKED
Opioid consumption, Chile, 2024108
Last checked 2026-09-24.
The highest in Latin America. The source does not state the reporting year; 2024 is the publication year.
Cite this figure: - 114 percent of needMODELED ESTIMATE · 2025
Distributed opioid morphine equivalent against modelled palliative need, Chile, 2025107
Last checked 2026-09-24.
The source does not state the reporting year; 2025 is the publication year.
Cite this figure: - 2.50 percentSOURCE-CHECKED · 2018 DATA
Non-medical opioid use, national drug survey prevalence, Chile, 2018107
Last checked 2026-09-24.
One percent in 2002 and 1.2 to 1.5 percent in 2022 to 2023.
Cite this figure:
Consumption has risen roughly eightfold since 2000 to the highest level in Latin America, with distributed supply now above modelled palliative need. Non-medical use in national surveys stayed low. Two papers read the same trend in opposite ways, one as an early warning and one as legitimate access.108,107
What share of supply is domestically produced, and what is the reporting year of the INCB figure?
Help answer it:Search PubMedHow does Chile regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
A national pain relief and palliative care programme dates from 1994. Palliative care for advanced cancer became an explicit health guarantee in 2005, and a 2021 universal palliative care law extends the right beyond cancer through a phased rollout.106,107,109
Which decree governs opioid stocking and dispensing, and did it change with the 2021 law?
Help answer it:Search PubMedWho can prescribe morphine in Chile?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
Who may prescribe oral morphine, and is there any nurse role?
Help answer it:Search PubMedHow does palliative care reach patients in Chile?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
- 93 percentMODELED ESTIMATE · 2019
Cancer patients in need who had access to palliative care, Chile, 2019106
Last checked 2026-09-24.
Cite this figure: - 58 percentMODELED ESTIMATE · 2019
People in need of palliative care without access, Chile, 2019106
Last checked 2026-09-24.
About 61,000 people, almost all with non-cancer conditions.
Cite this figure: - 42,214 patientsSOURCE-CHECKED · 2019 DATA
Publicly insured patients with palliative care access, Chile, 2019106
Last checked 2026-09-24.
Against 1,756 newly enrolled privately insured patients.
Cite this figure:
The guarantee reached nearly all cancer patients in need, but coverage stopped at cancer, so most of the national gap lies in non-cancer illness. The 2021 law is meant to close it.106
How many palliative teams operate, and how are they distributed by region?
Help answer it:Search PubMedWho pays for palliative care in Chile?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
The guarantee is funded through the public insurer, which covers most of the population at no charge for guaranteed care, and through private insurers with capped co-payment. Central public procurement held down drug price growth.106,109
How is the 2022 to 2026 rollout of the universal law funded?
Help answer it:Search PubMedHow are palliative care clinicians trained in Chile?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
Medical and nursing schools teach palliative care, with gaps in mandatory hours and teaching methods attributed to a shortage of qualified faculty.110
When was palliative medicine certified as a subspecialty, and how many hold it? The count was seen only in a search summary.
Help answer it:Search PubMedHow does Chile prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
Chile has one of the highest medical opioid consumption levels in Latin America (1,363 S-DDD per million per day in 2016-2018), backed by a national cancer pain relief and palliative care program set up in 1994 and expanded in 2014. National drug surveys put non-medical use of opioid analgesics at 1.2% to 1.5%, described as stable and low.107,232
Does Chile run a unified electronic prescription monitoring system for opioids, and how available are methadone or buprenorphine treatment and take-home naloxone?
Help answer it:Search PubMedHow do children get palliative care in Chile?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
At Hospital Roberto del Río in Santiago, two thirds of 99 children with advanced cancer in the palliative care program needed strong opioids, and pain was controlled under a protocol without serious complications. In a survey of 78 Santiago pediatricians, 29.5% had palliative care training and 47.7% had ever referred a child to a pediatric palliative care team.744,745
How many children with non-cancer life-limiting conditions in Chile receive specialist palliative care, and are oral liquid morphine formulations available outside Santiago?
Help answer it:Search PubMedHospice care in Chile
How the hospice model works here, who can use it, who pays and who it reaches. Covered 0 of 4.
What does hospice care look like in Chile?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
PubMed returned no Chilean source that describes hospice as a distinct service (inpatient hospice, home hospice or hospice teams). Chilean papers found describe palliative care programs and the palliative care law without using the hospice concept. Does any hospice-type provider exist in Chile, and does the local literature treat hospice and palliative care as the same thing?
Help answer it:Search PubMedWho can get hospice care in Chile?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
No hospice-specific admission criteria for Chile were found in PubMed. Are there prognosis or diagnosis rules for entry to any hospice-type service, separate from the cancer palliative care guarantee?
Help answer it:Search PubMedWho pays for hospice care in Chile?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
No PubMed source describes who pays for hospice care in Chile. Is any hospice-type care covered by public insurance (FONASA) or the palliative care law, or is it charity funded?
Help answer it:Search PubMedHow many people reach hospice in Chile?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
No PubMed source counts hospice services or hospice use in Chile. How many hospice-type services exist, and what share of decedents use them?
Help answer it:Search PubMedWhat fills the gap in Chile
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
At a Santiago palliative care unit, 75% of 207 family caregivers were women, 82% cared for the patient daily and 31% cared alone; caring alone was linked to high-intensity burden. In the rural Los Lagos case, daughters took turns at night and learned to manage oxygen, pulse oximetry and a clinical bed at home.539,538
Subnational evidence- Community health workers and home-based care
In rural Los Lagos, the primary care home program for people with severe dependency (PADPDS) supported an older man with advanced lung cancer to stay at home, with home visits, oxygen and possible access to morphine patches through primary care. The program has no specific end-of-life guidelines, although teams often care for people in terminal stages. This is one ethnographic case the authors describe as exceptional.538
Single-site evidence- Traditional and complementary healers
In the rural Los Lagos household studied, the family practiced the Catholic faith and used local herbs alongside visits from the primary care team. This comes from a single case.538
Single-site evidence
Sources cited here
- 108Leon PJ, Altermatt FR, Vega EA, Elgueta MF, Leniz J.
Opioid use in Latin America: chronicle of a death foretold? Journal of Global Health 2024;14:03040. DOI 10.7189/jogh.14.03040. INCB-derived consumption for Chile, the highest in Latin America, and an eightfold rise since 2000, framed as an early warning. Full text read.
- 107Palma A, Perez-Cruz PE, Pettus K, Pastrana T.
Opioid use in Latin America: a vital challenge for health systems. Journal of Global Health 2025;15:03030. DOI 10.7189/jogh.15.03030. Response to a warning about rising Chilean opioid use: distributed opioids in morphine equivalent against palliative need, and national drug survey prevalence of non-medical opioid use in 2002, 2018 and 2022 to 2023. Full text read.
- 106Perez-Cruz PE, Undurraga E, Arreola-Ornelas H, Corsi O, Jiang Kwete XX, Krakauer EL, et al.
Bridging gaps to universal palliative care access in Chile: serious health-related suffering and the cost of expanding the package of care services. Lancet Regional Health - Americas 2023;19:100425. DOI 10.1016/j.lana.2022.100425. Palliative care access in 2019 under the explicit health guarantee for advanced cancer, the coverage gap concentrated in non-cancer conditions, the modelled cost of extending the essential package to all in need, and the 2021 universal palliative care law. Full text read.
- 109Vargas V, Leopold C, Castillo-Riquelme M, Darrow JJ.
Expanding coverage of oncology drugs in an aging, upper-middle-income country: analyses of public and private expenditures in Chile. Journal of Global Oncology 2019;5:1-17. DOI 10.1200/JGO.19.00223. The explicit guarantees programme from 2005 covering cancer types with associated palliative care; the public insurer covers most of the population; central public procurement contained drug price growth better than private insurers. Full text read.
- 110Gallastegui-Brana A, Parra-Giordano D, Perez-Cruz P.
Training in palliative care in nursing and medical schools in Chile [translated title]. Revista Medica de Chile 2022;150(4):541-548. DOI 10.4067/S0034-98872022000400541. Abstract read. Gaps in mandatory palliative care hours and teaching methods, linked to a shortage of qualified faculty.
- 232Maia LO, Daldegan-Bueno D, Fischer B.
Opioid use, regulation, and harms in Brazil: a comprehensive narrative overview of available data and indicators. Substance Abuse Treatment, Prevention, and Policy 2021;16(1):12. Low availability versus high-income countries, mid-level in Latin America; codeine dominant; morphine and codeine on the essential list; special form, prescription notification and supply limits; physician and dentist prescribing only; out-of-pocket prescription cost. Abstract and full text read.
- 746Rojas-Concha L, Troc-Gajardo J, Leiva-Vasquez O, et al.
Cross-Cultural Adaptation and Content Validation of the Spanish Carer Support Needs Assessment Tool (CSNAT) in Family Caregivers of Patients Receiving Home-Based Palliative Care in Chile. J Palliat Care 2026;41(4):451-462. Adaptation study with 9 experts and 36 family caregivers at two Chilean institutions identifying caregiver support needs; small sample. Abstract read.
- 744Fernández Urtubia B, Trevigno Bravo A, Rodríguez Zamora N, et al.
[Use of opioids in palliative care of children with advanced cancer]. Rev Chil Pediatr 2015;87(2):96-101. Retrospective review of 99 records of children with advanced cancer in the palliative care program at Hospital Roberto del Río, Santiago, 2002-2013; single site, self-evaluation. Abstract read.
- 745Ceballos-Yáñez D, Astudillo P P, Eugenin-Soto MI
Facilitators and barriers perceptions to early referral to pediatric palliative care perceived. Andes Pediatr 2023;94(3):307-315. Survey of 78 pediatricians at three tertiary centers in Santiago on pediatric palliative care training and referral; small, urban sample. Abstract read.
- 538Navarrete I, Fuentes-García A, Aliaga-Castillo V
["Until God says 'yes or no', but here, in my home": autonomy and end-of-life care for rural older adults in the Los Lagos Region, Chile]. Salud Colect 2026;22:e5969. Ethnographic case study from rural Llanquihue province (2022 to 2023) of an older man with advanced cancer, his daughters and the primary care home program team; one case the authors describe as exceptional. Full text read.
- 539Soto-Guerrero S, Palacios J, Langer P, et al.
Objective burden, caregiver psychological distress, and patient religion and quality of life are associated with high-intensity burden of care among caregivers of advanced cancer patients in a Latino population. Palliat Support Care 2023:1-9. Cross-sectional study of 207 patient-caregiver dyads at one palliative care unit in Santiago. Abstract read.