 The prevalence of chronic diseases such as cancer, major organ failure, and dementia is increasing globally, particularly in low- and middle-income countries, lmix. These patients and their families often have to pay a large portion of medical costs out of pocket, which can lead to catastrophic financial consequences when they are faced with a serious illness. A recent review of the literature identified the extent of out-of-pocket costs near end of life in lmix, finding that these costs increase with advanced illness and disease severity. The main drivers of these costs are medication and hospitalization, leading to high percentages of affected populations experiencing financial catastrophe, lost income, and other pressures. Despite a small number of included studies and heterogeneity in methodology and reporting, this review demonstrates the importance of addressing the issue of out-of-pocket costs near end of life in lmix, suggesting a need for widespread, targeted efforts to avoid poverty traps and financial protection policies for those suffering from incurable disease. Additionally, further research into the macro and microeconomics of palliative care delivery in L. This article was authored by Eleanor Reid, Araneng Shugoshal, Ayesha Khalil, and others.